Is Tooke being listened to or is our government so entrenched in its ways that the only hope for the NHS is to throw it out and hope the others can see the light? Is Tooke seen as a heretic or a saviour? Dr Grumble fears he knows the answer.
Here are some quotes from Sir John who was interviewed on Radio 4 recently (with thanks to Sam who pointed the programme out).
Different professional roles require different educational foundations. If you pursue a medical practitioner type of role, then you need a profound foundation in science, you need a deep education to enable you to undertake the clinical reasoning which is absolutely key to diagnosis - finding out what’s wrong with people. If the pattern doesn’t fit, you need to be able to go back to base principles and work things out from a knowledge of the science.
On substituting healthcare professionals for doctors:
The results of role substitution experiments are not particularly well publicised, but when they have been conducted they’ve tended to reveal that the role substitutor for the doctor is no more cost effective and indeed in some cases less cost effective than the doctor doing that role. And the real reason for that is that a role substitutor may be able to follow a protocol, but unfortunately human beings and human disease don’t conform very neatly to protocols and that gets forgotten.
Referring to the skills escalator
In combination with a hierarchical control system and loss of clinical engagement on the ground, then it’s not surprising that doctors have felt somewhat de-professionalised and undervalued.
These few paragraphs are packed with Grumble themes. Some of you may remember speculation that Sir John must be reading Dr Grumble. But he probably hasn't. Everybody is actually thinking this way but not everybody is prepared to admit it. So will it be Lord Tooke or Tooke for the Tower? We shall see.