As we take a step back from the events of the summer, perhaps now it is possible to look rationally at the effects of the alleged terrorist attacks in Glasgow and London on the medical profession in this country.
Firstly, we need to recognise that the issues are those of criminality and global politics and are in no way medico-legal or related to overseas recruitment procedures. We must not succumb to the blind panic that overtook government and regulatory bodies following the Shipman revelations. As a consequence of this ethos, a lawyer specialising in medical negligence was put in charge of the investigation and with stunning intellectual laziness, promptly succeeded in conflating criminality with competence issues. Dame Janet Smith has done a lot of good things in her career, many of which I hugely respect, but on this central point, I believe she was simply wrong. The GMC caved-in and implemented a highly prescriptive system of revalidation, regardless of the irony that Shipman would be highly likely to have passed such an assessment with flying colours. Similarly, following the aborted attacks on Glasgow Airport and central London, in which a few doctors are alleged to have been involved, xenophobia overcame logic, with hysterical calls for the GMC to look at recruitment procedures for overseas doctors. This same, stereotyping mentality resulted in a wholly innocent man in Australia being incarcerated for weeks-on-end while the authorities there systematically lied in a way redolent of the Metropolitan Police in the De Menezes case. In my opinion, the real focus of our attention in this morass should be the dynamic between the law enforcement, security and intelligence services, and the media in the UK. Above all, as doctors, we are rational, humanist beings — this is the basis for all science — and in the framing of policy we, and our organisations, must not succumb to hot-headed populism disguised as ‘concern for patient care’. Through logic, do we retain our humanity.
Secondly, over the past 20 years there has been a sustained corporate attack on the values that underpin the NHS. Now we see supermarkets being brought in to colonise primary care. Management speak dominates the discourse, divide-and-rule is the modus operandi and drug company research rules the roost. League tables and other punitive measures are manifestations of the pathological culture of bullying and intimidation that defines transnational capitalist structures. Many diseases of affluence are actually diseases of corporatism.
A few weeks ago, a colleague of mine in Glasgow was stabbed in the middle of her morning surgery. Are we now going to suspect all patients and install CCTV in our waiting and consulting-rooms? No, of course not. Bad eggs do bad things, whether they are priests, patients, accountants, or doctors. The anti-doctor atmosphere generated by a largely right-wing press perennially hostile to what they regard as the last bastion of socialism in this country (but which more accurately is a pillar of rational humanism) helps to deflect anger away from the sources of power. The GMC needs to develop some steel in its spine and we all need to stop being defensive. Otherwise, we risk playing into the hands of those who care nothing about the health of nations. To paraphrase the old song: Let's not be fooled again.
- © British Journal of General Practice, 2007.