MEDICINE
The men at the top
JOHN ROWAN WILSON
The salient fact about Ministers of Health is that most of them, good or bad, are soon. forgotten. Only now and then does a particu- lar individual succeed in imprinting his per- ' sonality on the public consciousness. At this time, when we are confronted with yet another incumbent in the job, it is perhaps worthwhile to recall the four Ministers who, in the last twenty-five years, have managed to leave any kind of vivid memory behind them.
The first was Aneurin Bevan. It isn't easy to imagine a more unfortunate choice for a Minister to introduce the National Health Service. Since everyone was agreed that some form of service would have to be introduced, the problem of working out how it should be done was largely technical. A diplomatic, low-key type of Minister was obviously in- dicated. Unhappily, Bevan was a man who lived his life in an atmosphere of melodrama, and if it was not present he felt the necessity to create it. In this particular situation he saw himself as the apostle of progress, merci- lessly beating down reactionary opposition. He adopted a kind of Bismarckian strategy, sometimes arrogant, sometimes wheedling, alternating veiled threats with synthetic Celtic charm. He constantly attempted to set one branch of the profession against another. The atmosphere of conflict which sur- rounded the inception of the service was largely the reflection of his own psycho- logical needs.
Another man who imposed his own per- sonality on the Health Service, though in a quite different way, was Enoch Powell. He was confronted with the greatest problem which has affected British medicine since the war; that is to say, the emigration of young doctors. This situation was brought to light, not by Ministry figures, but by a young and at that time obscure medical man with an interest in statistics. Mr Powell reacted in a way which casts an interesting light on his method of attacking problems. He read the statistics and called in experts to comment on them. They told him the statistics were faulty and the problem exaggerated. He listened carefully to their analysis and was convinced by it. From that moment there seemed to be no means known to man by which his opinion could be changed. He directed all the powers of his exceptional mind, all his formidable personality and capacity for dialectics, to demolishing these alarmist predictions. Only one thing marred this supremely logical sequence. The pre- dictions, as it turned out, were perfectly right.
Soon after this we moved into calmer waters with Mr Kenneth Robinson. Mr Robinson didn't do a lot that was memor- able, yet he is nevertheless remembered. The people who had personal dealings with him remember him for his manner, and the im- pression he gave, unlike almost any other politician, that Minister of Health was what he really wanted to be. He stayed, he did his best, he wasn't always looking for a bigger job, and he didn't get one. He seemed to regard the service as a cooperative, and essentially non-political, enterprise.
Mr Crossman, by contrast, was a true Wil- sonian man, with a style which depended heavily on a blend of moral indignation and public relations. Whenever it was revealed, by some hair-raising incident, that the hos- pitals for which he was responsible were grossly out of date and dangerously under- staffed, the Secretary of State was appalled. Something must be done; this must not hap- pen again. Radical, gritty, dynamic action— like the setting up of a committee or the holding of a press conference—would be taken without delay. Nothing much actually came out of all this; but at least the public could see that the Minister's heart was in the right place.
But what Mr Crossman will really be re- membered for is one particular remark he made during the doctors' pay dispute just before the election. Perhaps conscious that he was going to leave his Ministry anyway in a few weeks, he allowed his mask of amiability to slip for a moment and showed his attitude to the doctors with a clarity that was alrhost embarrassing. He first castigated them for demanding publication of a report that he and Mr Wilson had been sitting on for two months, and told them they were
very lucky to have a special arbitration body at all, never mind demanding that its find- ings should be honoured. He then made the historic pronouncement that the Govern. ment had decided to delay publication, not for political reasons, but entirely in the in- terests of the doctors themselves. He thus personally established himself as the author of the least credible statement made by any Minister since the original passing of the Act.
And what of Sir Keith Joseph? One can only wait and hope for the best. In any case. it is possible that he may not be with us for long if MrHeath decides to unscramble Mr Wilson's unnatural mixture of medicine and pensions. There isn't really a great deal in common between taking out a man's stomach and handing him out £8 12s 9d every week over a counter at the post office. The National Health Service is surely big enough and important_ enough to carry a Minister in its own right. The deputies Mr Crossman used for dealing with health matters did the best they could, but everyone knew they had no authority. What we need is somebody who cares primarily about the Health Service and is prepared to make an effort to understand the collection of highly individual people who operate it. And if there isn't a really good Minister available, let it at least be someone we can easily forget.
Previous page
