futurefit, healthcare, shropshire, shrewsbury and telford nhs hospital trust, Sath

As FutureFit, the much-needed programme to improve the delivery of healthcare in Shropshire, continues  towards a conclusion, I think it’s time to take stock of where we have got to so far. Much of the discussion in the press and on social media has focussed on differences between points of view. At times, the debate has become rather heated and has resulted in opinions polarised around geography or party politics.  If we are going to make any progress, I think we need to take a different track. My work on the Generation Q programme looking at dialogue offers some different possiblities. In modern society we have tended towards using adversarial debate as a way to change public services. The way this works is I state my position, people who disagree with my point of view point out all the flaws in my thinking and I then explain why they are wrong. In my experience, this intensive advocacy rarely results in  anyone changing their mind or in any new ideas.

Dialogue is different to debate. The word dialogue comes from an Ancient Greek root and can be understood as “meaning through words”, in dialogue we aim to find new meaning rather than impose a point of view. The concept of dialogue has its roots in ancient civilisations when decisions were made by a group of people sitting around a fire and talking. In the twentieth century, people such as David Bohm and Bill Isaacs resurrected the concept of dialogue as an antidote to the adversarial nature of interactions in modern journalism, business and public life. Issacs describes 4 principles of dialogue:-





It is only by giving attention to all these areas that we can make any progress towards a new understanding and make the difficult decisions we need to improve healthcare in Shropshire and the whole of the UK. A key feature of dialogue is to find areas when we agree and build on these, rather than our traditional and destructive focus on differences. So perhaps if we really wish to improve healthcare in Shropshire we should develop a list of things we agree on and develop them. Here are my first thoughts, let me know what you thing.


I propose that we agree that:-

People  in Shropshire deserve the same quality of healthcare as people in London.

We need to change the way healthcare is delivered in Shropshire.

General practice in Shropshire (and the UK)  is struggling to recruit doctors and keep up with the workload.

(So are some of our hospital services .)

People should only go to hospital if that’s is the only way to deliver the care they need.

Healthcare  in the U.K. is underfunded compared to other Western nations.

The current means of allocation of healthcare care cash favours cities over rural counties like Shropshire.

Consolidating some of our hospital services on one site will improve  quality.

We cannot afford to wait too long before we make some changes.


I am sure there’s more we can agree on , or maybe not! Let me know!

I hope we can use the forthcoming public consultation on FutureFit to develop this ideas further, rather than resorting to name-calling and narrow-minded parochialism.







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