Fiona Godlee asks for evidence without ideology, as though it were
possible either to discover or use evidence without ideology of some kind.
Scientific evidence is derived from hypotheses conceived within an
ideology, that is, a set of prior assumptions about the real world,
established by previous evidence, and/or by faith. New evidence can then
be produced by testing hypotheses derived from those assumptions against
reality. The validity of competing hypotheses, including those macro-
hypotheses about the world or society we call ideologies, depends on their
explanatory and predictive power in the real world.
About the Private Finance Initiative and the Blair government's
disintegration of the NHS into a competitive market led by consumer wants
rather by national health needs, nobody has published more evidence than
Allyson Pollock. For the editor of the Britsh Medical Journal (BMJ)to
dismiss this as led by ideology is an impertinence. Without exception,
every paper published by the BMJ starts from ideological assumptions of
some kind. That the editor's assumptions apparently coincide with those
of currently fashionable and conventional opinion does not change their
ideological nature. Readers can make their own judgements as to which
ideology has most explanatory and predictive power, either experimentally
or in the more chaotic real world of practice, which in the absence of
pilot projects is all we have to go on in assessing the consequences of
marketisation.
This is a deadly serious business. Asked to describe the nature of
the Corporate State in the 1920's, before the full consequences of fascism
were understood by comfortable people outside Italy, Benito Mussolini
answered that in his State the worlds of government and business would
become one and indivisible. Fiona Godlee should consider how far we have
already travelled along that road; and then to reconsider the ethics of
neutrality in such a situation. At the birth of the NHS, the BMJ played a
role of which its later editors were frankly ashamed. Today, when the NHS
is being buried alive, has it lost the power of speech?
Rapid Response:
No evidence without ideology
Fiona Godlee asks for evidence without ideology, as though it were
possible either to discover or use evidence without ideology of some kind.
Scientific evidence is derived from hypotheses conceived within an
ideology, that is, a set of prior assumptions about the real world,
established by previous evidence, and/or by faith. New evidence can then
be produced by testing hypotheses derived from those assumptions against
reality. The validity of competing hypotheses, including those macro-
hypotheses about the world or society we call ideologies, depends on their
explanatory and predictive power in the real world.
About the Private Finance Initiative and the Blair government's
disintegration of the NHS into a competitive market led by consumer wants
rather by national health needs, nobody has published more evidence than
Allyson Pollock. For the editor of the Britsh Medical Journal (BMJ)to
dismiss this as led by ideology is an impertinence. Without exception,
every paper published by the BMJ starts from ideological assumptions of
some kind. That the editor's assumptions apparently coincide with those
of currently fashionable and conventional opinion does not change their
ideological nature. Readers can make their own judgements as to which
ideology has most explanatory and predictive power, either experimentally
or in the more chaotic real world of practice, which in the absence of
pilot projects is all we have to go on in assessing the consequences of
marketisation.
This is a deadly serious business. Asked to describe the nature of
the Corporate State in the 1920's, before the full consequences of fascism
were understood by comfortable people outside Italy, Benito Mussolini
answered that in his State the worlds of government and business would
become one and indivisible. Fiona Godlee should consider how far we have
already travelled along that road; and then to reconsider the ethics of
neutrality in such a situation. At the birth of the NHS, the BMJ played a
role of which its later editors were frankly ashamed. Today, when the NHS
is being buried alive, has it lost the power of speech?
Julian Tudor Hart
Primary Care Group, Swansea University Clinical School
julian@tudorhart.freeserve.co.uk
Competing interests:
None declared
Competing interests: No competing interests