Doctor knows best


On Tuesday, as I listened to David Cameron on the Today programme, I found myself wondering why it is that Tories often seem to know better than the professionals when it comes to fixing problems in our public services. Cameron was trying (yet again) to defend the government’s proposals for junior doctors on the grounds that we need a 7-day NHS in order to improve outcomes for people admitted at the weekend. As Sarah Montague pointed out to him, that particular argument has already been thoroughly discredited.

So why do Cameron and Hunt persist in trying to win an argument using evidence that has effectively been thrown out of court? Partly, of course, because they are hoping that the general public aren’t reading the small print in the first place. Partly, because they know that most of us won’t understand the technical and statistical language that the critics (who include the medical director of NHS England, no less) are (rightly) using to point out why Hunt is wrong to say what he does. Partly, too, because the government are trying to win the argument by reducing the trust that people generally have in doctors. As the odds are rather against politicians winning a trust game against doctors, the politicians are left playing the mortality card (the “we’re the ones who will protect you when it really matters most” one). And finally, because they know better than the doctors. Apparently.

I bet neither Mr Cameron nor Mr Hunt tells their chauffeur how to drive, or a plumber how to fix their sink. Nor do they appear on news programmes offering management solutions to the private sector.  So what is so different about the people who run and work in our public services from the people who run and work in the private sector? Does being paid by the tax-payer render them immediately less knowledgeable and less skilled than their equivalents in business? No. Does agreeing to pay the NHS bill make Cameron and Hunt overnight experts on management techniques useful for wringing most benefit from an under-resourced, multi-layered and complex organisation? No. It does give them a say in NHS priorities, but not in how to go about achieving them.  Having an interest is not the same as having expertise. Better political leaders would be spending time working with the doctors and all the other health service professions to maximise benefit from the system, not playing trust games and trying to assume superior knowledge.

I’d expect a plumber shown the same disrespect as Cameron and Hunt have been showing the doctors to walk away from the job. I’m not surprised the junior doctors are doing the same.  It may be too much to hope that Cameron and Hunt stop misusing statistics, but let’s hope the junior doctors get the courtesy as well as the working conditions they need.



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