Intended for healthcare professionals

Rapid response to:

Analysis And Comment

Democratic control is essential

BMJ 2006; 333 doi: (Published 27 July 2006) Cite this as: BMJ 2006;333:251

Rapid Response:

Everything related to human activity can be called politics

Those who dab in public discourse are often accused of indulging in
politics. The difficulty with a pure political solution is of course the
fact that it is based on the rule by the majoirty. How many would vote for
the needs of the little baby with epilepsy, the child with complex needs
or the youngster with neurobehavioral problems? We already have
difficulties in attracting funds to many Cinderella specialities and if
even the limited clinician led funding we currently have is closed down we
may be left with the battle of the support groups.

I agree with the need to reform the executive based decision-making.
This is often based on the premise that the person concerned has the
ability to appraise, assess and evaluate complex medical requirements as
well as qualities needed in every speciality. We are of course then left
with higher marks for vague concepts like "team working" and
"communication skills " as defined by the establishment.

As a minority doctor in a small sub speciality but hopefully with the
required skills I fear for the future of the children under my care with
rare diseases whose treatments may be expensive but worthwhile.

Jayaprakash A Gosalakkal

Consultant Paediatric Neurologist

Competing interests:
Consultant in a sub speciality and President of an EMD organization called UKAID

Competing interests: No competing interests

01 August 2006
Jayaprakash Ayillath Gosalakkal
Consultant in Paediatric Neurology
University Hospitals of Leicester