The great
problem with over arching noble principles and ideals is what happens in
practice. If you are not careful you
stumble into the Great Grimpen Mire of no right decisions and disappear from
sight.
Especially if
you are pursued by Hounds of the Baskervilles in the shape of people and groups
whose moral imperatives or personal interests blind them to the nature of
reality.
The reference
is Sherlock Holmes and Dr. Watson material from the works of Arthur Conan Doyle
and his tale of the Hound Of The Baskervilles. In the Holmes stories Dr. Watson
did not seem to do much doctoring.
Perhaps he
took early retirement on a offer that he was unable to refuse. One thing is certain, then there was no
National Health Service but there were many and various ways of insuring or
being a member of something which gave access to medicine and medic's.
The National
Health Service is a noble ideal. But there are the problems of organising,
managing and paying for it. These
involve choices that are made not in conclaves of right minded idealists
seeking the ultimate good but in others.
These are
politicians and the organisations they set up. In turn the politicians want to
be popular but are engaged with vested interests, major corporations, trade unions
and a whole raft of other bodies all anxious for decisions that suit them.
As it is
health it involves the people. The media
are anxious to have stories of those for whom things go wrong; all those deserving
persons, tragic cases, rare conditions and
emotional stories to grab our attention and sell the papers or TV
service.
At the cutting
edge, the front of stage and the crucial decision making are the doctors and
nurses. Recently, they have been
reorganised almost every other year. Also, their training and work has been a major target for the application of many and various high principles.
So there are
many issues and conflicts of interest and ideals and they are taking longer and
longer and becoming more and more difficult to resolve. To add to this the more people you have
employed then the more there are at the margins and the greater the potential
turnover.
If what are
deemed "right" decisions are those that conform to the politics and
its dogmas and to particular interests and not to the general health then we
are heading for a situation where there is no National Health Service at all.
If we are not
there already then we will be soon.
It's going to be fascinating watching Osborne's new take on this when he takes over.
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