Monday 27 February 2012

The prelude


DZ has often mentioned that he has been in the NHS a long time. He can remember what the profession was like in the 1970s and 80s. He has seen many changes. Some of these, like the introduction of controls on the working hours of trainees represent a huge improvement. 

It is possible that my recollection of those days is distorted but I remember a great sense of cohesion, from individual medical firms, to the profession as a whole. GPs and consultants were far closer then than they are now, and direct communication was far more common. Many knew each other personally. Clinical autonomy was strongly preserved and management kept out of clinical matters. Consultants consistently worked way over their contractual obligation without complaint or resentment because the work was satisfying and gratifying. Consultants felt valued. Morale and motivation were high. The profession enjoyed great popular respect.

This made them, as a body, very powerful. This in turn inevitably made the politicians distrustful. In my next post I am going to present a little guide. A guide to politicians and managers on how to demoralise and demotivate such a great profession. 

2 comments:

  1. "Consultants consistently worked way over their contractual obligation without complaint or resentment because the work was satisfying and gratifying. Consultants felt valued. Morale and motivation were high. The profession enjoyed great popular respect"

    Teachers of the same generation feel the same way. From public spirit and enthusiasm to drudgery and despair (forgive cliche).

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  2. Your mind is not distorted. Your recollection is spot on. That is the way it was.

    I recollect a conversation with someone very close to HMG some quarter of a century or more ago. I was told politicians of all parties felt the medical profession was too damned powerful and the aim was to make them less so.

    Slowly but surely it has come to pass. Some may feel that is a good thing, but ill witches would much rather be treated by consultants whose morale and motivation was high and whose prime concern was not their pensions but the individual patient in front of them.

    But is not all the fault of successive governments. Doctors themselves, little by little have allowed themselves to creep into crazy situations. For example who in the 1970's would have believed that not only did GPs and consultants rarely communicate but even a referral letter about a patient was highjacked by a third party.

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