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.