26 October 2010

Grumble takes the pulpit

Dr Grumble's father was supposed to go into the church. That was what his mother had planned for him. But Grumble's father wanted to become a doctor and, although he did not go to school until he was 12, that is what he became. He was, without doubt, a much better doctor than he would have been a vicar. Grumble's uncle was a man of the cloth and so was his grandfather but it was Dr Grumble's grandmother who wrote all the sermons. In those days, behind every great man was a great woman. Dr Grumble's mother often told him he was like his granny. It was not intended as a compliment.

Dr Grumble himself never goes to church. He cannot remember the last time he heard a sermon. Probably it was decades ago. But Dr Grumble thinks we do need sermons. There is a need for our minds to be opened to thoughts that we may not get from elsewhere. This is especially true in the modern world where there are malign influences on our thinking generated by people interested only in making money.






It was something Dr Grumble heard on the radio this morning that generated this post. There was a retired army officer on the radio. He was talking about a charity to look after the interests of ex-soldiers. It was something he mentioned that struck Dr Grumble as very important. Essentially he said that problems occurred when soldiers moved from an organisation that values loyalty, dedication and commitment to a society focussed on acquisitive self-interest.

Unfortunately the NHS has moved from an organisation which valued loyalty, dedication and commitment towards one focussed entirely on acquisitive self interest. We used to have secretarial staff who felt that working for the NHS was worthwhile and that the pay was not the only thing that mattered. If Dr Grumble sees that something needs to be done he does it. Some of his younger colleagues, faced with the same problem, are beginning to ask where the money is. An organisation that was happy because it valued staff like Dr G is changing to an organisation that is sad because people only do what they are paid for.

The management consultants would say that all this is right and proper. The only way to get people to do what you want is to motivate them with pay. Every item of work must be paid for. People are expected to work for money and not love.

But it is not money that really motivates people. It is more often love. Dr Grumble has listened to soldiers on leave from Afghanistan. They talk of the horrors of returning to the front line. Doubtless they could get out of it somehow if they really wanted to. They could feign some illness or other. Or they could just refuse. Being locked up would be better than having one's limbs blown off. But they go back again and again. They do it out of a sense of loyalty, dedication, commitment and duty. They are not doing it for money they are doing it for love - the love of their comrades who need them there.

Take now your GP. Is he working for money or for love of you, his patient? Do you want him to treat your cholesterol because he thinks it is right for you? Or do you want him to treat your cholesterol because he gets paid to do it?

Suppose you need to see a surgeon? Do you want him to operate because you really need an operation or do you want him to operate because he gets a fat fee every time his wields his scalpel?

The answers are obvious. Of course your GP and your surgeon work for money. But they should also need a sense of loyalty to you, commitment to you and they have a duty to do what is right. We need a balance and things are going much too far in the wrong direction.

Dr Grumble could have enjoyed himself in the pulpit but he has had to content himself with blogging. Which, of course, is much better because the whole world can hear. But will they listen?

18 comments:

BenefitScroungingScum said...

I also thought no-one would listen. But, I've been overwhelmed by the response to my Dear Prime Minister video http://www.youtube.com/watch?v=8qagXyuEZaE, so much so that we've set up a campaign, The Broken Of Britain to provide a voice for disabled people.
The stories of how people have struggled to work are heartbreaking and hold a mirror to modern Britain.
http://thebrokenofbritain.blogspot.com/

Thanks for speaking out too, BG

Dr No said...

Despite rather different purposes, the Armed Services and the National Health Service have much in common. The are both services, and services don't make money, they cost money - a point Mrs Hacksaw and her BATman never understood (and let us not forget when and where the modern monied evil began). Once the suits had their feet in the door, there was no way of keeping them out. Cash would be king, money would rule, and all would know the cost of everything, and the value of nothing.

A few months ago Dr No did his on take on the importance of belonging here. Such matters may be soft subjects, incomprehensible to suits, but they are the glue that holds the whole together. Destroy the invisible glue, and it all falls apart.

Anonymous said...

"The management consultants would say that all this is right and proper. The only way to get people to do what you want is to motivate them with pay. Every item of work must be paid for. People are expected to work for money and not love."

Is it really fair to blame this mentality entirely on management consultants?

A cursory look at the comments pages on GP rags like Pulse would suggest that the doctors are more interested in what income they can get rather than how they can improve patient care. Every article detailing new changes is met with comments along the lines of 'and what pay will we be getting for this?'

the a&e charge nurse said...

One of the effects of competition and markets in health has been a division between those who feel a certain amount of loyalty to the founding principlesof the NHS, and those 'go-getters' who are continually jockeying to keep themselves one step ahead of the game (a game which has certain air of inevitability about it)

Put another way, NHS staff are using most of their energy nowadays to fight local battles (such as branding your A&E department in such a way that it is preferred to a neighbouring one when both are fighting to stave off closure) that few seem overly concerned about the bigger picture?

'Divide and rule', after all, is one of the oldest, and most effective tricks in the book?

Anonymous said...

Some of us can remember the time when GPs thought it was their duty to provide care to patients 24/7. It certainly wasn't the money that made them feel that way. In fact when the new contract paid them for the out-of-hours work, they mostly stopped doing it. It was duty and not money that drove them to provide such onerous care.

So, to some extent, GPs have been changed from doctors with an ethos into managers of small businesses (which they always were). There are not many small businesses that offer you something for nothing so you really can't blame them for demanding payment for extra work.

The taxpayer would appear to have been getting a better deal when GPs were paid less and had fewer hoops to jump through to get their pay. If you go back to before the NHS, doctors often provided services for nothing. This was what was expected of a doctor.

Are the management consultants responsible for this change? Along with other changes in our society, I think they are.

Witch Doctor said...

It may be that “The Big Society” is searching for the “love” ethic, in the form of “compulsory volunteers” who will work for very little or preferably nothing.

The Big Society worldwide may also be looking for “love” from the wealthy – people to do what Bill Gates and Warren Buffett are doing and can well afford to do. People like the leaders of industries and of banks can afford to “love.” People like ‘cough’ Tony and Cherie Blair can afford to “love.”

But will they find this “love” when it is contrived rather than rooted in the grass? What will happen if those with little money and many responsibilities feel they are subject to the manipulation of the social engineers in our society to donate their time? Will they embrace the “love” ethic then?

Anonymous said...

Are you sure the Blairs are wealthy, WD? I have just found this:

Penny Pinching Blair

Between her husband’s speaking engagements and her own legal practice, one would have thought Cherie Blair, wife of former British Prime Minister Tony Blair, wouldn’t be short of a bob or two. But apparently that hasn’t stopped her from trying to flog her husband’s autograph on e-Bay.

Witch Doctor said...

Glory be!

The Blairs must have altruistically given everything away to those in need and now they can't afford to buy the mince!

Maybe the bloggers could get together and form a charity for them.

Dr Grumble said...

This was also somewhat tawdry.

Dr Grumble said...

A cursory look at the comments pages on GP rags like Pulse would suggest that the doctors are more interested in what income they can get rather than how they can improve patient care.

Is it really fair to blame this mentality entirely on management consultants?
________

It is an interesting question. The answer is touched upon in this pdf on pages 6 to 8.
http://www.worldscibooks.com/etextbook/6041/6041_chap01.pdf

Referring to American doctors the author points out that the 'income' of doctors was traditionally non-economic: self-esteem, respect, selfless professionals. As medicine became a commodity these things went and doctors got paid more. But they seem to have become more unhappy in the process.

As an example, Dr Grumble used to just teach the students. He never asked for money to do it. But if you are in an environment that itemises everything you do it is only natural to demand pay for things formerly seen as a duty or even a joy. It is no way a professional should behave but it has been forced upon us.

In the Grumble view the management gurus, in trying to squeeze more from less, have done the reverse and have killed a goose that was laying golden eggs.

ZI said...

About this Stephen Fry thingy Dr G;

http://www.guardian.co.uk/media/2010/oct/31/stephen-fry-sex-women-relationships-attitude

I've always wanted to know, are all men 'Stephen Frys' deep down?

Dr Grumble said...

No, ZI. They are not all gay for one thing. But that may not be quite what you meant.

Do you think he is right about women?

ZI said...

Of course he is right, given the type of 'stuff' he's talking about! Exactly what he said in that article, I find his type of animal like stuff 'disgusting' and downright 'f*lthy'. Very wise of him to stick to his own kind because no woman on earth would subscribe to this 'stuff' unless, as he says, she's the type who gets paid! ... but then I am not a feminist and come to think of what that means nowadays, thank goodness for that?

... now, about you Dr G, your thoughts on same please ... and on romance

And I hope you don't answer me with just a 2 letter word or another question this time ...

Witch Doctor said...

My Black Cat followed your "tawdry" link and has been spewing all over the place ever since.

I told her this money in exchange for a very handsome photograph would probably been donated to those in need, but she's still retching.....

Dr Grumble said...

I am beginning to regret putting up that ‘tawdry’ link. It interested me because Dr and Mrs Grumble have discussed these behavioural differences between men and women.

Actually, ZI, I am not at all sure that if there were available women on Hampstead Heath heterosexual men would behave in the same way as the homosexuals – though doubtless some would.

As for romance, perhaps while I am in the pulpit I should be preaching that sex should be an expression of love rather than a recreational activity. But these days we are suppose to let people decide on what is right and wrong for themselves. Perhaps that's a mistake.

Of course Fry is right that women use sex as a currency. Mostly they get a long way without actually spending any money. Even old Grumble has had female medical students reach over and touch his knee when he is giving them their marks. Don’t tell Mrs Grumble!

ZI said...

"I am not at all sure that if there were available women on Hampstead Heath heterosexual men would behave in the same way as the homosexuals"

I sincerely hope not! Dare I say? I do not believe in equality either, men and women are not equal whether one believes in religion or in evolution. Both anatomies are different, psyche is different, roles are different - so why should we be equal socially?! And what is the result of this so called 'equality'?! Young men and women getting confused about the roles they are supposed to play in society, women becoming more masculine in their appearance and behaviour, such as those who will hide behind bushes in Hampstead Heath ... and women are still getting less remuniration than men in the work place despite that so called 'equality! ... and men will let the revolving doors hit a woman in her face as they walk past her not bothering to hold the door for a few seconds, pregnant women standing in buses while great big muscle infused men sit down ... etc, etc!

But I blame the women! For following all these 'feminists' and their super unnatural ideas and hope for the day that women will stand up and say enough is enough, we want to be treated like women again - we, are not equal! We can be independant, if we want to, or if we have to, because some still believe in the traditional roles but sometimes don't get that ... whatever it is, we are not 'equal'!

Those men close to me, whether friends, aquaintances, relatives, etc, still hold the door for me and sit me first. I don't ask or force them to do so, it is the way you behave as a female that decides on these 'little' things and men usually react accordingly - and I hope to see this coming back, en masse!

"Fry is right that women use sex as a currency."

Wrong! Decent women don't - those women who do that are usually after 'any' man for his money so romance or love has no place in the deal anyway - and usually the men who court these women know exactly where they stand!

"Even old Grumble has had female medical students reach over and touch his knee when he is giving them their marks. Don’t tell Mrs Grumble!"

... I was wondering when would that come in .... :-)

Would Mrs Grumble 'dare' say the same?! See, you have just proven my very point! Men and women are NOT equal - and thank god for that!

Dr Grumble said...

"Fry is right that women use sex as a currency." Wrong!
______

It depends perhaps what you mean by sex. Substitute 'female charms' and I think that men can feel very manipulated by women. But this occurs much less than it did. I am thinking of the young girl with the fluttering long eye lashes trying to get Dr G to fix the photocopier etc. There is a sexual undercurrent to it all.

Dr Grumble's mother was a doctor. She always said that she would never want a female anaesthetist. She was brought up to believe that women were no good in a crisis and would just collapse in tears. Nobody would dare say that now and I don't see much evidence for it. My young female next door neighbour is an Army officer and has described bombs raining down on her. She is the boss.

I have though discovered that many of our junior female doctors get home from work and cry. I know because I have asked them and they have told me. I am ashamed to say I didn't ask the men the same question - mainly because it never occurred to me that any man would do that. Another reason could have been that no man would admit to it.

Of course women and men are very different but our culture has also turned women into a weaker sex than they really are. In some ways I think they are tougher than men.

As for the key question about women's enjoyment of sex, I am reminded of Mrs Grumble's patient who told her, "My husband is very good. He doesn't bother me much." It's worrying that she knew what she meant.

ZI said...

"Substitute 'female charms' and I think that men can feel very manipulated by women"

;-) yeah, but that the idea, what nature intended, isn't it?! ... and you have your ways too, don't forget that! Actually, this 'equality' business is eroding that natural charm between the gendres ... result? The rise in singleness due to inability to 'charm'! Very sad! I bet if we started 'teach'm how to charm' classes we'd make a foooortune ... it's that bad! ... especially amongst scientists of both sexes, eh?

"My young female next door neighbour is an Army officer and has described bombs raining down on her. She is the boss."

And society has come to admire that, while a woman who chooses to stay at home to take care of her man and children proper and raise a generation who would contribute postively to society is looked down upon as 'merely a house wife'! Stereotyping the later as a a near illiterate dumb woman in leggings with a push chair in one hand and an ice cream in the other! Explain please

Incidently Dr G, how would you feel if Dr Mrs G wake up tomorrow to tell you she doesn't want to work anymore and will live on what you bring home, but will also promise to attend to yours and the children's needs in everyway so, for example, you won't have to iron your own shirt in the morning and find your meals ready ... etc? Would that make her defficient in your eyes because she will be letting go of her status as consultant doctor? ... or even thinks it?

"many of our junior female doctors get home from work and cry. I know because I have asked them and they have told me. I am ashamed to say I didn't ask the men the same question - mainly because it never occurred to me that any man would do that. "

But that's genetic! Women are easier to shed tears than men since time began, why should that change?! ... and I wouldn't like to see my boys crying like girls either! As for the girl, mine does sob her heart out like her mother when she needs too, but at home, because you can't do that professionally, nor can I in public - there is a balance for everything.

... maybe the reason why doctors never show their emotions, because other doctors will straight away 'diagnose' them as depressed, suicidal and hence, not fit to practice? ... I have had this happen to me ... and found it really bemusing! Diagnose, diagnose, diagnose, let go sometimes, give us a break! @@

"our culture has also turned women into a weaker sex than they really are. In some ways I think they are tougher than men. "

Shshshsh ;-)

""My husband is very good. He doesn't bother me much." It's worrying that she knew what she meant."

Maybe there is something wrong with him, or her ... or maybe that's how it suits them both, who knows? Not everything is black and white after all!

:-)