Who on earth should health workers vote for? “Infantilised as a democracy….”

For those of us in the Health Services this is the most important issue facing us all, and yet all our options in voting are dishonest.. I would like to know it was built on a rock before I die, but increasingly this looks less likely. Issues such as GP indemnity and recruitment are brushed under the carpet. Professional leaving the health services are forgotten or ignored. Exit interviews are virtually unknown. Honesty is dying, and the infantile approach of the media lets politicians off the hook on ideological issues. (Such as whether we can afford care, and new methods of funding).

Image result for infantilized health cartoon

Matthew Paris in the Times 27th May opines: May won’t say it but Brexit is all that matters – It’s time the PM talked about the most pressing issue the country faces — and helped restore her damaged reputation

….What the hell are we doing having a general election just as the British government embarks on decisions about our nation’s future that will define the country we leave to our successors — without talking about Brexit?

We’ve been talking about grammar schools. They aren’t going to happen. Never were. No return to the 1944 Education Act. The whole debate has been much ado about little. We’ve been talking about social care, and dementia; and ended up with a consultation that will totter into oblivion, and a few modest tweaks.

We’ve been talking about “capping” energy prices. This won’t happen either. Some token caps will be imposed and the market will find ways to dodge them, just like last time in the 1970s. And now we’re talking about security and terrorism. The micro-debate — how to safeguard — is fairly pointless as we hardly know what our security services are up to and we probably shouldn’t. The macro-debate — how we got here in the first place — has already been won by Jeremy Corbyn. That invading Iraq, Afghanistan and Libya was anything but a blunder is now believed by very few people in Britain, most of them newspaper columnists.

Education spending? The NHS? Whatever is said now, ministers after June 8 will set their faces against hefty increases in spending, only to be worn down gradually by the pressure of evident need.

Meanwhile we sail almost silently onward towards the biggest, hardest negotiation our country has faced in my lifetime. And nobody speaks. Theresa May is all but struck dumb. The Labour Party is muted, trying to avoid an argument about whether it even wants this to happen. The Lib Dems, led by a glorified bingo caller, duck behind the cover of a hoped-for second referendum.

Will nobody talk about Brexit? Are we to enter the polling booths in 12 days with the biggest question all but undiscussed, still hanging above our country? It would be like conducting a British general election in 1938 without mentioning the Third Reich…..

What’s to happen to farming? Will there still be subsidy, and how targeted? Food imports: is protecting our farmers a red line in trade deals we hope to negotiate with food-exporting nations? The City? Is getting a special deal on equivalence in financial rules a priority?

How about immigration once we’ve taken back control? We make country-by-country rules, and will for the EU as a bloc. Any thoughts, Amber Rudd? Don’t business, the City and farming need to know before they vote? What analysis has been done (or planned) of the costs to our economy of migration limits?

It’s not enough for Theresa May to say we’ll keep the “soft” border with the Republic of Ireland. How? This is desperately important.

If we want to stay with Europol, the European arrest warrant, the Schengen information system, how do we reconcile this with the European Court of Justice’s jurisdiction? Does the Manchester atrocity affect priorities? Have we assessed the costs of setting up new bureaucracies if we leave EU regulatory agencies on medicines, competition, aviation safety and the like?

With Donald Trump looking flaky and Nato shaky, might we seek associate membership of the EU’s foreign and defence policy-making? Or are we prepared to depend entirely on America?…

May says “no Brexit deal” is a possibility. Would we then raise tariffs against countries (including the EU) that impose tariffs against us? Or do we believe in open trading even where others don’t reciprocate?

These questions are capable of discussion now. Of course the British government can’t fully “reveal its negotiating hand” but major insistences (leaving the single market and customs union) and major concessions (paying our fair share of the bill for divorce) have already been announced. These have consequences. Both major parties owe the electorate a look-in on their thinking about how to approach them.

We’re being infantilised as a democracy. May, meanwhile, is in some trouble this weekend. She needs to break out of an impression of haplessness that can only feed itself if she goes silent. How better, 12 days before this country’s last chance to vote on Brexit, than by a fireside chat in which she trusts us with her thoughts? Or is the cupboard bare? People will begin to wonder.

Chris Ham (kings Fund) is afraid to mention rationing. So is everyone else. A plague on all their houses?

What does the engaged profession think: “Lead ‘national debate’ on what services NHS should cut, GPC told”

With increased stress, litigation, complaints and expectations, all doctors know they are at risk of burnout or mental illness.

The dissonant ideology between social care and the NHS: “One is heavily rationed and means-tested, the other free at the point of use and tax-funded”.

There are thousands of “ranting doctors”, but they keep their rants to themselves. Times for honest and open “exit interviews”.

An exodus because of poor planning and the shape of the job. Deprofessionalisation….

BMJ 18th May: Next government must tackle GP indemnity costs, royal college says


This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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