NHS reorganisations: who's kicking whom, who's protesting?: Will and power

doi:10.1136/bmj.333.7571.752-b

BMJ 2006;333:752 (7 October), doi:10.1136/bmj.333.7571.752-b

Letter

NHS reorganisations: who's kicking whom, who's protesting?

Will and power

The first 150 words of the full text of this article appear below.

EDITOR—Godlee laments the demise of medical professionalismin the NHS and quotes Greener, who wonders whether doctors havelost the will or power to stop believe to be vandalism.^{1 2}

They have certainly lost the power and with it, of course, thewill, because politicians have long believed, as accountableguardians of public finance, that they have a duty to cull theinfluence of the medical profession on healthcare provision.The medical profession was uncontrolled by Bevan, and thereafterproved to be a source of expanding expense. This is due to itsingenuity and the development of new treatments totally unpredictedby the Beveridge report (1942), which believed that nationalhealth care would be so good that the need for it would soondiminish.

The loss of consultant power started locally when the "cog-wheel"system was introduced into hospital management in the late 1960s.The consultant dominated "firms" were . . . [Full text of this article]

D Mark Jackson, consultant anaesthetist

Great Western Hospital, Swindon SN3 6BB dmjackson@doctors.org.uk