Power and Control in Healthcare

The polarised debate in England about the future of the National Health Service is, at its heart, about power and control.

The British government intends to eliminate layers of bureaucracy and a system of centralised direction, replacing it with one whereby the patient and his/her doctor chooses what, how and whence any necessary care is provided, and budgets are managed locally. The plans have aroused huge opposition from unions, opposition politicians and many medical bodies most of which have a vested interest in maintaining the status quo whereby jobs are saved, positions of visible authority are preserved, GPs have little autonomy, and the individual has minimal say over his or her health treatment.

The present situation reminds me of certain long-established religions where members are expected to communicate with their God directly through appointed representatives, often a priestly hierarchy, and where rituals of belief, action and conformity are required. This is power and control visibly in action and the same template can be fitted perfectly onto the British Health Service, and probably many medical systems throughout the world.

I welcome freedom of choice, thought and deed in every situation and while I recognise that the proposed changes to a costly, cumbersome system have their risks, I applaud the opportunities they will bring to simplify and modernise and, most importantly, to empower people and to return a sense of local community to health care.

Because I live in Wales I will be unaffected by this since it applies only to England, and I am rather sorry that I will not experience the changes first hand. I will watch the roll-out with the greatest interest, and wait to see how my Celtic home land responds.