Intended for healthcare professionals

Rapid response to:

Letters Feeling safe working on front line

Doctors faced with impossible rationing decisions must seek legal advice

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n458 (Published 22 February 2021) Cite this as: BMJ 2021;372:n458

Rapid Response:

Re: Doctors Honesty about rationing

Dear Editor
What a pity that the politics and politicians preclude the honest debate demanded by Mr Stevens over 7 years ago. Since nobody other than the professions recognises rationing, it has to remain covert until things get much worse. Enoch Powell recognised this in his book Politics and Health which Richard Smith described as "The best book written abotu the politics of the NHS".
How much better to have a debate about the choices in methods of rationing, and how to achieve the best ethical outcomes. Even your author Kar declined to use the word, and has not responded to my reply 11th November.
https://www.bmj.com/content/371/bmj.m4315
Kar says that patients deserve honesty about the limits of the NHS.1 To quote Enoch Powell: “The worst kind of rationing is that which is unacknowledged; for it is the essence of a good rationing system to be intelligible and consciously accepted.”23

If we continue with the collusion of denial between politicians and media, and assuming that technology advances faster than (any) government can keep up with, we are heading for a two tier system once again, as before 19

Competing interests: No competing interests

28 February 2021
Roger Burns
Retired GP
Welsh Health Service Victim
HILL LANE