|Making the public finances in Scotland visible and understandable - one of Audit Scotland'sPinterest infographics|
Our guest at Ramsay Garden this month was Caroline Gardner, Auditor General for Scotland. She took office in July 2012 at a time of tight budgets, high demand, constitutional change and global financial crisis. As the Chinese would say: interesting times. It has also been a period of significant scrutiny of public (and private) finances – a time when accurate accounting and reporting matter.
Caroline offered the example of the city of Detroit – which filed for bankruptcy this summer with debts of $18.5bn after decades of poor stewardship of the public finances and poor (or worse) decision-making. When the financial crisis hit, the city was in a poor position to cope. As a result people are suffering.
|Conference notes captured by apprentice artist in residence Tristan Leicester|
“Breathe out all your worries and confusion, breathe in new life”. This was the Presence Card from Kitbag drawn at a remarkable conference in Glasgow last month on staff care in the NHS, hosted by Ayrshire and Arran Health Board and brilliantly facilitated by IFF Converger Andrew Lyon.
It had been an emotional day, beginning with a powerful account by Linda Kenney of her experience as a patient when a routine operation went badly wrong. A few years later, realizing the lack of help available for people surviving such events, she set up MITSS (medically induced trauma support services) to provide support to other people - staff and patients - who find themselves involved in medically-induced trauma. Linda said that as a patient she wants her doctors and healthcare staff to be well and supported emotionally to do their work. And if things go wrong, patients and their families want transparent communication in real time, an apology and an organizational response to prevent recurrence.
There is a renewed interest in the UK government in "horizon scanning" as a way both to encourage working across Departmental boundaries and to engage with the future. It is billed as "a new approach for policy-making". So I was pleased to be invited recently to experience this myself by helping to facilitate a horizon scanning session for a group of senior policymakers on the implications of demographic change.
The group was to be presented with the latest horizon scanning data and then invited to consider its implications for policy. My concern was that participants would treat this data like any other - and consider it through the standard lens of 'evidence-based policy making'. Whereas for me data from the future is of a different quality: however robust, it is still imagined, it refers to things that have not happened yet, it is not the same as evidence from the past.
Secondly, it struck me that our interpretation of data from the future will depend on our own stance and what we are scanning the horizon for. If we are trying to navigate towards a particular island then we will be paying attention primarily to anything that will blow us off course. On the other hand, we might be open to spotting a more attractive island and changing course when we do. Or we may be genuine explorers, interested only in the unknown. I find it helpful to consider the balance in our intentions between agency and uncertainty - how fixed we are on a course of action, how willing we are to engage with uncertainty. Which stance we take is going to colour what we regard as significant in the information we receive from the 'horizon'.
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|Deputy Director of Public Health, NHS Fife|