Think like a patient, act like a tax-payer: This was one of the more interesting take-aways from Simon Stevens’ recent speech about the new focus of the National Health Service in the UK.
Although the sentence might be seen as a bit of cheap spin, I think that if most health services asked themselves if they think like a patient, then, with hand on heart, they would probably say no. My experience from working with health services in Scandinavia is that they strongly believe that the health service was established to serve the patient. However, they stopped thinking like a patient a long time ago. Something happened in the 80’s and 90’s that pushed them to think like efficient industrial organizations, and to do that, they turned their back on the patient (and also on what a service is all about). There was a belief that by becoming efficient organizations, that they would naturally serve patients in a better way, and that the patient benefits would be a logical consequence of their analytical thinking. The thought was very much upon  patients, who were predictable and malleable, and therefore did not need to be considered. Gradually, the patient became more and more a distant stakeholder in a hunger to develop systems that looked fantastically good on paper. However, we all know now that you cannot remove the user from the equation, and there is a need to bring the patient back, at both the macro level and the micro level.
So, how do you think like a patient and act like a tax-payer? Add Service Design. The reason for this is that I think Service Design is really good at thinking like a patient (and to a large extent has a fairly good understanding of business economics). However, I think that the natural tendency of a service designer is to think like a patient (or user, or customer – dependent upon situation). That is one of the great strengths of Service Design. However, I do believe that it needs a counter balance. In many ways, the counter-balance already lies in the projects, due to it being built into the culture of most health organizations for the past 30 years. Time and time again I meet a culture in service providers which is focused upon themselves, how they do things and how they would like customers to fit into this self-view. Instead of seeing this as being something outdated, I think that it can offer this counterbalance to the Service Design view. So, maybe the answer to thinking like a patient and acting like a tax-payer is to just add Service Design? Experience from various projects seems to point to the same conclusion. It’s a small addition, but a very valuable one.