While I was having my mini-break from this blog there were two major initiatives announced – one in Education and one in Health. Both initiatives were deemed to be “transformational”, the new buzzword that along with “leverage”, “foster” and “harness” is to be found in any policy document worth the name these days.
Minister Quinn announced plans to create Technological Universities and Regional Clusters. The former were the subject of some (but surprisingly little) comment while the latter seemed to provoke virtually no reaction at all.
Minister Reilly announced the formation of Hospital Groups. Dr Reilly described his proposals as “the most fundamental reform of the Irish acute hospital system in decades” and promised that they would be implemented immediately.
One could be skeptical and say that these are initiatives taken by cynical politicians who want to be seen to be doing something rather than actually doing anything of real consequence. But you cannot be too critical of politicians here because this kind of strategy – clustering of some kind – is the default one for ‘experts’ who wish to effect change in systems of all kinds.
Here’s my view: neither of these initiatives will have any meaningful effect on the quality of the Education and Health sectors. Let me give you two examples as to why this is.
I teach half of an introductory engineering module on Bioprocess Engineering to our Second Year students. In recent years, I have stopped trying to teach engineering and instead I do basic maths, especially algebra! These are students with 400+ Leaving Cert points. This reflects a deep-rooted problem with the first and second level systems and no amount of third-level clustering will enable us to bring students like this up to the appropriate standard by the time they graduate. Our only option is to ‘dumb down’. The Minister can talk in all the jargonese he likes, and fiddle with structures until the cows come home, but the core problems will remain. As it is, the Minister and many policy makers are living in a parallel universe where words like “transformational” are believed to actually mean something rather than being the gibberish that they are.
Last summer I spent a night in the Mater Hospital. I was in a room with three others – no problem there. I’ve shared hospital rooms many times and it doesn’t bother me. One of the other patients had had a single-lung transplant and to put it crudely, his new lung was going ‘belly up’. This guy was oxygen-dependent and generally pretty wrecked. The team needed to do a CT scan to see what exactly was going on in his new lung. To his great distress, he had been waiting for over a week to get a scan and despite the best efforts of the medical registrar, there was no sign of a scan forthcoming. The basic problem here is that there is just not enough capacity within the system (especially in the whole area of diagnosis) and no Hospital Groups will fix this. In this case, more CT scanners are needed and/or the existing ones need to be used more.
What’s going on here? For me, the policy makers are approaching major societal problems from the wrong direction. They need to start at the bottom and work upwards, not the other way around.
In education, we need to figure out why pupils and students are not learning at each stage of the education system. Perhaps the fault is ours for having expectations of our young people that are simply too low. This is as much a societal issue as it is an educational one and requires an honest conversation as to whether this generation has made bad decisions when it comes to educating the next generation.
In Health, the policy makers need to get back to basics and really see things from the perspective of patients. Health is not a ‘system’ to be optimised. It is about looking after people. The Minister and/or hospital managers need to ask themselves how it can be that a seriously ill person can suffer such delays in getting access to diagnostic equipment. If it is a simple capacity issue – which I suspect it is – they need to figure out how they can increase capacity. Of course, it is questionable whether anyone (other than the patients) really wants to increase capacity as that would increase costs.
It seems to me that our policy makers suffer from a sort of ‘cluster syndrome’. Instead of addressing the real questions ‘head on’, they think that by reconfiguring systems, excellence will emerge as if by magic.