12 October 2016
The annual Conservative Party Conference (CPC16) was held in Birmingham earlier this month. Billed as "a chance to learn about our ideas and policies for the year ahead" and a "unique opportunity to engage with our Party", the venue teemed with predominantly men in dark blazers (blue or black), white shirts (no prints) and dark ties (blue or black). Most of the few women present were dressed similarly. And much like the delegates, who all started to look the same, the ideas, issues and even solutions raised seemed to repeat themselves, whilst the odd more exciting discussion seemingly evaporated with the end of a session in the absence of records or wider publicity.
As a non-Party Member (a fact that prompted one delegate to ask me, ”You’re not?! Then why are you here?”), I hoped the CPC16 would be a forum for productive discussions intended to improve policy and a place to learn about how key problems are being tackled. I left Birmingham somewhat disappointed.
Having attended as many sessions on healthcare, science and digital technology as possible, I was hopeful yet frustrated. The obvious was stated – regularly – that the NHS is " underfunded, underdoctored and overstretched". More interestingly, various panelists seemed to agree that “we need to focus on how we’re spending money, not where we need to get the money from”. This includes understanding the local context of health services and issues associated with a producer-led system and frustrating government bureaucracy.
The extent of systemic bureaucracy and the degree to which it undermines the efficiency and effectiveness of public services could not be ignored during this conference. For example, apparently the NHS continues to use fax machines (possibly even the only service still doing so). Other sobering anecdotes included government departments with no idea of how much they were paying providers (in one case, predicting £60 million worth of business with one client but discovering contracts exceeded £1 billion). This is one reason why a number of delegates suggested it might be better to let private companies try things (and potentially fail) before the government implements them.
In general, however, there was little mention of practical policy proposals to tackle such problems.
Finally, a number of sessions focused on the role of digital technology in the future of public services. In healthcare, this was raised in reference to reducing avoidable errors, improving efficiency and giving power back to the individual. The notion of empowering individuals also emerged repeatedly within the context of personal responsibility for health and the notion that individuals bear responsibility to a great extent for making healthy choices and taking care of themselves.
With plenty of experts gathered for each session, the discussions were engaging, yet several key issues were left surprisingly unexplored, and practical suggestions thin on the ground. Just as the debilitating impact of excessive bureaucracy on service provision was acknowledged, but largely unaddressed, the slow rate of diffusion of digital health, and the apparent absence of an effective strategy to propel this diffusion, irked many delegates, but no innovative solutions were proposed.
More significant questions were also prompted by some of the arguments made. The emphasis on personal responsibility alone raised a number of questions, including how to square the concept with the notion that individuals are free to make their own choices. Aside from a suggestion that 'shocking' advertisements should be revived, there were also few new ideas regarding how to educate the public to make better health choices.
Considering the challenging situation the UK currently faces, including a struggling NHS and a monumental hard Brexit ahead, a surprising number of topics were either ignored or given only a superficial mention during CPC16. In particular, science, research and the life sciences generally were rarely explored in detail. Considering the UK's competitive advantage in these sectors and their potential to both generate revenue and save the country a significant amount of money, I came away far from reassured that these sectors were a priority for Theresa May's government. Admittedly there were sessions on innovation and digital technology, but very few if any references were made to research funding or the need for greater investment in life sciences infrastructure, for example. Theresa May did refer to the life sciences as an area of strategic importance to the economy, but little else at the conference conveyed this recognition.
Conference sessions were filled to capacity, with delegates forced to stand or wait outside. Experts from diverse fields gathered to discuss complex topics like the role of digital technology in improving public services, the efficiency of the health service and the role of law in healthcare. And yet, in the frequent absence of government officials or key decision-makers, it felt like preaching to the choir. Nodding heads and frequent murmurs of agreement made clear that these panel discussions rarely raised new ideas or challenged long-standing beliefs. To a great extent, it was usually experts telling other experts what they already knew. Occasionally innovative ideas emerged or policy suggestions were made, but in the absence of policy-makers (and on occasion even in their presence), these ideas seemingly evaporated with the end of a session. With no notes taken or record of discussion made public, the CPC16 was more of an opportunity to take pictures and network rather than develop policy.
In response to that journalist who wondered why I was there - I had hoped to learn what the Conservative Party had planned for health and science over this parliament and the next. Instead, I came away more convinced of the size of the problems, the difficulties of the solutions and a nagging feeling that it will be a long time before we see effective change.