In response to the recent post on NHS failings, Nick Drew commented:
It's a ghastly story, Sackers, and very saddening. But my observation is, that the NHS is really only for delivering a broadly-based, rather undifferentiated 'mass average service', which on average will do quite a lot of good - a kind of "hygiene plus" - mass inoculations are a prime example.
If what's wrong with you can be (a) recognised fairly easily, and (b) improved or cured with simple measures - drugs for the most part, but other things like re-hydration and rest - then chances are, you'll see the benefit. Anything requiring subtle diagnostic detective-work, or a highly-trained eye, or an ultra-tailored course of treatment ... and you're back in the lap of the gods. Only the Queen is guaranteed to get the very best that medical science has to offer
The parallels with education are strong: take an illiterate population and impose compulsory, fairly decent basic schooling, and you'll raise the average level quite markedly - indeed, you'll effect a trnsformation. Will every child get exactly the customised teaching etc that would absolutely maximise their life chances? No.
To which I replied:
In principle, agreed; but the f-ups here were down to lack of basic skill (hoist usage), care and attention (reading X-rays, monitoring drug combinations, noticing when the patient isn't sleeping) and not following the sugeon's after-care plan (not the only case I've seen).
Ticking boxes is no replacement for vigilant, shop-floor-walking management.
Now JD offers his perspective, based on his own experiences:
Have you heard of Henry Willink's 1944 proposal for a National Health Service?
As I understand it from various other references, Willink would have retained the many Cottage hospitals in the country. Most have now been closed in the name of 'efficiency' meaning 'customers' are obliged to travel to the nearest big shiny new hospital. This is an example of the 'bigger is better' approach to health care which in reality is nothing more than an extension of Henry Ford's production line with doctors and nurses instead of car builders. We already see it on a smaller scale with your local GP allocating ten minutes only to each patient.
Now that I am old I have had the opportunity to enjoy(?) the experience of our sanctified NHS. It doesn't work, it serves only to hand out coloured aspirins (my grandfather's phrase for the pills and tablets handed out for anything and everything).
The medical profession accept the reality of psychosomatic illness. Why then do they not encourage the equally valid concept of psychosomatic well being?
"Candace Pert, Ph.D. is a research professor in the Department of Physiology and Biophysics at Georgetown University Medical Center in Washington, D.C. Dr. Pert is best known for her discovery of opiate receptors in the brain. She was a featured expert in the highly acclaimed Bill Moyers PBS series Healing and the Mind. In addition to her research efforts, Dr. Pert lectures and teaches about how our minds and feelings influence our health and well-being. She is the author of the bestseller Molecules of Emotion."
I read about Dr Pert a long time ago and I have discovered for myself that psychosomatic wellness does work after doing the opposite of what my epilepsy doctor told me to do: instead of increasing my tablets, I reduced them. She was not amused when I told her which is understandable but I have had no seizures since that time. It's all in the mind!
....and yes, it is the management which is in urgent need of reform, starting in Whitehall!