Political Commentary
BY HENRY FAIRLIE
rrHE activities of Mr. Robert Turton are becoming almost 1 as alarming to the student of politics as they are obvi- ously intended to be to the more susceptible members of the public. A few weeks ago I criticised this publicity- conscious Minister of Health for officially advocating the use of the poliomyelitis vaccine. I argued that it is no part of the duty of a politician who is on his way through the Ministry of Health to the House of Lords to offer what is in effect profes- sional medical advice to parents whose children he does not know. In the following week the British Medical Journal devoted a leading article to the point and gave it its expert and powerful support. Since then, probably coincidentally, the propaganda on behalf of the vaccine has noticeably diminished, but Mr. Turton has burst out again this week with an enviably equivocal statement about the relationship between smoking and lung cancer. Mr. Turton, of course, is an expert on neither poliomyelitis vaccine nor lung cancer. Nor am I, and I do not intend to discuss them as such. I am again interested solely in the Minister's usurpation of the medical practitioner's duties. If we go on like this Ministers of Health will have to start taking the Hippocratic oath.
There seem to me to be three points at issue. The first in- volves the position of the Minister of Health if he gets into the habit of issuing medical bulletins. It is, said the British Medi- cal Journal, a `farcical and dangerous' position `because he cannot escape the suspicion that to some extent [he] may be influenced by political considerations. This can be said with- out calling in question Mr. Turton's sincerity. Mr. Turton and Miss Hornsby-Smith want to show the masses they are just as keen on health as Mr. Bevan appeared to be. . . .' The danger surely needs no emphasising : the danger that some future Minister of Health might, in order to achieve popularity or make his name, launch on an unsuspecting and, by then, in- doctrinated public a drug which had not been properly tested. Today it all seems harmless enough. The Minister has this week merely uttered a cautionary word about cancer-producing agents in tobacco smoke. But it is not beyond the bounds of possibility that a future Minister might, for any one of several conceivable reasons, bring all the instruments of propaganda at his disposal to bear against the doctors who had discovered that smoking was a cause of migraine or flat feet.
The second point is that it is extremely dangerous to en- courage people to look to some central authority as the fount comes, may not be as obviously horrific as Orwell described it; but if the present trends continue it will be essentially true and every field of human activity and interest will have its 136 Brother, speaking in the same accents as Mr. Robert TurtolL I am quite sure that an important battle is being fought 10 Britain just now to prevent the means of communication, the channels by which ideas reach the public, becoming centralised. The battle will only be won if people continue to believe that the freedom of thinkers and artists and of the professions i5 worth preserving. This freedom is not threatened directly; 110 one is going to try to censor the British Medical Journal or the Lancet. It is threatened by the growing assumption that it i5 possible to erect above the professional man an omniscient omnicompetent authority, a Big Brother who can do no vvronS. On the same day as he made his statement about smoking' Mr. Turton told the House of Commons that it would be Pre. mature to make any changes in the National Health Service at the moment. This struck mews an odd and revealing coiner dence. Most people are agreed—and, in opposition, Conserv3' tives were agreed also—that the success of any health service; depends on the efficiency of the general practitioners.
medicine depends on the doctor knowing his patient ideally, this implies a particular relationship between docinf and patient; even a specialist is likely to be more effective if, is a difficult case, he can turn confidently to the general cracti' tioner who has sent the patient. There is no weaker point in the National Health Service than general practice, and there v135 no indication in Mr. Turton's statement to the House Commons on Monday that he intends during the next years to pit his and his department's minds to the task ni improving its quality. There is no reason for being surpris4 about this. I have met some of the medical advisers it the el Ministry of Health : sincere and conscientious men they seer but they have long since ceased to be doctors and beale medical bureaucrats. Here is the third danger. It does not matter how g°°1 their qualifications are, how genuine and varied their Well' ence has been, professional men once drawn into the Govern' ment machine become more a part of their departments (or tb e departments which they are advising) than a part of the Pr°1° sion to which they still formally belong. It is worth pulatirl out that the important changes in the schools examingti° system which were introduced after the war were the dream' children of civil servants. I am not arguing whether the dersoap, to introduce them was right or not; the simble fact remains tb„at the decision had almost nothing to do with George Tornansoo the Minister of Education at the time, but quite a lot to do f Sir John Maud, who spent seven years at the Ministiry o Education between the Ministry of Food and the MinistrY Fuel and Power. Again, my point does not rest on the spi decisions taken; it rests solely on the danger of subordinatit/5 the opinions of professional men-to bureaucrats. If the House of Lords could take some time off from debt ing subjects which have already been debated in the House Commons it might discuss the functions of the Ministry Health. Paging Lord Hailsham—and Lord Altrincham, 01311 he were there.
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