Views & Reviews Personal View

A Reformation for our times

BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b1080 (Published 18 March 2009) Cite this as: BMJ 2009;338:b1080
  1. Joanne Shaw, chair, NHS Direct NHS Trust
  1. joanne.shaw{at}healthstrategy.org

    We are experiencing a healthcare reformation. Traditional paternalistic relationships between patients and doctors are being undermined in much the same way as the religious Reformation of the 16th century empowered the laity and threatened the 1000 year old hierarchy of the Catholic church in Europe. The Reformation had irreversible consequences for Western society; the implications of the healthcare reformation could also be profound.

    Before Martin Luther it was the custom for everyone in Catholic Europe to attend church at least weekly. Although church going was an essential part of everyday life, lay people could not participate in services in any meaningful way. Services were held in Latin, not the local language. Bibles were objects of great beauty, hand written by highly skilled craftsmen in monasteries, enormously expensive—and only available in Latin. Nearly all copies of the Bible remained in the hands of monks and priests.

    An educated priesthood was seen as essential to explain the meaning of the Bible to ordinary people, who could not be trusted to interpret it for themselves. Indeed, it was believed that if lay people were to have direct access to the word of God, misunderstanding and misinterpretation would lead to dire consequences, potentially …

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