Alaskan Déjà vu

The first time I saw a presentation about The Nuka System of Care, I was sat at the back of a big lecture theatre, next to an old fella who was chuckling his way through the whole thing. The presentation was full of the typical marketing malarkey used by people flogging a story that they played no part in. Blah Blah, was in a bad place, blah blah, did something profound, blah blah, perfectly logical in hindsight. I couldn’t help asking what was so funny.

The bloke turned out to be Dr Morton Warner. He explained how in the 1970s he’d been involved in planning healthcare for various communities and indigenous populations in British Columbia. He’d worked on establishing family health practices similar to those in place throughout the South Wales Valleys. You know the sort, the ones carved into posterity that eventually led to the birth of the NHS. General Practice and wider primary care services as we know them, didn’t really exist in that corner of Canada at the time.

A few years later someone in Alaska was looking for solutions to a crisis they were facing, with increased mortality and a whole range of public health issues, particularly in their indigenous people. They noticed that just the other side of an arbitrary red line on a map, the communities seemed to be enjoying much better public health. So the Americans popped over the border, learned all about the Family Medicine in Western Canada and took it back to Alaska. They then spent a few years doing the only thing the Americans are good at, which is throwing money at it and marketing the living daylights out of everything. They even had to change the law to allow a little bit of political heresy, in the form of social ownership.

Anyway, roll forward two decades and I’m sat next to a bloke, laughing away at some poor soul, who unbeknown to them, had been shipped half way around the planet to tell us about a way of delivering community health that we invented. Notwithstanding that the Canadian’s had quietly mastered the idea, we’d both managed it “without the American bells and whistles”. That made me laugh out loud. Everybody turned to look and Morton waved back. Several other old boys around the audience recognised him and acknowledged the irony, as a sympathetic chuckle started to circle the room. I’m pretty sure a few of them helped to write this, back in 1994:

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