The blindingly obvious

I came across an opinion piece in the Health Service Journal recently. Well written, to the point and with a clear call to action. It’s been bothering me ever since.

The piece, written by speechwriter Simon Lancaster, described the damaging affects of the car metaphors we use in the NHS. He pointed out words like drive, toolkit, dashboard, accelerate and phrases such as ‘step up a gear’ and ‘patients in the driving seat’.

Simon’s argument was that the language is demotivating, emotionally detached and jars with the very idea of change. The killer point is that this has a direct impact on our behaviours and culture.

I might not use all of these words and phrases but I definitely have drive and dashboard in my lexicon. Or should I say, did. If my job is help make the NHS less about corporate speak, less management jargon and more about being connected to people – to patients, families and staff – then I have let them down.

I consider myself pretty self aware, tuned in to plain language and customer insight and yet I have been blind to these metaphors. Sure, I can pick up an acronym at 40 paces, spot the latest management buzz word or question the meaning of a gobbledygook sentence. But the subtle power of the clunky, mechanical and detached car metaphors? They were under my radar.

I am indebted to Simon. He opened my eyes to something right in front of me, allowing me to see the blindingly obvious. As we approach the publication of the Francis report, such fresh perspectives on our behaviours will be crucial.

This blog was originally written for the NHS Top Leaders programme website.


7 thoughts on “The blindingly obvious

  1. I too was affected by this piece and took it to,discuss at our team meeting, certainly it created discussion around links we would never have identified. We haven’t quite managed to stop using the terms but we do recognise when we use them and consider an alternative, with an added element of humour too. It has been a great discussion tool. Thank you.

  2. This is fascinating, haichess, and a new one on me (I’ll link it on my blog if that’s OK). It’s amazing how easily we’re seduced into adopting generally accepted jargon and metaphors without thinking about the implications or the impact on those who are affected by their use — sometimes in subtle ways, as Simon points out. I just read his piece on this and especially like this suggestion:

    “If the NHS is to change and restore public trust, it needs a new metaphor that breeds new values and behavioral patterns. A better metaphor would be the metaphor of the NHS as a person.”

    • Thanks for your comments Wordwatch – and I’d be thrilled to be linked to your blog. The quote you pull out from Simon’s piece is perfect – and exactly where we need to be with our language.

  3. I’m really glad my article has got people in the Health Service talking – exactly as I hoped. As Helen says, metaphor is something which is often missed in communication because it is below radar – but it is because it is below radar it has so much power.

    Once your mind is opened to this, you can see the most appalling persuasive images pervading the public consciousness, framing issues and directing opinion.

    Just to highlight three metaphors which are dominant across the media at the moment.

    1. Al Qaeda are vermin – the press writes about trapping them, capturing them, hunting them down, smoking them out, their lairs – therefore, extermination is the best option.
    2. Financial crisis was an act of nature – the press writes about the ‘economic storm’, ‘dark clouds looming’, ‘riding the waves’, navigating our way home – therefore, no-one was responsible for it.
    3. Politics is a circus – the press, particularly the more right wing press, writes about walking tightropes, showmen, clowns – therefore, it’s all a joke and there’s no point voting.

    If any of you are interested in continuing this dialogue do get in touch with me either through my website or email –

    • Thanks Simon. Your insightful observations on language are very inspiring – though I must also admit, I’m simultaneously a bit saddened that we can be so easily manipulated. Subliminal messaging is very powerful indeed.

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