The doctor as production line worker

The GP is no longer a member of a liberal profession but an executor of government diktats or obiter dicta

Ever increasing numbers of doctors: acute shortages of doctors. Such a miracle, writes Dalrymple, is one that

only our government could have wrought.

Dalrymple points out that about 250,000 doctors are registered in Britain,

but it is more difficult now to get to see any of them. There is said to be a crisis in medical manpower and that this necessitates the importation of a further 3,000 doctors this year. Fewer than two-thirds of doctors in Britain trained here. Britain parasites the rest of the world. It has outsourced a lot of undergraduate medical training.

Bureaucratic fatuity

There is a big shortage of general practitioners (i.e. family doctors or primary care providers). Young doctors do not want to go into general practice; training posts go unfilled. This is to a great extent because of the administrative burden. GPs must

spend untold hours filling forms of a soul-destroying and unnecessary kind. This is a slow kind of torture. The demands placed upon them by a bureaucracy composed of people who have little or no understanding of medical practice are immense.

Rules laid down by fools

GPs’ pay

depends on their compliance with rules laid down by fools, and this is not a happy situation for an educated and intelligent person.

Computerisation has been a factor, because for the bureaucratic mentality,

if a piece of information can be recorded, it ought to be. Before the spread of the computer, the bureaucrats’ dream of replacing all other human activity by form-filling was impossible.

Loss of prestige

The more the work

is reduced to algorithms, the less attractive it is.

The GP

is no longer a member of a liberal profession, but the executor of government diktats or, worse still, of its obiter dicta. Eventually the GP will become redundant. What is done by GPs will be done by computers or nursing assistants.

Dalrymple points to the

steep decline in the attractiveness of medicine as a vocation, profession and career.

And no one

who ever experienced an ordinary Soviet hospital will be in any doubt as to what a decline in the prestige of the profession meant to patients.

It has long been the goal of the government, he points out,

to deprofessionalise medicine and to turn its practice into a mere job. An independent profession, with its high standards and old traditions, is dangerous to the government, especially when it is as respected as the medical profession, in a way in which a mere group of shift workers will never be. Shift work dehumanises patients and deprives the work of most of its satisfaction. It is also grossly inefficient.

The independence of doctors

has eroded almost completely, and you cannot expect highly educated people who have undergone a long and strenuous training to remain contented for very long with being harried and reprimanded by people who are of lower calibre than themselves.

A vivid exemplification of the New Hospital Order is the noticeboard in the corridor of the hospital in which Dalrymple works, which

informs the public of the senior staff of the hospital. The senior consultants, all men of considerable distinction, appear on the fifth and bottom row, under four rows of bureaucrats. The impression is given that they are of very minor significance.

The shortening of training,

both graduate and postgraduate, is another straw in the wind. New hospital consultants do not have the breadth of experience that old consultants had at their appointment, and this is because doctors are increasingly regarded as technicians and nothing more.

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