If you are a member of the Medical and Dental Defence Union of Scotland (MDDUS) you will receive their quarterly publication ‘Insight’ which arrived through my letterbox this week.
It is a good publication.
In this quarters edition there is an article written by Joanne Curran who is the associate editor on the subject of Mandatory Service that seems to have reared it’s head yet again in the NHS.
So first let me frame this with some historical context.
I was the Chairman of the Local Dental Committee in Nottingham in the late 90’s and early 00’s when people talked about the mythical land of ‘local commissioning’. Most of my colleagues at that time said it would be utterly impossible and dental money would remain, there would be no risk to dental services because it would be a political bombshell.
Well here we are, further down the line, local commissioning is it and dental money is going fast.
And so to mandatory service, Jeremy Hunt (have to be careful to spell that correctly!) now has a bee in his bonnet about the cost of educating doctors and the fact that they are leaving the profession early, either to do something else or to go to another country.
This fascinates me in philosophical terms because Jeremy Hunt is a Conservative and clearly quite right wing. Jeremy Hunt would be a subscriber to the ‘free market’ he would suggest that interference from the government should be minimised and market forces should apply.
Assuming that is the case why do you think the doctors are leaving the service? The answer to a capitalist would be to improve the service or improve the conditions. It would be to keep the most important asset that would be the doctors (and incidentally the nurses, the radiographers, the pathologist and everybody else that works in the health service). It seems very much like the Conservatives want to have it both ways. They won’t to strangle the service through reduction in funding making it the worst place to be and if there is a better offer for the assets (the people) to go somewhere else they won’t to control that too. But to control the assets is socialism. To conscript medics is nationalisation.
Why would I be remotely interested in this and remotely interested to write it in a blog?
Well the reason for this is that dentistry is a sub set of medicine and in fact conscription and mandatory service could be much easier applied and much easier justified to the dental profession.
It is extremely expensive to train a dental graduate (more than to train a doctor) and dentists leave the NHS service much more quickly that the doctors do.
It is ok for me because I did my mandatory service in the NHS for many years so I can take the moral high ground on this if I choose to support it. I think, as with all these things there has to be ‘legitimacy and authority’. If you want mandatory conscription in service then it must go across the board and the first place it must go is the lawyers. By all means impose mandatory service to the medical profession but not before you have insisted that all lawyers have to work within the legal aid service on legal aid wages for their first five years.
Blog post number: 1390
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