The day after the night before

Concentrating on my thesis seems rather difficult today, it bit like it does when you have a really bad hangover and you start to remember all the really embarrassing things you did the day before, that you wish you didn’t.

Yesterday, we voted to leave the EU; our neighbours.  We voted to ‘reduce immigration’ and ‘reduce regulation’ and to ‘take back control’.

My thesis is about regulation; and when I started it, I was pretty sceptical about it. I understand very well why regulation is often despised and people want to reduce it.  Yet, as I indicated in my last blog, I have had to wildly revise my views, I had misunderstood the purpose of regulation, I had misunderstood the nature of regulatory enforcement; and I learnt that the tide of regulation continues to grow, even under supposedly de-regulatory regimes and even when it is perceived to ‘fail’.  Regulation – despite all its faults arises to try to reduce market failure, protect us in the ‘public interest’ and crucially reduce issues of inequity.   The parallels with the EU debate seem so similar, and so by leaving the EU – it seems reasonable to assume, that some aspects of inequity and market failure that EU regulations were trying to resolve may quite easily increase.   Yet, the inequity that has grown particularly since 2008, ironically seems to underpin the voting logic for people who chose to leave.

The inequity felt in the post-industrial north and other areas, articulated in this tweet, showing the difference between inner Manchester and outer Manchester in many ways to me is driving the anger felt by those who have felt left out of the ‘new’ growth.  Voters that have felt invisible to the political establishment, and usurped by ‘others’ – labelled as immigrants: in school place applications, in the misery of the daily commute, in the lack of affordable housing or decent job security, in the doctor’s surgery and as hospitals reconfigure their services creating perceived winning and losing geographies for both healthcare services and jobs.   In Greater Manchester, of the new jobs developed in the so called Northern powerhouse, very few have been created in the poorer northern outskirts of the conurbation.

These feelings of inequity, of losing out, of being controlled by ‘faceless bureaucrats’, of being left behind, of being shut out, from many of the changes that have been made in the name of austerity or globalisation (or maybe even for improved clinical outcomes), this to me at the moment, is what has driven this leave result.

Perhaps, this underlying social inequity together with this leave outcome of the referendum, will force us back to thinking about why we were in it to begin with, and as reality sets in, why were some of the seemingly bonkers regulations developed in Europe there?  Were they really trying just to control us, and get one over us?  Or were they there to, within the confines of the political constraints they had, try to reduce some of these inequities that exist?  To ensure that doctors didn’t have to work godforsaken hours and potentially cause harm, via the European working time directive.  To ensure that manufacturers didn’t undercut workers’ wages in different countries and then profit from this exploitation on the EU free market.   To ensure women didn’t lose out if they had a baby.  To ensure we shared out growth more equally among us in Europe than we have done historically.  It seems, given the growth in inequality across Europe and within the UK since 2008, these regulations didn’t go far enough, were obsolete or were inadequately enforced or maybe didn’t cover the inequity that needed regulating, perhaps because this was still a Westminster prerogative, and by voting against Europe, this is a two fingered salute in response to the EU, and also to Westminster.

In my view, the best thing now for our villages, towns and cities has got to be a recommitment to fairness, to reduce inequity, and improve lives for those who feel dispossessed, devalued, isolated and lost, through truly listening to them and working together to try to move forward on these issues, across all areas including in healthcare. With the change in Tory leadership, and maybe Labour leadership, new political opportunities arise and perhaps a General Election will be called early.  We need to reach out to these voters and promise to focus on the growing inequity and help to redraw the political landscape, and refocus the current divisive national narrative, so that our great nation can become one again.  Perhaps then we can have a new day after the night before, only this time without the dreadful hangover.

[I kind of had to get how im feeling about this off my chest! Got a thesis to finish!!]


About joyfurnival

Interested in TQM, lean, Quality Improvement, Healthcare, Regulation, Accreditation, Inspection Improvement Science, QI, improvement capability.
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