The former collegiate nature of our profession as doctors has disintegrated.
Meetings between consultants and GPs occur much less frequently than they used to. The unofficial debates that occurred at the fringes of the regular meetings were much appreciated by many “old lags” such as myself. There were discussions around problems of individual cases, information about new investigations and imaging, and the confidence of choosing a consultant that one knows for ones patient. At last the BMA has had a debate. The “notice of motion” was “This house believes heathcare rationing should be overt”, and was proposed by myself, and opposed by Dr Clive Weston from Swansea. Here is both the written and the audio for the debate:
Roger Burns text: Debate Rationing final
Roger Burns speech.
2nd October 2014
Since this disintegration there has been a professional silence and an unofficial collusion to disengage from the political process. Power has shifted from clinicians to managers, and the open nature of debate has been stopped for fear of “gagging” punishments… Whistleblowers have their careers ruined, and there are so few exit interviews that Trust Boards rarely hear what retirees think. The opinions of experienced consultants, GPs and Nurses are not being heard. They are however getting stress related problems (Stressed doctors urged to work part-time in bid to avoid burnout – LYNDSAY BUCKLAND in The Scotsman 30th September 2014)
With this in mind I have attempted to bring the art of debate back to the professional life of doctors in Pembrokeshire. I am grateful to Clive Weston from Carmarthen for agreeing to oppose the motion, but I am also surprised and disappointed that none of the BMA members in the Trust Management are opposing, or seconding.
The debate fits nicely with the move from a deference society to reference society, (or autocratic to facilitative) as advanced by George Pitcher and Sir Tim Bell, and in the book “The Death of Spin” 2002
My three handouts in the debate were:
Then finally The Information Age. Why not ask your MP or WG member whether they agree that health care needs to be rationed overtly? See his discomfort…
Watch the debate as the election approaches in 2015. Health is important for all of us, and the politicians wonder why there is a disenchantment with politicians when they conspire in denial and collude to pretend that rationing does not exist.
The West Wales BMA debate had a low turnout, but of the 24 or so present there was a clear majority in favour of the motion. This should tell the politicians and administrators why the profession is and will remain disengaged – until this debate goes national… One of the arguments against rationing is that it creates and legitimises inequalities. I would suggest that reducing inequalities is a role of government, by progressive fiscal legislation, but that they can never be removed. Certainly a less unequal society is desirable, and will find rationing more acceptable.
The Spirit Level: Why More Equal Societies Almost Always Do Better Richard Wilkinson & Kate Pickett