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Prime Minister talks of "health not sickness"

Listening today to the PM’s speech on NHS reform, he spoke of a health service being more focused on “health and not sickness.” I presume he meant the health of individuals, of communities and of the nation as a whole perhaps.

Whilst millions of words have and will be written about NHS reform, this short phrase is an interesting take on how we can view not only something as gargantuan in scale as the NHS, but much smaller entities, such as our teams, services and organisations.

Setting this apparently positive frame on the proposed NHS reforms suggests that when thinking about our organisations and their ‘health’, there is great merit and good science to support inquiring into its good ‘health’, e.g. what is life giving and what works well. This is what Appreciative Inquiry (AI) calls the “positive core” of our organisations. It can be a counter-intuitive position to take when starting out on organisational change, particularly in hard times, yet for many organisations and their constituent teams, this positive framing provides a release from the top-down, deficit and problem-centred nature of so much change, i.e. the study of failure and problems.

A wide and growing variety of public, voluntary, community-based and commercial organisations have experienced the power and liberation of positive energy when using AI. AI never ignores what isn’t working, rather it asks us to concentrate our efforts differently, to start our inquiries in an appreciative mind and capture what works well, and then build on that to create new directions and eradicate weaknesses and problems along the way.

What we inquire into is fateful and we will always find more of what we choose to inquire into – so, would we rather inquire into and find examples of great service and resilience, or failure and unsustained change. I posit this as a stark choice, ‘though in reality it will be more a matter of emphasis and balance.

Peter Drucker wrote that the role of leaders is to align the strengths of their organisations, rendering weakness irrelevant. Not necessarily easy, but a statement of intent, of hope and potential for liberation from yet more ‘solutions’ to problems – problems that nevertheless seem to return with depressing regularity.

This appreciative stance might not work every time, but surely to take the appreciative route at least offers a credible alternative to methods that seem to provide only short and medium term palliatives to the wicked issues of public policy formation and public systems management.

The NHS has great stories of success, particularly during its renaissance of recent years, providing deep evidence of a positive core. Concentrating reform on health and not sickness could deliver yet more great stories and also protect that positive core, without which reform will founder in the longer term.

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Steve Lorraine