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Dodgems or doctors, training or education?

BMJ 1995; 311 doi: (Published 11 November 1995) Cite this as: BMJ 1995;311:1309
  1. Alan Munro, general practitioner
  1. in Beauly, Invernessshire

    The NHS has been tolerably effective in making the fruits of technical medicine widely available. But there is much of which I am less proud. Sir Douglas Black has described the difference in health between rich and poor, others have shown that the difference is increasing. International inequality is an even more onerous indictment but we have taken no effective action. We still have tobacco advertising and political parties conceal from the electorate the extent to which they are funded by the tobacco and alcohol industries.

    We have been seduced into taking responsibility for happiness. Doctors offer alternative utopias alongside tested or at least rational remedies. We fail to insist on bearable terms and conditions of work for our junior colleagues and for ourselves. Doctors have long been aware of unsustainable annual increases in the cost of medical services but they feign surprise when budgets are controlled. When the NHS is assaulted by the ethics of the bazaar the profession flounders.

    We are good at getting on with seeing patients but oblivious to the implications of our bustling about. We stop to ask neither what we should be doing nor what …

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