Tuesday 6 October 2015

Was There A Doctor In The House?

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.

1 comment:

  1. It's going to be fascinating watching Osborne's new take on this when he takes over.