22 March 2009

Democracy RIP

We used to have something of a democratic process in the United Kingdom. There were left wingers and right wingers. There was the Tory party which was a bit to the left of New Labour and the there was the Labour party which was to left of anything you can now dream of. Each party had their mavericks who expressed views that were two standard deviations more extreme than their party's mean. There was genuine debate in parliament. A full range of views was aired. We had a vibrant press. You could easily find newspapers with a very left wing perspective and newspapers with a very right wing perspective. But many of those differences are now much more blurred. The main political parties no longer look to separate themselves with clear blue water. Instead, like the coxes in the boat race, they fight for the middle way. Mavericks are no longer admitted to the exclusive club at Westminster. To become a parliamentary candidate for a major party the first prerequisite is to be prepared to toe the party line. If you have the misfortune to meet any of these colourless people you will find it hard even to know which foot they kick with.

All this is bad. Consensus may sound good but it's dangerous if it is just a consequence of being given the same hymn sheet to sing from. For too long fundamental wrongs about the way we
have been heading have gone unquestioned. The banking catastrophe is just one example. Why were no questions asked about that? Was it really that people were unable see the evils of what was going on? Or was it that they had no way to blow the whistle?

If there is one group that is mostly to blame it is the journalists. What, for example, have they really done to flag up the problems of the misdirection of the health service? How often have they picked up stories spoon fed to them by the bloggers? The word 'never' springs to mind.

The journalists do have some insight. Here's Nick Cohen:

... those who ought to have shouted from the rooftops about patients begging for help from excrement-stained beds bit their tongues. Their dereliction of duty is all the stranger because, while Labour did not regulate the City, it sent an army of quangocrats to monitor the NHS and helped staff raise urgent concerns by providing statutory protection for whistleblowers.

For all that apparent encouragement, whistles were not blown by doctors or nurses in Stafford. Instead of independent professionals with the confidence to defend the public interest, the Healthcare Commission described sullen staff, bullied by managers and neglectful of patients. Doctors told its investigators that they had been "proletarianised": turned from professionals with their own codes and standards into employees who must obey.

And here is a telling paragraph:

Suppose whistleblowers were to turn to the press. They would find a cowed Fourth Estate, which is being battered by the recession, and a judiciary which does not believe in freedom of publication. (Source)

Of course this does not make sense. The recession is no reason not to publish a good story. And it can't really be the judiciary blocking the truth. So why has the press repeatedly failed to relay what the workplace bloggers have been saying for 4-5 years until, that is, the cat is already out of the bag?


Jobbing Doctor said...

One of the reasons I have taken to blogging is that I feel pretty powerless to influence anything.

I have ben appalled by events in the NHS in the last few years, from the hounding of Rita Pal and Steve Bolsin, the treatment of Ian Mackay, right through to the bullying and intimidation by Government through their lapdogs in the media.

We need to keep the rressure on.


John said...

And it's because of what happened to the people mentioned above that it would be career suicide for any doctor to try to bring too much attention to places like Stafford.

Keep 'em scared and keep 'em cowed is how HMG would like doctors, BMA isn't exactly the mot fearsome union.

Lets hope over the years Remedy UK can begin to do what the BMA is failing to do and look after the interests of doctors

Cockroach Catcher said...

Well posted. We bloggers need a wider readership at whatever it takes.

The Cockroach Catcher

Anonymous said...

The place of the medical whistle blower in the NHS is fraught with danger. And yes, some of us are giving a little toot in the blogosphere, but we all write pseudonomously (is that a word? my spell checker doesn't like it). I've been doing it for a few years now, and been round the houses more times than I care to think. We are read in the DoH, and by politicians, and we are constantly tapped (usually without permission) by the MSM. However, we have a problem. We don't write under our own names. So we can be ignored too. And if we don't put our own name to something, perhaps we deserve to be ignored. It's this aspect of it that now is getting me frustrated. It makes me more inclined to do totally off the wall rants, and keep re-address my own well known bete noirs rather than addressing other serious issues.

I am where I was with committee ten years ago. You start of calmly and get nowhere. Then you shout bit, and get nowhere. Then you try humour, and people laugh but still you get nowhere. Like attacking cotton wool.

Stafford is a disgrace, a scandal. Yes, it is one of the worst, but there is plenty more like that going on all over the country as we medical bloggers know so well. But now I have reached the stage that I find the best article of all on Stafford was the one in the Daily Mash. Because nowadays I often don't take myself seriously, I can't complain if others don't either.


Anonymous said...

The investigation into staffing and management problems at Birmingham Children's Hospital seemed to have been started by doctors, I found that a bit encouraging - you'd think it would be medical and nursing staff who would be best placed to see problems early and if they act together they won't be too easily intimidated. (http://www.guardian.co.uk/society/2009/mar/20/birmingham-childrens-hospital-nhs-report)

Patients are often not familiar with hospitals, are under stress, and may not notice problems or 'near misses' until things are really bad.

Anonymous said...

Patients are often not familiar with hospitals, are under stress, and may not notice problems or 'near misses' until things are really bad.
Yes. And the government wants the patients to rate their treatment. They should get the doctors to rate the care. And the doctors should rate the hospital management. Not the other way around.

Dr Grumble said...

So why has the press repeatedly failed to relay what the workplace bloggers have been saying for 4-5 years until, that is, the cat is already out of the bag?
The Jobbing Doctor tells you how to find out the answer to this mysterious question in this post:


Dr Aust said...

Isn't all this another argument for why importing Hospital Chief Execs, and higher echelons of the Trust / PCT Management, from business, management consultancy, or other non-medical things is a travesty?
Think Railtrack and engineers.