Intended for healthcare professionals

Rapid response to:

Head To Head

Will a market deliver quality and efficiency in health care better than central planning ever could? No

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c1302 (Published 10 March 2010) Cite this as: BMJ 2010;340:c1302

Rapid Response:

Please, no lesson on morality to the Afgan doctors!

Why Tomlinson choosed Afghan doctors for promoting his opinion on
market deliver quality?
Long ago the famous author George Bernard Shaw closed the discussion: “That any
sane nation, having observed that you could provide for the supply of
bread by giving bakers a pecuniary interest in baking for you, should go
on to give a surgeon a pecuniary interest in cutting off your leg, is
enough to make one despair of political humanity.”(2) Shaw also gave the
solution in his 14 points conclusions: “Nothing is more dangerous than a
poor doctor: not even a poor employer or a poor landlord.”

Tomlinson’s description of the Afghan doctors is based upon a very
limited personal experience and lacked references. It contrasts with a
recent report from the United Nations Office on Drugs and Crime showed
that doctors and nurses are among most honest public officials.(3) The
percentage of adult population who paid bride after contact is less than
25% for doctors or nurses and more than 50% for prosecutors, judges,
police officers… The average value of brides paid being respectively 60-70
$ and 220-230 $.(3 Fig. 10 and 11)

1 Tomlinson J. Will a market deliver quality and efficiency in health
care better than central planning ever could? No. BMJ 2010;340:c1302

2. Shaw GB. The doctor’s dilemma: preface on doctors. 1909. Project
Gutenberg ebook. http://www.gutenberg.org/dirs/etext04/dcprf10.txt
(accessed 17 March 2010)

3 United Nations Office on Drugs and Crime. Corruption in
Afghanistan. Bribery as reported by the victims. Jan 2010
http://www.unodc.org/documents/data-and-analysis/Afghanistan/Afghanistan-
corruption-survey2010-Eng.pdf (accessed 17 March 2010).

Competing interests:
None declared

Competing interests: No competing interests

19 March 2010
Alain Braillon
Sacked (BMJ 2010;340:c711)
80000 Amiens