AMSPAR Chief Executive
"Choice" has been a buzzword in recent years. The public has regularly been consulted and polled on a wide range of topics and situations. This has been epitomised by public participation in "reality" TV programmes such as Big Brother and telephone voting on a variety of talent shows. Such participation is now very much taken for granted. But just exactly how broad is this choice that we are being given?
Who would have thought that ballroom dancing could create such a storm? Everything was going so well with the programme format of the BBC's Strictly Come Dancing until ex-political editor John Sergeant came stumbling into the frame.
His antics appealed to the public, but infuriated the "experts".
Week after week, Mr Sergeant's popularity gained momentum, much to the exasperation of the judges and other competitors. The viewers kept voting for him, regardless of the fact he was not the better dancer – something you have to put up with if you allow everybody to have a say. A resolution was found when Mr Sergeant gracefully withdrew from the competition.
On that occasion, the phone voting was actually registering. Elsewhere, many producers have fallen foul of the regulators by continuing to charge for calls after the phone lines have closed, or simply ignoring the results to suit their own ends. While the public may believe they are influencing the outcome, the producers have already decided the dénouement of the series – how else can you explain "Jedward", the Irish twins who somehow managed to progress to the late stages of last year's X Factor competition on ITV?
When you give the public free reign, they can make the most unexpected decisions. You may remember H'Angus from Hartlepool. This was the local football club's mascot (a man dressed as a monkey), who decided to move into politics and run for mayor. Whether for the novelty value, the intellectual prowess or sheer disillusionment with all politicians, the good people of Hartlepool elected H'Angus the Monkey as their mayor.
Upon appointment, Stuart Drummond, the man behind the monkey suit, decided to take the role seriously. He threw down his banana, climbed out his monkey suit and donned the chain of office. Some voters were disappointed, as this was not part of H'Angus's manifesto. However, all credit to Mr Drummond – last June he was re-elected for the third time, so he must be doing something right.
The TV format has now extended to the recent general election. For the first time, we have seen the leaders of three of the political parties going head-to-head in a trilogy of debates. But just what was the choice being put in front of the public? The producers had decided that only the three main parties warranted representation – any other would distort the symmetry of the format and, of course, the running time.
A total of 72 rules were in force for these televised leaders' debates to keep everything in order. So what was the purpose of the debates? Was it a choice of personalities or policy?
The example of the US presidential debates was often cited as justifying the UK's decision to follow suit. This ignores the fact that in the US, the electorate has a vote to cast for the candidates participating in the debates. While Gordon Brown, David Cameron and Nick Clegg sounded off for the cameras, only around 200,000 people living in their three constituencies could actually cast a vote for any of them (as it turned out, they received a combined vote of 90,856 between them).
To add to the TV experience, while the leaders were at their podiums, some members of the carefully selected audience were "wired" to react – just to help the viewers at home to know what to think and who was doing well.
The "debates" themselves were paper-thin – but what else could you expect? Who would say they are not going to do the best they can for healthcare? Besides, none of the three leaders is responsible for healthcare outside England. The platitudes were plentiful, but after 6 May reality has to set in. It is no longer the time to talk about who has the most suitable tie, or who puts their hands in their pockets at the appropriate time, but of making hard choices.
The choice agenda
Choice has been the mantra of government in most areas, including healthcare of course – be it choice of hospital/GP, extended access, etc. Again, we have to look not just for choice, but informed choice. How many people are genuinely given a free choice of hospital? And, if they were, how did they make this choice? Their GP's advice? A neighbour's experience? An indepth study of the league tables? Even then this isn't necessarily authoritative. For instance, teachers are finally to take action on the SATs, which are used to build the school league tables, on the basis that they do not provide a "true" picture of performance.
Choice is welcome in all walks of life, but it takes up resources – something we are seriously short of. The increase in health funding was scheduled to end before we hit the recession. Pre-election inertia has inevitably meant avoiding the issue, but you can be sure that a comprehensive spending review will be announced by whoever now holds the keys to 10 Downing Street.
As I write this on the morning of 7 May, we continue in a state of limbo. Going back to our talent show choices over the past four weeks, we have travelled down a yellow brick road that split into three. Has David Cameron donned the blue outfit of Dorothy and stepped into Gordon Brown's ruby red slippers? Will Nick Clegg play the wizard and grant someone their greatest wish – or is it bluff and smoke coming from behind the curtain?
We need a strong team. Who will play the Tin Man – or, of course, Tin Woman – and find a heart for the health service? Where do we find a Lion to have the courage to address the serious problems of the economy? And we certainly need more than one Strawman with a brain. What we will probably find is that the heroes were really at home all the time – working on the frontline.