Competent or Not Competent?

Recently, I decided to expand what I do and work towards becoming an emergency medicine doctor and a GP. This process involves understanding what I need to achieve, the curriculum involved and passing relatively difficult exams. It was not based on how many people in a sector that I know, how others perceive me, or my opinion of myself. The next stage in the process will involve different exams looking at how I work and include both objective and subjective measures that deem whether or not I am competent to work in this field of medicine.

Unfortunately, there are no similar political tests that can help us understand whether someone is competent or incompetent. There are no qualifications, metrics, or regulations to assess whether or not we have been governed correctly. Politicians often use their narratives or take her messages to assess their own performance and sell a story of how well they are doing. Individuals often make their own assessments based on their preconceived ideas, the heavily biased media and form opinions from those closest to them.

When metrics are used, they are often used selectively, out of context, to try and support a narrative rather than have an objective discussion about what they mean in the overall context of a system. Like many other industries, in healthcare, this is not the case. We have individual regulations in the form of appraisal, organisational appraisal in CQC inspections, and legal frameworks we need to adhere to. These regulations use both objective and subjective measures to try and understand the truth about how we deliver healthcare.

This week we have seen more bashing of GPs in the media and using out of context metrics by politicians to shame healthcare professions into changing their practice. A good example of this is the idea that Matt Hancock, the then health secretary, said only last year that most GP consultations should be online. In addition, the new health secretary has announced ‘hit squads’ for GP surgeries not meeting a mandated face-to-face appointment regime.

So how do we deem whether politicians who govern us are competent to make these decisions? A recent YouGov poll showed that 57% of people deem Boris Johnson incompetent. But what is that based on, our own subject perceptions, the perceptions of others or on objective regulated facts?

Perhaps looking at how individuals answer the question based on their political allegiances gives us a better clue. For example, when Conservative voters were asked, 55% felt Boris Johnson was competent(although this has dropped from 90% at the start of the pandemic):

When Labour Voters were asked, there was a very different outcome, with only 8% who thought he was competent:

The point here is not a political one, but rather it highlights the fact that how we perceive the competence of politicians is significantly affected by our own perceptions. As the metrics we use are often selective and have inherent biases, it is difficult to get past our perceptions, media narratives and portrayal in the media.

During a national health crisis, it seems to make little sense to have a healthcare sector so heavily regulated when those who decide how healthcare is run are not. Surely it is time to move to a more transparent way of governing systems using both objective and subjective measures in an evidence-based way to allow us to make the best decisions on competence next time we visit the ballot box.

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Twitter: @dmmcmenamin

Dad. Husband. Urgent Care GP. Interest in Management and Leadership, Personal Finance and the Human Operating System