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Stakeholder—This derives from shareholder, a person with the right to be consulted because he or she has a financial investment in a business. A stakeholder need have no investment beyond a vague interest and a pushy personality. He or she holds no stake beyond the one bearing a banner with the legend "Listen to me!" Let’s stop listening.
World class—As in "world class commissioning," a programme launched by the NHS without defining who in the world of commissioning is actually world class or how you would find out anyway. Do you get marks for artistic impression as well as technical merit? Are there judges raising scorecards like in ice dancing competitions? The criteria are just about as ill defined. Go for a triple Axel and let’s have done with it.
Service user—This means patient or, possibly, client, in the kind of English that Orwell might have understood. It’s often used of those who seek psychiatric care, so it may be an attempt to avoid stigmatisation. Nothing wrong with that, but since when has the word patient been stigmatising? Stand by for the roll-out of the service user involvement best practice toolkit! It’s bound to be world class.
Key worker—Here I can’t improve on (though I’m tempted to edit) an anonymous blog I came across on a US website. It read: "In the UK a ‘key worker’ is a nurse or policeman or some other government employee judged worthy of things like subsidised housing and transport etc, because their roles are ‘key to society’ and therefore are valued more by the state than a mere shop worker or banker or delivery driver or computer repair technician or cook or architect or web designer or babysitter or plumber or builder or publisher . . . in other words, the rest of us whose mouths are not completely glued to the tax-funded public teat." Rude chaps, some of these bloggers.
Frontline—A dishonest usage by all parties in the election campaign designed to imply that cuts in NHS spending can be engineered so as to have no effect on services. If that were possible, why not make the cuts anyway and save lots more money for the "frontline"?
Investment—Also known as spending. Investment is used to make it sound as though we are putting public money into something that is going to make us a return. The UK has "invested" hugely in the NHS since 2000, but productivity hasn’t risen. Services are better, but that’s because we’re spending more. What lies ahead is "disinvestment," also known as cuts. Oddly enough, NHS productivity will almost certainly rise as the cuts bite; it usually does. So the paradox is that if you are talking of health care as an investment vehicle, you get a better return from not investing than from investing. That’s why it’s the wrong word.
"Our NHS"—Am I alone in finding this a creepy usage? It’s meant to imply that the speaker and the listeners are at one in defending the status quo. Include me out. As I’ve said before, the NHS is just a vehicle for delivering health care, not a religious movement.
Clinical governance—Everybody thinks they know what this means, but they’re not quite sure, and it’s been around so long that they are all too shy to ask. I’ve never quite grasped it, frankly, but I’m sure it’s a good idea.
Passionate—"Stella is passionate about the NHS in Bolton" is the kind of sentence I keep reading. Really? It sounds as if Stella (not a real person, by the way) is lacking something in her life if her passion finds its outlet in NHS Bolton. It’s not good enough any longer to be keen or enthusiastic: nothing less than passionate will do. Start listening and you’ll hear it every five minutes.
