Intended for healthcare professionals

Observations Life and Death

Are policy makers really listening?

BMJ 2011; 342 doi: (Published 02 June 2011) Cite this as: BMJ 2011;342:d3218
  1. Iona Heath, president, Royal College of General Practitioners
  1. iona.heath22{at}

Distortion of words in the interests of those seeking to exercise power has a long history, says Iona Heath, writing in a personal capacity

The quality of healthcare has always depended on the quality of listening: intimate, attentive listening shared between the patient and the doctor or nurse. Now, suddenly, there is much talk of listening at the much less tangible level of policy making. The word “listen” is a beautiful and ancient one, thought to be first recorded in written English in the Lindisfarne Gospels of ad 950. The complementary verb “to hear” is equally ancient and makes its first appearance in the same exquisite text.

Words are precious and dictionaries the treasure chests within which the history of each word’s usage is stored. According to the complete Oxford English Dictionary, to listen means “to hear attentively; to give ear to; to pay attention to.” The marvellously idiosyncratic Samuel Johnson, in his great Dictionary of the English Language, published in 1755, defined to listen as “to hearken, to give attention.” The inclusion of the notion of giving in both definitions suggests the moral content of listening. Doctors have a grave responsibility …

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