Thursday 23 August 2007

A view from the North

This piece was written by Dr Clive Peedell, a cancer specialist in the North of England:

In terms of the reforming the NHS, the medical profession is as a big problem for politicians because the public trusts doctors.
Doctors are on top of the Mori Veracity index (http://www.ipsos-mori.com/publications/rmw/whomdowetrust.shtml). Politicians score the lowest along with journalists. It follows that if groups of doctors speak out against the government and its policies, the government are likely on end up on the back foot. For this reason, the government have used the following tactics to reduce the voice of doctors:

1. Empowerment of a few powerful yes men and women from within the profession. This actually takes advantage of the Veracity index. Government Csars such as Professor Sir George Alberti (former PRCP) have been rolled out to promote Reconfiguration of DGHs. Lord Darzi is another prime example. Knighthoods and Peerages increase the
2. Doctor Bashing. This attempts to reduce the veracity rating and public trust in doctors. There is a very clear agenda to focus on doctor’s pay at present. Remarkably, the DH also managed to blame Doctors pay for the NHS overspend.
3. Disempowerment and deprofessionalisation of the medical profession. Whilst a few medical apparatchiks are empowered, the rest of the profession is being disempowered. Loss of professionalism will be very harmful to our credibility and how the public see us. It is likely that the role of the doctor will be merged in with other health care professions. A flooded medical Labour market will reduce the influence of the BMA because they will lose negotiating power. This is what MMC is all about.
4. Media manipulation. This takes many forms. Highlighting medical scandals and high pay are obvious targets to get column inches. Journalists themselves are also manipulated by the DH press officers (spin doctors). Those who spin stories in a positive light will get better access to senior MPs and will be first in the queue for breaking news and leaked stories. This is obviously very important for the career prospects of journalists. Those who attempt to expose the truth will be shunned – career suicide. Another technique is to manipulate the press releases of senior medics such as the Csars. The best recent example involved the Heart Disease National Director (Csar), Professor Roger Boyle. He published a document called “Mending Hearts and Brains” which essentially called for more specialist services for acute MIs and strokes. This was very sensible, but a DH press release statement accompanied the document (on page2) that explained that the document was about “reconfiguring” of services. This press statement has since been removed, but other evidence is still available on the DH website (see point7): http://www.dh.gov.uk/en/AdvanceSearchResult/index.htm?searchTerms=Heart%20diseases
“Roger Boyle, National Director for Heart Disease, makes the clinical case for reconfiguration in the context of heart disease and stroke services”
It was then all over the BBC how Boyle and Alberti were in favour of reconfiguration. (http://news.bbc.co.uk/1/hi/health/6208936.stm). This was definitely not what Roger Boyle intended. In fact, I questioned him on the issue via e-mail and he replied:
“You will find that neither George Alberti nor I said a single word about closing hospitals, A&E departments or any other service. What we did say and repeated many times to the media was that services needed to be modernised further.”


These are the sort of dirty tricks our profession is up against, but it is time our leaders stood up to tell the truth about the reality of government healthcare reforms. The BMA and HCSA must start spending money to advertise OUR point of view. It won’t be easy to win a media battle, but as professional people we owe it to patients and the public/taxpayer.

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