sign in sign up
<<
Home , Alan Milburn, Andrew Lansley, Patricia Hewitt

ENT FEATURE

An idiot’s guide to the Ministry of Health

BY CHRIS POTTER

Neville Chamberlain on an ill-judged charm offensive

“Those of you fortunate enough not to inhabit the People’s Revolutionary

© AP Photo/ Hoffman Workers’ Collective that is Her Britannic

ow I like to consider myself a overseeing the rebuilding of the Houses Majesty’s National Health well brought up sort of chap, of Parliament and installation of the huge Service may be blissfully and was always taught never bell which many think was named after to bring up religion, politics unaware that we are N him – he was a big chap by all accounts. or (heaven forfend!) a lady’s name at Now the NHS is comfortably the currently undergoing one the dinner table. However, these are biggest employer in the Western world, extraordinary times for our profession in with a talent pool second to none in of our periodic paroxysms the UK. Those of you fortunate enough these islands. Thus if you were to appoint not to inhabit the People’s Revolutionary somebody to oversee its smooth running, of political interference.” Workers’ Collective that is Her Britannic one may expect to recruit a character Majesty’s with some experience in healthcare, may be blissfully unaware that we are free or otherwise at the point of delivery. currently undergoing one of our periodic Thus, dear reader, take a guess as to how paroxysms of political interference. It will many of the subsequent 43 Principal this sort of thing gives me the urge to no doubt have blown over by the New Secretaries of State for Health in Her storm the barricades at the Palace of Year and be completely forgotten well Majesty’s Government have experience Westminster and hoist the current before Epiphany, but for those baffled of any form of employment in the NHS. Secretary’s head on a pike. However, bystanders gazing on with wild surmise, Bearing in mind that just about every there is some good news – long before fear not; help is at hand. and Attorney General the NHS was founded, a surgeon The first Health Boards in the UK were has been recruited from the judiciary somehow found himself running the founded in 1831 and amalgamated into from time immemorial, one might expect show. Christopher Addison, later 1st a General Health Board in 1848 under perhaps 80-90% to have some sort Viscount Addison (1869-1951) qualified in the oversight of (I’m not making this of NHS background. You may thus be 1892, took the FRCS in 1894 and taught up) the Commissioner of Woods and somewhat disappointed to discover that anatomy in Sheffield from 1896. He Forests. Some might say we’ve been led not a single minister has ever performed became editor of the Quarterly Medical by various planks and blockheads ever any function in the NHS (even shovelling Journal in 1898 and Hunterian Professor since, but I’m personally not prepared mushy peas in the canteen) prior to at the English College in 1901. As a to comment. The first actual President appointment. Well fancy that. Seventeen Liberal MP he was appointed Minister of of the Board of Health, Benjamin Hall, (yes seventeen) have been lawyers, Munitions by Lloyd George during WW1, was appointed in 1854. He was to set a five ex-military, five academics, four and when the Department of Health was predictable pattern for future Health aristocrats and four union firebrands, made an independent entity in 1919 he Ministers in that he was a civil engineer with seven miscellaneous misfits, became its first Minister. However, his by trade with no discernible expertise dingbats and oddballs making up the major contribution came late in life when or interest in healthcare of any form. numbers. he was Labour Leader in the House of He spent most of his time in office Now call me old-fashioned, but Lords in 1948 and was asked to steer the

ent and audiology news | JANUARY/FEBRUARY 2016 | VOL 24 NO 6 | www.entandaudiologynews.com ENT FEATURE

“To be a Minister of Health with some low-rent humanities degree is very much (to use Raymond Tallis’ memorable phrase) to be a eunuch at the orgy.”

NHS bill through the Upper Chamber Bridgpoint Capital), against huge opposition. (Bain and Company), and Addison was a true giant of health (Cinven – owners of BUPA) all spent their politics in the UK and given his time in office paying lip service to the undoubted achievements one feels benefits of socialised healthcare whilst somehow his name deserves to be far lining up lucrative consultancies to better known. It also seems doubly undermine it in the private sector once perverse that nobody has thought to the whole tiresome thing was done with. repeat the experiment in nearly 100 The current incumbent, Mr Jeremy years of dismal mismanagement. For Hunt, is I am sure a delightful chap, to be a Minister of Health with some but I fail to see how his Oxford degree low-rent humanities degree is very much in Politics, Philosophy and Economics (to use Raymond Tallis’ memorable (shared by 35 MPs currently – only three phrase) to be a eunuch at the orgy [1]. have science degrees) prepares him One is reduced to wandering round for his role. Indeed his enthusiasm for glad-handing the troops and generally homeopathy should surely raise a few encouraging their efforts without John in a reflective moment. eyebrows. An Attorney General who any first-hand experience or useful believed in trial by ordeal or ducking knowledge to impart. would be one Enoch Powell, another of witches would probably not last Speaking less metaphorically, Harry complex and flawed character. Having long in office. Forgive me if I share my Crookshank was Secretary of State been appointed Professor of Greek at the profession’s lack of enthusiasm for his 1951-2 having served in the Grenadier age of 25 (narrowly failing his ambition reforms, but I would counsel my junior Guards in WW1. He was invalided out of to beat Nietsche, appointed at 24), he colleagues to avoid hasty action. To the armed forces in 1916 having been hit abandoned his students to enrol as a quote Tallis again – “They will be doing by shrapnel in the Dardenelles (which private soldier at the onset of WWII. By their best for sick people in the dark sounds jolly painful). He was indeed the end of the conflict he had enjoyed hours when the hostile critics of the emasculated by his wounds, and was to the most spectacular career in the profession are chattering away at dinner make a formidable enemy of Winston history of the British Army, attaining the parties or safely tucked up in bed” [2]. Churchill. The latter somewhat spitefully rank of Brigadier-General. His political Another Secretary of State and offered him a hereditary peerage in career was similarly meteoric until 1968, another bunch of crazy reforms will be the full knowledge that he was a closet when he made an extremely ill-judged along before you notice. homosexual with no external genitalia, and inflammatory speech critical of mass References judging that he was therefore quite immigration and was promptly sacked. unlikely to sire an heir. Crookshank 1. Tallis R. Newton’s Sleep (2): The Eunuch at the His name has unfortunately become Orgy. PN Review 78 1991;17(4). declined in a huff, but accepted a a byword for casual bigotry, a strange 2. Tallis R. Hippocratic Oaths: Medicine and its peerage late in life and established the legacy for an extraordinary polymath Discontents. London, UK; Atlantic Books; 2004. eponymous Crookshank lectures at the who continues to provoke strong feelings Royal College of Radiology. to this day. Little wonder then that John Having excluded the elite of the Reid famously exploded “Oh XXXX not medical world from the Ministry, one health!” when told of his promotion by might expect the office to attract the . elite of the political world. However it More recent holders of the office is widely regarded as a career-ending have been notable for their enthusiasm “poisoned chalice”, with only a single to open up NHS services to external minister progressing to higher office contractors in the private sector, only as Prime Minister. The lucky chap was to reappear after their sacking in a one , now mostly paid advisory capacity employed by remembered for his dismal record of said private providers, considerably Nazi appeasement and bringing about enriching themselves at the taxpayers’ supposed “Peace in our time” in (oh expense. Ken Clarke (Alliance Unichem), dear) 1938. It could be argued that the Steven Dorrell (KPMG), only post-NHS health minister whose (PriceWaterhouseCoopers and career survived the trauma of office Chris Potter MA, FRCS (Eng), FRCS (ORL), Consultant ENT Surgeon, “Another Secretary of State and another bunch of Torbay Hospital, Torquay, UK. crazy reforms will be along before you notice.” E: [email protected]

ent and audiology news | JANUARY/FEBRUARY 2016 | VOL 24 NO 6 | www.entandaudiologynews.com