I have just returned from a weekend in the the West of Ireland, staying with my brother Alun, and his wife Sue, in their home called ‘Penglas’ — a little piece of Wales, surrounded by the magic of West Cork. The view from Penglas is shown above.
We talk rugby (naturally) — and I will avoid Saturday’s result (‘counts for nothing in the long run, bach.…’) — but because Alun is an ex-dentist,and for a number of years a dental business coach and consultant to dentists and other players in dentistry, we talk dentistry and medicine.
The parallels between what has happened to UK dentistry and what has, and might happen to UK medicine, have always interested me. The government, for all sorts of reasons, have got away with things in dentistry that they would like to do to medicine, and in turn, the dental profession has failed to outwit the dark forces of central government. There are perhaps lessons to be learned. Some thoughts.
- Despite words to the contrary, the major political parties in the UK want to privatise whole swathes of healthcare. Nye Bevan and Harold Wilson may have resigned over the introduction of charges for spectacles, but most politicians are unable to believe that there are any alternatives — or at least that is what they tell themselves. TINA.
- Decision making is corrupted by on the one hand ‘compatible scholarship’ produced by the universities; and the revolving doors between those companies that pay politicians (as in fund political parties), and those people who move between government / NHS positions and the work for industry. Their opinions those of their masters.
- The private drivers are not about building responsible and credible long term businesses but are based around yet more financialization. So, private equity etc / debt / 2008 all over again
- I think neither of us is convinced that those tasked with educating the next generations of dentists (or dentistry related AHP) have thought hard about their responsibilities in terms of what sort of career there will be available for their graduates. Not so much meliorism, but a failure of critical scrutiny. Bums on seats, and a lack of moral integrity. Morality always loses out to institutional survival.
- Expect more and more of health care — especially from what might be called the periphery — to be removed from free provision.
- The commissars will keep saying everything is ‘world class’, when all the evidence points in the other direction.
- Nobody knows a way for Excel spreadsheets to reflect clinical expertise. So, everybody is an identical widget. Not so much ‘the drugs don’t work’ but ‘the incentives don’t work’.
And below is the view from Casey’s in Glandore, after a couple of pints of Murphy’s. And sadly, my phone is not doing it justice. BTW, Casey’s, a bar that has been in existence for close to 200 years. That is is a credible business model, but not one based on financialization.