BREXIT: DEMOCRACY IS COUNTING HEADS REGARDLESS OF WHAT THE HEADS CONTAIN
It is a source of constant amazement to me how often brilliant, very brilliant people step outside their area of expertise to pontificate on things they are not equipped to speak authoritatively about. The sight of Nobel Prize winners queueing up to demand audience re the EU Referendum, of Archbishops urging their flock how to vote, of reputable Editors of the BMJ lecturing doctors what to do – all this tells me that brilliant as they all are they do not know that the agreed rule for conducting the Referendum was something called Democracy whose best definition is counting heads regardless of what the heads contain. Simply put, if Remain heads are outnumbered by Brexit heads then the game is over regardless of voters’ brain sizes.
DEMOCRACY CAN BE PAINFUL FOR SOME PEOPLE
Brilliant Margaret McCartney calls the aftermath of the Referendum messy, and she is “heart-broken” [1], while another BMJ Editorial brilliant performer who because of what he calls “mindlessly inflicted self-harm” plans to emigrate post-Brexit [2], but Goh Shyan speaking from far away Australia accepts the above definition of Democracy: “The people have spoken, like it or not” [3] This is not the first time democracy has infuriated intelligent people. Prime Minister Winston Churchill was rejected after winning the Second World War. Prime Minister Margaret Thatcher was rejected by a democratic decision of her Conservative Parliamentary Party. Winston Churchill might have considered it ingratitude for the British people to throw him out democratically, but he is alleged to have been the one who said “Democracy is the least bad of all the systems”. Those of us who once lived in a country where democracy was either subverted by soldiers or undermined through international intrigue, are greatly appreciative of the British system which (as the late Tony Benn was never tired of preaching) can “periodically throw out those you have elected to rule over you”. And as regards objective, intelligent, discourse on British and World Politics I miss the likes of Bernard Levin (The Late) and Lord William Rees-Mogg (The Late). In analysing what is happening right now, these two would have been head and shoulders above the present Commentators in the medical and non-medical press. They knew what Democracy was all about.
DAVID CAMERON’S NEW EU UNIT: WHAT EFFECT ON UK MEDICAL PRACTICE?
In his House of Commons EU Statement on Monday 27th June 2016 the Prime Minister announced formation of a New Government Unit to examine “all the complex issues” resulting from Brexit including (and this was what startled me at precisely 4.15 pm during his speech) “examining which British Laws need to be rewritten” [4]. How many, I thought instantly, of these British Laws have a Health Dimension? There are literally hundreds of EU Regulations and Directives constituting Legislative Acts some of which relate to Health [5].
DO EU REGULATIONS WORK AGAINST PROVEN BRITISH HEALTH FINDINGS?
I could give (but will not) example after example of recommended UK Medical Practice Directives in recent decades which I considered not only inimical to the patient’s welfare but which also directly contradicted what Clinicians who looked after the British Royal Family taught me at Westminster Hospital School of Medicine in Horseferry Road London SW1. It suddenly struck me during Mr Cameron’s Commons speech on Monday that some of the UK Health Directives and Regulations which I considered very odd could have come from Brussels. Even Research: Who would have thought that any of my eminent British teachers would have countenanced a scientific research project of sending teams around the world to do global gene sequencing ANONYMOUSLY? [6 7 – The capitals mine]]. Only the European Union, I thought, could have got away with such a ridiculous scientific project. Also do some of the NICE [National Institute for Clinical Excellence] Directives have fingerprints of Brussels on them? Do we not have enough geniuses in the UK to take care of our health needs and we must take Directives and Regulations from elsewhere? When Mr Cameron considered “which British Laws need to be rewritten” [4] might he also have in mind some Health Related Laws?
FINANCIAL PROFIT FIRST, PATIENT WELFARE SECOND?
Of course, without money all health initiatives must be inadequately pursued, but I felt very uncomfortable reading parts of “Review of the Balance of Competences between the United Kingdom and European Union: HEALTH” [5]. Why my discomfort? ANSWER: I was struck by how many times the word “stakeholders” appeared in that document in contrast with the paucity of any reference to patients and patients’ welfare. Do the NICE Guidelines that I have criticised before on the basis of the fact that patients have died through them [8] have anything to do with the stakeholders that keep cropping up in the EU document [5]? May the EU laws that the Prime Minister hinted needed rewriting include some Health-related Directives and Regulations? Tamara Hervey too has concerns about impacts of European Union Law on the health care sector [9]. And where are the 21st Century British Clinicians and Epidemiologists who can advise removal of EU Regulations that favour stakeholders at the expense of patients?
GLOBALISATION GONE MAD?
I personally know some 21st Century British Clinicians and Epidemiologists who although retired from active practice, are quite capable because of their superb mid-20th Century British undergraduate and post-graduate Medical Training of diagnosing that much of present day defects in modern Health Programmes is due to deliberate push for something called “globalisation”. I have already alluded to the ghastly “Global Gene Sequencing” exercise that is being done ANONYMOUSLY [6 7], and I find it most refreshing to see that someone I have always had the greatest respect for, Professor Jeffrey D Sachs, a person who is more perceptive than most modern epidemiologists, has got it one hundred per cent correct. Brexit, says Jeffrey Sachs, “is a symptom of globalisation’s deeper ills” [10]. He goes on: “Brexit by itself will not be a catastrophe. Brexit is a rejection of globalisation as currently implemented”, and adds “Brexit, in short, is a powerful signal of deep and pervasive problems in our approach to globalisation”. [10]. Well, all I can say is to modify a Scripture quotation: “He that has ears to hear, let him hear what the voters have democratically expressed!”
Felix ID Konotey-Ahulu MD(Lond) FRCP(Lond) DTMH(L’pool) FGCP FWACP FTWAS Kwegyir Aggrey Distinguished Professor of Human Genetics, University of Cape Coast, Ghana and Former Consultant Physician Genetic Counsellor in Sickle Cell and Other Haemoglobinopathies, 9 Harley Street Ltd, Phoenix Hospital Group, London W1G 9AL
1 McCartney Margaret: Our messy divorce from the EU BMJ 2016; 353 doi: http://dx.doi.org/10.1136/bmj.i3551 (Published 24 June 2016)
Cite this as: BMJ 2016;353:i3551
6 Wise Jacqui. Consortium hopes to sequence genome of 1000 volunteers. BMJ 2008; 336: 237 (2 February) re http://www.1000genomes.org/files/1000Genomes-NewsRelease.pdf International Consortium Announces the 1000 Genome Project – January 22 2008.
8 Konotey-Ahulu FID. Management of an acute painful sickle cell episode in hospital: NICE guidance is frightening! September 7 2012 www.bmj.com/content/344/bmj.e4063/rr/599158
9 Hervey T. Impacts of European Union Law on the health care section: Institutional Overview www.lse.ac.uk>pdf>eurohealth>Hervey Eurohealth Vol 16, No 4
Rapid Response:
BREXIT: DEMOCRACY IS COUNTING HEADS REGARDLESS OF WHAT THE HEADS CONTAIN
It is a source of constant amazement to me how often brilliant, very brilliant people step outside their area of expertise to pontificate on things they are not equipped to speak authoritatively about. The sight of Nobel Prize winners queueing up to demand audience re the EU Referendum, of Archbishops urging their flock how to vote, of reputable Editors of the BMJ lecturing doctors what to do – all this tells me that brilliant as they all are they do not know that the agreed rule for conducting the Referendum was something called Democracy whose best definition is counting heads regardless of what the heads contain. Simply put, if Remain heads are outnumbered by Brexit heads then the game is over regardless of voters’ brain sizes.
DEMOCRACY CAN BE PAINFUL FOR SOME PEOPLE
Brilliant Margaret McCartney calls the aftermath of the Referendum messy, and she is “heart-broken” [1], while another BMJ Editorial brilliant performer who because of what he calls “mindlessly inflicted self-harm” plans to emigrate post-Brexit [2], but Goh Shyan speaking from far away Australia accepts the above definition of Democracy: “The people have spoken, like it or not” [3] This is not the first time democracy has infuriated intelligent people. Prime Minister Winston Churchill was rejected after winning the Second World War. Prime Minister Margaret Thatcher was rejected by a democratic decision of her Conservative Parliamentary Party. Winston Churchill might have considered it ingratitude for the British people to throw him out democratically, but he is alleged to have been the one who said “Democracy is the least bad of all the systems”. Those of us who once lived in a country where democracy was either subverted by soldiers or undermined through international intrigue, are greatly appreciative of the British system which (as the late Tony Benn was never tired of preaching) can “periodically throw out those you have elected to rule over you”. And as regards objective, intelligent, discourse on British and World Politics I miss the likes of Bernard Levin (The Late) and Lord William Rees-Mogg (The Late). In analysing what is happening right now, these two would have been head and shoulders above the present Commentators in the medical and non-medical press. They knew what Democracy was all about.
DAVID CAMERON’S NEW EU UNIT: WHAT EFFECT ON UK MEDICAL PRACTICE?
In his House of Commons EU Statement on Monday 27th June 2016 the Prime Minister announced formation of a New Government Unit to examine “all the complex issues” resulting from Brexit including (and this was what startled me at precisely 4.15 pm during his speech) “examining which British Laws need to be rewritten” [4]. How many, I thought instantly, of these British Laws have a Health Dimension? There are literally hundreds of EU Regulations and Directives constituting Legislative Acts some of which relate to Health [5].
DO EU REGULATIONS WORK AGAINST PROVEN BRITISH HEALTH FINDINGS?
I could give (but will not) example after example of recommended UK Medical Practice Directives in recent decades which I considered not only inimical to the patient’s welfare but which also directly contradicted what Clinicians who looked after the British Royal Family taught me at Westminster Hospital School of Medicine in Horseferry Road London SW1. It suddenly struck me during Mr Cameron’s Commons speech on Monday that some of the UK Health Directives and Regulations which I considered very odd could have come from Brussels. Even Research: Who would have thought that any of my eminent British teachers would have countenanced a scientific research project of sending teams around the world to do global gene sequencing ANONYMOUSLY? [6 7 – The capitals mine]]. Only the European Union, I thought, could have got away with such a ridiculous scientific project. Also do some of the NICE [National Institute for Clinical Excellence] Directives have fingerprints of Brussels on them? Do we not have enough geniuses in the UK to take care of our health needs and we must take Directives and Regulations from elsewhere? When Mr Cameron considered “which British Laws need to be rewritten” [4] might he also have in mind some Health Related Laws?
FINANCIAL PROFIT FIRST, PATIENT WELFARE SECOND?
Of course, without money all health initiatives must be inadequately pursued, but I felt very uncomfortable reading parts of “Review of the Balance of Competences between the United Kingdom and European Union: HEALTH” [5]. Why my discomfort? ANSWER: I was struck by how many times the word “stakeholders” appeared in that document in contrast with the paucity of any reference to patients and patients’ welfare. Do the NICE Guidelines that I have criticised before on the basis of the fact that patients have died through them [8] have anything to do with the stakeholders that keep cropping up in the EU document [5]? May the EU laws that the Prime Minister hinted needed rewriting include some Health-related Directives and Regulations? Tamara Hervey too has concerns about impacts of European Union Law on the health care sector [9]. And where are the 21st Century British Clinicians and Epidemiologists who can advise removal of EU Regulations that favour stakeholders at the expense of patients?
GLOBALISATION GONE MAD?
I personally know some 21st Century British Clinicians and Epidemiologists who although retired from active practice, are quite capable because of their superb mid-20th Century British undergraduate and post-graduate Medical Training of diagnosing that much of present day defects in modern Health Programmes is due to deliberate push for something called “globalisation”. I have already alluded to the ghastly “Global Gene Sequencing” exercise that is being done ANONYMOUSLY [6 7], and I find it most refreshing to see that someone I have always had the greatest respect for, Professor Jeffrey D Sachs, a person who is more perceptive than most modern epidemiologists, has got it one hundred per cent correct. Brexit, says Jeffrey Sachs, “is a symptom of globalisation’s deeper ills” [10]. He goes on: “Brexit by itself will not be a catastrophe. Brexit is a rejection of globalisation as currently implemented”, and adds “Brexit, in short, is a powerful signal of deep and pervasive problems in our approach to globalisation”. [10]. Well, all I can say is to modify a Scripture quotation: “He that has ears to hear, let him hear what the voters have democratically expressed!”
Conflict of Interest: None declared felix@konotey-ahulu.com Twitter@profkonoteyahul.com
Felix ID Konotey-Ahulu MD(Lond) FRCP(Lond) DTMH(L’pool) FGCP FWACP FTWAS Kwegyir Aggrey Distinguished Professor of Human Genetics, University of Cape Coast, Ghana and Former Consultant Physician Genetic Counsellor in Sickle Cell and Other Haemoglobinopathies, 9 Harley Street Ltd, Phoenix Hospital Group, London W1G 9AL
1 McCartney Margaret: Our messy divorce from the EU BMJ 2016; 353 doi: http://dx.doi.org/10.1136/bmj.i3551 (Published 24 June 2016)
Cite this as: BMJ 2016;353:i3551
2 Delamothe Tony. Should I stay or should I go now? BMJ 2016; 353:doi:http://dx.doi.org/10.1136/bmj.i3337 16 June 2016 [BMJ 2016;353:i3337]
3 Shyan Goh. The people have spoken, like it or not www.bmj.com/contents/353/bmj.i3551/rapid-responses 27 June 2016
4 Cameron David. Prime Minister’s Commons Statement on the result of the EU referendum: 27 June 2016 https://www.gov.uk>speeches>pm-co...
5 Review of the Balance of Competences - Publications - GOV.UK
https://www.gov.uk/government/publications/review-of-the-balance-of-comp... July 12 2012 - Review of the Balance of Competences between the United Kingdom and the European Union. PDF 247KB, 24 pages ...
6 Wise Jacqui. Consortium hopes to sequence genome of 1000 volunteers. BMJ 2008; 336: 237 (2 February) re http://www.1000genomes.org/files/1000Genomes-NewsRelease.pdf International Consortium Announces the 1000 Genome Project – January 22 2008.
7 Konotey-Ahulu FID. Sequencing genome of 1000 volunteers: Why do this anonymously? African J Health Sciences 2011; 18:37-52 52 www.ajhsjournal.or.ke/admin/current/914vpjkSBOS.pdf or http://bit.ly/1CZRIAT
8 Konotey-Ahulu FID. Management of an acute painful sickle cell episode in hospital: NICE guidance is frightening! September 7 2012 www.bmj.com/content/344/bmj.e4063/rr/599158
9 Hervey T. Impacts of European Union Law on the health care section: Institutional Overview www.lse.ac.uk>pdf>eurohealth>Hervey Eurohealth Vol 16, No 4
10 Sachs Jeffrey D. Brexit is a symptom of globalization’s deeper ills. THE BOSTON GLOBE JUNE 27 2016 https://www.bostonglobe.com/opinion/2016/06/27/brexit-symptom-globalizat...
Competing interests: No competing interests