10 Sep, 12 | by BMJ
When I was twelve, I had a splendid bicycle. I cleaned and oiled and polished it. I looked for ways to improve it. One day, I thought I would take the Sturmey Archer three speed gear hub apart to oil it and make it work better, faster, and more smoothly for less effort.
I knew it would be a complex job, so I studied diagrams first and read bike maintenance manuals. When I was sure I knew what I was doing, I made a start. I carefully laid the parts out in a line as I dismantled the hub. My father looked over my shoulder and said “Are you sure you know what you’re doing?” and my Mother said “You’ll need to clear those parts off the table in time for supper.”
With a growing sense of wonder at the precision machining, evolved by engineers throughout the history of the bicycle, the first tendrils of doubt began to curl around my viscerae. I carried on, not wanting to look a fool, or admit defeat. And anyway, I thought defiantly, it was my bike. Who was to tell me what to do?
At supper time, I had more parts than you would have ever thought possible from one small mechanism and absolutely no idea how to reassemble the cogs, springs, washers, D-rings, sprockets, and ratchets.
Hubris and nemesis. No bike. It was time to admit to failure and ask for help. I kept the bag of parts for years to remind me.
Now Andrew Lansley has left. The NHS has been taken apart, and he has left the bag of bits in the office now occupied by Jeremy Hunt along with an act containing incomprehensible diagrams and notes indicating how it all used to work and how to get the private sector to put it back together—to work better, faster, and more smoothly for less effort.
The early signs are not good. Mr Hunt has indicated support for homoeopathy in the past. This betokens a tendency to magical thinking. My view is clear—homoeopathy is a load of Hogwarts. You can’t cure or prevent diseases with it and it is dishonest to claim successes for it should people chance to get better through the normal processes of immunity and repair.
You certainly can’t fix the disassembled NHS with magical thinking. It will take years of dedication and courage from clinicians and managers, whose protests during the reckless deconstruction were haughtily ignored. It is they who must hold on to the founding principles of a comprehensive service, funded from central taxation and free at the point of use. And these benighted souls will have to do this under a hail of protests from patients experiencing rationing in a contracting, underfunded service. It is they who are likely to bear the brunt of misery while the politicians congratulate each other, distribute lucrative contracts to the private sector, and look forward to retirement to the Lords, cushioned by privilege and private insurance.
In righting a wrong, a good place to start is in owning up. The NHS was working well. The reforms began when the ratings were at their best ever, and were pushed through despite a collapse in western economies and their banks. Just when we most needed the mechanism to work at its best to deal with the demographic time bombs of ageing and obesity, it was dismantled with arrogance and ignorance.
So, Mr Hunt, like me with my bike, you have to admit to failure and ask for help. We’re listening.
Peter Bailey is a retired general practitioner, Cambridge