Mad Medicine

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This new book by local retired rheumatology consultant Andrew Bamji is an entertaining, thought-provoking and depressing reflection on the National Health Service over the last few decades.  At a time when all political parties appear to be guaranteeing its future, almost without questioning the structure or underlying philosophy, this book reminds us of issues such as mismanagement, misdiagnoses, and shortages of staff which pervade some areas of the service.

The sub-title of the book is “myths, maxims and mayhem in the National Health Service” and these are illustrated by an extensive collection of hard evidence (very well referenced) brought to life by case studies and anecdotes.   Although, of course, details differ, many issues can be transferred to other professions such as education and social work.

Complaints about “too many managers” are common throughout accounts of medical practice including this one.   Andrew sums up the argument thus: “Once was the case that clinicians decided how to run their service and managers facilitated; now doctors find ways to meet management targets set by the managers (or politicians). What surprises me is how the new generation of doctors do not seem to have a problem with this; they obey like sheep.”(page 49)

The author is sufficiently self-deprecating to realise that he may be regarded as an old fart (although I’m not sure he really believes that!) but his examples of outrageous managerial practice really convince the reader that the doctor knows best on the whole.   I suspect that all professions suffer from distance between generations, just as in the general population. Sometimes we have to trust to future practices. After all, they have taken us from the caves to the skyscraper, or from leeches to clinical blood transfusion. Andrew Bamji’s book, however, as well as being entertaining and containing local references, really makes us re-evaluate many of our own, long held, beliefs about illnesses and treatments.

The book is available online from Amazon.

Image Credits: Andrew Bamji .

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