My father, a retired History Teacher, pointed out to me that “All Education is divisive”.
Whilst we have formative education in Medical school, consider how were we originally selected to get in?
At the end of Medical School we have a summative assessment, which a few fail (dividing off the chaff) and a few are “prize winners”, a fact that immediately goes into the Doctors CV. He is proud to achieve excellence.
“The object of education is to prepare the young to educate themselves … There is only one justification for universities, as distinguished from trade schools.” Robert Hutchins.
When my grandchildren are at primary school they are being assessed as well as taught. Concentration, language, mathematical ability all combine to give some an advantage and some a disadvantage through lack.
The lifelong learner, the owner of the enquiring mind has a duty to aspire. Doctors are such people, and they aspire to be excellent, have research as part of their on-going portfolio, and to “make a difference”. So doctors in peripheral hospitals are less likely to have such an opportunity, and GPs even less. This lack of opportunity can lead to demoralisation and I wonder if this is some of the cause behind the Mid Staffs and other Hospital downgrades.
We as a Medical Profession have a duty to speak out. Nurses and Doctors, Physios and Managers. When we see things wrong we must speak out, when we don’t have exit interviews we should ask for them, and when we are ignored we should not be gagged. There is nothing shameful in aspiring, and any Regional Medical System which aspires to less than excellence should be taken apart and re-built. It will also need new leadership to match its new philosophy..
“First they came for the communists, and I did not speak out—
because I was not a communist;
Then they came for the socialists, and I did not speak out—
because I was not a socialist;
Then they came for the trade unionists, and I did not speak out—
because I was not a trade unionist;
Then they came for the Jews, and I did not speak out—
because I was not a Jew;
Then they came for me—
and there was no one left to speak out for me.”
Martin Niemöller
The big divide is now between those professionals who will, and those who won’t, speak out. Medical Education needs to emphasise this duty as much as any other.
And just to remind you of the gagging
The Telegraph’s By Steven Swinford, Senior Political Correspondent reports 15th Septrember 2013:
NHS ‘covered up’ £4m of gag orders
The head of the NHS has been accused of a “systemic cover-up” after official figures disclosed that hospitals have spent more than £4 million on secret gagging orders.
The Times (Ruth Geldhill) reports 25th September:
Doctor sacked for e-mailing Christian prayer to colleagues loses appeal
“A doctor who was let go for e-mailing a Christian prayer to colleagues has lost his appeal against his dismissal.
David Drew, 65, a consultant paediatrician, claims that he was targeted for being an NHS whistleblower.
He sent a 16th-century prayer by St Ignatius Loyola to colleagues in April 2009 in an effort to motivate the department.
Dr Drew, who had an unblemished 37-year career in the NHS, was told to “keep his religious beliefs to himself” after a review panel investigated his conduct in March 2010……
“We were a very, very happy department with people of different faiths and even some atheists who were quite outspoken.
“But we were senior, intelligent, well-educated people who were not extreme in our beliefs in any way. We co-existed quite happily.”
Dr Drew, who has four children and lives in Sutton Coldfield in the West Midlands with his wife Janet, continued: “My case was never about the religion. It was about the fact the hospital wouldn’t listen to its most senior paediatrician telling them they were cutting costs to the bone and putting patient safety at risk. It’s all about whistleblowing.”
He referred to Robert Francis, QC, who chaired the public inquiry into the Stafford hospital deaths and who called for a ban on gagging clauses that stopped doctors and nurses from speaking out for fear of losing their jobs.
Dr Drew said: “There were five gags put on my case so we’ve never been able to interrogate the process used in the review which led to my dismissal.
“My case is the exact opposite of the transparency that’s being called for in the NHS today.
“We have to give doctors and nurses freedom to safely report when they see things going wrong and putting patients at risk.
“It’s a scandal.”….
The culture of an organisation which behaves like this to a loyal longserving staff member, with no clinical complaints, really needs questioning. Perhaps the BMA or his MP will recommend him for a “gong”.
