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Friday, January 21, 2005
I'ld just like to take the time to congratulate Theodore Dalrymple on his retirement from Britain's National Health Service.
His latest article, in which he announces his retirement, discusses how doctors have lost their integrity and status at the hands of government bureaucrats. His experience is from Great Britain but I suspect you could find similar sentiments from doctors here in Canada:
The now ineradicable managerialism so insouciantly introduced into the public service by the Conservatives, and that serves so well the megalomaniac centralising ambitions of the current government, for whom increasing bureaucratic clientelism is the key to eternal power, has created a Kafkaesque atmosphere in the health service, in which it is impossible to point one’s finger at precisely who is responsible for what latest idiocy. The very expansion of management — 17.6 per cent in one year alone — dilutes responsibility to the point when it can no longer be said to exist with anybody. A miasma of intellectual and moral corruption hangs over every hospital and, though itself intangible, its effects are tangible, such as the decision of a very famous hospital to keep patients brought to casualty waiting in ambulances rather than allowing them inside, so that the waiting time in the casualty department could be brought into line with a target.Go read the whole thing.
The doctors are not entirely blameless for the spread of this corruption. As the late and much lamented Marshal Mobutu Sese Seko once pointed out, it takes two to be corrupt: the corrupter and the corrupted. As a group, doctors have not put up much resistance to the erosion of their integrity that has accompanied managerialism: either they have remained entirely supine, or they have been bought off with promises of extra cash, dispensed by managers. Thereby the doctors have developed the same vested interest as the managers in keeping quiet; and once they have accepted this, they have lost both their independence and their moral standing. They have sold the status of their profession for a mess of personal pottage.
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