The never knowingly over-punctuated health secretary

With crises on every front – primary care, elective care waits, rammed accident and emergency departments, ambulance delays, pensions, workforce, mental health, social care, resurgent covid variants, and dangerous hospital roofs – where to start?

Let’s start with that last sentence. Is the comma after “variants” necessary? According to Therese Coffey it is not. Between the dashes (or em dashes, if we are being pedantic, and we are) is a perfectly good list in no need of disambiguation. That superfluous comma is an unforgivable waste of punctuation at a time when the NHS needs to conserve precious resources.

Ms Coffey is the never knowingly over-punctuated secretary of state for health and social care. One of her first acts as the new boss at the Department of Health and Social Care was to issue a memo urging positive, Oxford comma-free messaging about the NHS.

This is important. The last thing you want when you’re waiting three hours for an ambulance after a stroke is to wallow in self-pity. Similarly, anyone facing a 12-month wait for cancer surgery has a right to expect upbeat headlines.

Positive construction

Ms Coffey’s point echoed that made by NHS England strategy and commas director Chris Hopson a few weeks earlier. After a decade of ferocious lobbying for hospitals, Mr Hopson delighted fans by going over to the enemy. He broke a prolonged silence in his new job with an impassioned speech exhorting NHS organisations to focus on positive messages.

Commentators were quick to diagnose Stockholm syndrome: Mr Hopson had fallen in love with his captors.

Building on the success of Mr Hopson’s address, Ms Coffey penned a message to DHSC and UK Health Security Agency staff, urging them to “be precise” and to “be positive”. She seemed blissfully unaware of the possible tension between these two modes.

The Hopson/Coffey line has much to recommend it. It’s one thing for the health service to be on the brink of disaster, but it’s quite another to be gloomy about it. Transparency and honesty are important, but they only work when things are going well. If you can’t give the public the solutions they crave, you can at least give them false hope.

Sadly, this message never got through. Ms Coffey allowed herself to be distracted by her crusade against the evils of the Oxford comma.

Ms Coffey’s dislike of the punctuation mark named after the university that asked her to leave before her finals is mysterious.

Capital offence

So, what does the Coffey approach to grammatical correctness tell us about the woman who will be dividing her time between the offices of deputy prime minister and health and social care secretary?

First, it tells us that she is out of touch with the real issues in public service grammar. Commas are the least of our problems. Most NHS lists use semicolons for the removal of doubt, even when there is no doubt to remove.

Ms Coffey had nothing to say about these.

Official documents are also littered with Spurious Initial Capitals, used for emphasis or for typographical scaffolding to support weak ideas. Without SIC we would be devoid of the memorable acronyms and abbreviations upon which the survival of the NHS depends.

Again, nothing from the minister.

She was also silent on whether it was acceptable to recklessly split infinitives or to go in search of prepositions to end sentences with.

And what about her attitude to rhetorical questions?

The affair also suggests that Ms Coffey’s grammatical opinions get more exercise than her expertise.

For example, she appears to think that a double negative is an extreme form of negativity rather than a solecism. One of her instructions is to: “Be positive — if we have done something good, let us say so and avoid double negatives.”

She could, of course, have avoided giving that impression with an Oxford comma after “so”.

Periods and colons

When news of Commagate was broken by the founation trust, the baying mob on Twitter swung into action. There were the usual howls of righteous indignation, and numerous conspiracy theories. The comma was a cover for privatisation, a distraction from bigger issues, or a tiny chisel to chip away at what remains of doctors’ morale.

There were also those who could see past the headlines to the real strategy, and enthusiastically welcomed Ms Coffey’s radical intervention.

There was this from an NHS transformation director:

‘Since we stopped using the Oxford comma this morning we’ve seen:

• 24 per cent reduction in emergency department attends
• 12 per cent improvement on the four-hour standard
• 100 per cent reduction in >12 waits
• 19 per cent fall in med fit for discharge

Should have done it years ago! This is the pro-active leadership we need…’

And this from a medical registrar:

‘Therese Coffey has announced that women’s health and bowel cancer services will be her top priorities as health secretary

“That’s why we’re dropping the Oxford comma,” she told the BBC, “so we can focus all our attention on periods and colons.”’

The DHSC comms team didn’t waste any time establishing the facts before trying to bury the story.

The Times Whitehall editor Tim Smyth posted: “Furious counter-briefing now underway insisting Coffey has no strong views on Oxford commas”.

Sadly, history does not bear out this claim of ministerial indifference. In 2011, Ms Coffey tweeted: “Delighted to read that even OUP starting to reduce use of the Oxford comma. I cannot bear it and constantly remove it.”

Mr Smyth helpfully collated other examples.

“I abhor the Oxford comma and refuse to use it,” Ms Coffey wrote on 15 August 2013.

Two years later, on 11 April 2015, she owned up to using one by accident, though she evidently did not inhale: “Apologies for posting that graphic which included an Oxford comma (one of my pet hates).”

Indicative case

Who cares about the fate of a contested punctuation mark? You might as well ask who would get cross about a leaky pen when he had just been made King of England. Coffey’s comma, like King Charles’s display of temper, is revealing.

This is a person who confuses matters of style with issues of substance, and who firmly believes that what she believes is correct because she believes it. Ms Coffey is the embodiment of the definite article.

More to the point, this is someone who used their first message to their team to wind them up, not wind them in: the new boss whose first memo is about the sanctity of executive car parking or responsible use of stationery. She could have used the opportunity to say: “I’m looking forward to meeting you” or “I’d love to hear your ideas”.

Only she didn’t.