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Hands off our jargon


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Thursday, 30 March 2017

Hands off our jargon

The BBC published a disgraceful attack on NHS jargon this week. The piece reveals a complete lack of understanding of how the NHS works, all too typical of the national media.

The article alleges that the NHS uses jargon to keep patients and the public in the dark, as if this were a bad thing.

You would think that the BBC, one of the world’s foremost news organisations, would appreciate that clarity is not the sole or even the main function of language.

While plain English may appear desirable to lay people, it simply wouldn’t work in an NHS context.  The NHS exists to treat things not prevent them. NHS communications are designed on similar lines: not to avoid misunderstandings but to make them better, slowly and as safely as possible.

It helps to think of communication as a long-term condition and an adverse reaction to jargon as a symptom. The patient presents in a muddled or completely uncomprehending state. He or she needs to be seen by a spin doctor as soon as possible and prescribed a course of treatment.

Self-care is cheapest and therefore best. Often a jargon buster or easy-read guide will do the trick. It is rarely a complete cure, but it may alleviate the worst symptoms.

In extreme cases there will need to be an admission, usually involving a complete plain English transfusion. This is an expensive and risky procedure, which the NHS can ill afford at a time of austerity. This is why most commissioners, even if they are capable of clarity, pretend never to have heard of it.

So why not just start with the plain English version, get straight to the point and avoid misunderstandings? If you need to ask this question, you should ask yourself if a career in the NHS is right for you.

Direct language is all very well if you want to have a meaningful conversation with someone or get a clear message across. But what if you are not interested in either of these things? Talkative patients slow things down. Answers lead to more questions. Before you know it, they’re queuing round the block or demanding to see the GP on a Sunday.

And if the message is unpalatable – such as that patients will need to wait hours or weeks to be seen – it is best obscured or delivered in such a way as to imply that any delay is largely their fault.

In these situations, think of jargon as the organisational equivalent of boiling oil, used to deter all but the most determined marauder from scaling the castle walls. Use any other kind of language and you have dropped the drawbridge, thrown down your weapons and told the enemy where you keep your gold.

The best jargon sounds deceptively like English, enabling a skilled practitioner to use it to give a convincing impression of helpfulness. Given the choice between pretending to understand and looking stupid, the person on the receiving end will usually give up after a couple of attempts.

Handy as it is for fobbing off patients, this is only a secondary use of jargon. Its main purpose is to fool ourselves.

Sometimes we may simply want to make each other feel better about an impending disaster, so for example we stop talking about failure and introduce the concept of a “success regime”. The facts of growing hospital deficits may not have changed, but how much nicer is it for two-thirds of trusts to feel they are part of a success than to be branded failures? The worse things are, the more successful we all become.

Faced with impossible tasks, such as returning the NHS to financial balance, stopping people from doing the things that make them ill or making the NHS paperless by 20-whatever, telling the plain truth would be reckless, demoralising and frankly wrong.

The collection of fibs we choose to tell instead needs its own special language. Jargon allows us to bluff, obfuscate and nuance our way out of the firing line, it buys us time, it creates the illusion that we know what we’re doing. It’s great.

Getting rid of jargon would be like preventing illness – pointless and counterproductive. It is difficult to see how our NHS could survive without it.

Semantics facilitator and integrated syntax lead: Julian Patterson


The BBC's travesty of the truth is here.

dr michael platt
dr michael platt says:
Mar 31, 2017 08:02 AM

Rather an over-sensitive response!
Doctors were made to stop using their 'jargon by managers after the managerialisation of the NHS in 1991..
I do think that there is too much jargon and we need to be clear and understandable in all our communications.

Julian Patterson
Julian Patterson says:
Mar 31, 2017 11:27 AM

The ongoing jargon situation has transformed marvellously in the post managerialisation era

Jon Collins
Jon Collins says:
Mar 31, 2017 09:43 AM

Needs more TLAs

Michael Westcombe
Michael Westcombe says:
Mar 31, 2017 10:10 AM