A doctor's primary duty when undertaking their activities is to do no harm.
The primary duty of a government employing them is to make sure that they can work in ways that mean that they need not cause harm.
Then, and only then, is a doctor personally accountable for their decisions.
Right now the UK government has, through its own negligence, decided to put the lives of doctors and other medical staff at risk by not supplying them with the PPE that they need.
And what the means is that not only are doctors putting their own lives ta risk - which we should not be asking them to do - but that they are also putting the lives of all those they move between in hospitals at risk, and that they are also putting their families and others that they meet in the community (and yes, the go shopping like the rest of us, where they will meet people) at risk as well.
A point will be reached - and I suspect it will be very soon - where doctors will say that the balance of those risks has shifted and that it would better for them not to work than to do so. The overall risk to society will be reduced by them not seeing patients in hospital.
Of course, people will die as a result. That is undeniable.
But the question of judgement is whether more will die as a result of doctors seeing those who are ill in hospital, and that might well become the case.
When that happens the consent that a key profession provides to this government will have been withdrawn.
But no one should see this as political. This is about duty.
The doctors would be honouring theirs.
The government has not honoured its.
And risk has to be balanced in that context.
Only one party is responsible for this mess. And doctors and the other medical and support staff they work with should not be asked to die in this situation.
The minimum duty of a government is to be competent. This one is not. And the price of that should be high. But doctors and other NHS staff should not be asked to die as a result.
Thanks for reading this post.
You can share this post on social media of your choice by clicking these icons:
You can subscribe to this blog's daily email here.
And if you would like to support this blog you can, here:
Perhaps more doctors could work on the 111 NHS telephone advice service if the conditions in hospitals are too dangerous. More nurses diverted to home care. Have a ministry of vital medical supplies similar to Lord Beaverbrook’s role in WW2 for armanent production.
If the doctors and other members of the medical profession withdraw their labour, it will be them who the Government & the MSM will blame and vilify. ‘Holding the Nation to ransom’. Just like any previous strike by any section of the working class.
I personally don’t think they will any more
Not if the PPE has failed
People know they would not go to work in this situation and cannot expect others to do so
I hope you are right Richard. But we are asking our politicians to take 180 degree turn of policy and practice. Policy and practice that their donors may not approve.
The simple response to “keyboard warriors” who attack medical staff who are no longer prepared to work in coronavirus ICU’s without adequate PPE is to ask if they would be prepared to risk their lives in such circumstances!
When I worked for an electricity board as an engineer I used to issue “permit to work” certificates on 11kV and 33kV systems. I personally used to certify that the system was dead and safe to work on – this all preceded by extensive switching testing (is it really dead) and on-site earthing.
Doctors without the appropriate PPE is analogous to me telling linesmen: “you don’t need to put up earths on this 11kV line, it’s dead take my word for it (even though I have not tested it)”. Their reaction would be to first laugh at me and then call a couple of doctors to have me sectioned under the mental health act.
Given the PPE situation, there is a case to have government minsters sectioned under the mental health act, their actions (or lack thereof) go far beyond mere incompetence and extend into the realms of insanity.
Agreed
I have to say that this has crossed my mind too.
It would be a very brave thing to do. But it would have to be (1) consistent and (2) very well organised.
Basically the way it could work is for enough doctors to be working for the supply of PPE to last, based on a ratio of PPE to doctors/nurse at work. The rest of the doctors/nurses could be outside on some sort of picket line, refusing to die because it would affect the service.
The potential for consequences though is horrendous – for the infected, the medical profession and the NHS because what must be considered is that this is now a one party state.
And no other modern party knows how to hold a grudge better than these Tories. I tell you – ‘nasty’ does not describe them well enough.
Could someone please provide me with some answers to a couple of things I don’t understand about the PPE issues.
– My understanding is that procurement & distribution of PPE is undertaken by the NHS Supply Chain, who ‘source & delivery healthcare products’ yet this is never mentioned. It seems to jump straight from doctors to ministers with no NHS management involved, who should at least respond to the complaints.
– Similarly, I believe the PPE required is already purchased & therefore the Supply Chain should have existing suppliers etc.
They seem to have shown a remarkable inability to think that the supply chain needed expansion
That’s the problem of a decentralised NHS denuded of resources
This is a political problem
NHS Logistics is private. It would be interesting to have some information about how much they are busy securing profit and how much they are focused on doing the job as they appear to have been incompetent.
By ‘they’ I assume you mean the government & not NHS Supply Chain management?
NHS Supply Chain is a centralised operation for England & Wales.
I still think the senior management have some questions to answer, I don’t think the ‘denuded of money’ arguments hold unless they confirm shortage of resources.
One thing to be clear about is that this refers to England. Scotland has been making its own arrangements and currently does not have a shortage of any particular PPE. For example, a 747 full arrived at Prestwick Airport from China on Saturday.
The way England has been running this affair reminds me of GOSPLAN, this was the USSR Central Planning Ministry which was supposed to come up with and then administer the Five Year Plan. It was always a bit of a disaster. So Whitehall carries out an analysis to decide on what PPE might be needed per year or whatever. This follows asking those in the field, i.e. the Trusts, but bearing in mind that gold stars are awarded for minimising your estimates. Whitehall then collates all of this and probably slices a bit off the total to show the Minister how efficient they are being on driving down costs. Then they place contracts with the cheapest possible supplier who is furthest away, so China. Now corona arrives but the 5 Year Plan does not allow for exogenous shocks. So nothing much happens because Whitehall thinks all is hunky dory and ‘on plan’ while those at the coal face don’t want to rock the boat as that is bad for your career. So it is only when there is a crisis out in the Trusts that anyone will stick their head above the parapet at which point it is all a total shock to the central planners who now run about like headless chickens because you can’t change the plan without a new data trawl and in any case we are not supposed to be doing that until next year when we start work on the next Plan. Admitting the Plan has broken down will go down very badly with the Politburo and Uncle Joe might well have a few folk shot pour encourager les autres.
So you can probably see how all this works. Keep your head down, pretend everything is wonderful and hope somebody else gets picked for the firing line. Eventually it becomes obvious but even Uncle Joe could not shoot everyone.
At the 1938 Party Congress the delegates did a standing ovation for Stalin that lasted over two hours as nobody was willing to be the first to stop clapping.
Your analysis of the failure of the NHS system – a Lansley creation – is almost certainly right
@ Timothy Rideout
Beautifully and incisively put:)
“At the 1938 Party Congress” – was that the 17th Congress in 1934, after which Kirov was assassinated and the purges get into their full swing, or the 18th Congress in 1939?
I suspect you are thinking of the (undated) anecdote in The Gulag Archipelago, which is said to be at a district party conference in Moscow Province, at a “obscure small hall unknown to the Leader”. The first person to stop applauding, after 11 minutes, the independent-minded director of a paper factory, was arrested the next day and sentenced on some pretext to 10 years in the gulag, and told “Don’t ever be the first to stop applauding”. (The anecdote is attributed elliptically to “N. G—ko”.)
Some recent context, in relation to Trump’s desire for standing ovations, here: https://www.washingtonpost.com/news/rampage/wp/2017/10/26/dont-ever-be-the-first-to-stop-applauding/
A new contract was awarded to Unipart- previously with DHL to provide NHS Logistics as part of the NHS Procurement System.
“This contract award (to Unipart) represents the final piece of the jigsaw in shaping the new NHS Supply Chain.
The new operating model involved the creation in April 2018 of Supply Chain Coordination Ltd as the management function for the model, which is expected to deliver some £2.4 billion savings over five years.”
https://www.logisticsmanager.com/unipart-wins-730m-nhs-logistics-contract/