Mammon and Blarney
Sir: The Blessed Virginia (creeper), Bot- tomley who may have been an inspired pre- fect and captain of her school hockey team, has swallowed the Tomlinson Report on NHS hospitals whole and undigested. This shows her dedication to the entrepreneurial ethos, and obliviousness to any other val- ues. She will either become a future Tory prime minister, as some foretell, or she will sink without trace, as others sincerely pray. It is reported that she has a daughter who is a medical student. This makes her, of course, an expert on the NHS.
Tomlinson was, I believe, once a patholo- gist. Most pathologists are devoted to the study of dead tissue. His main concern seems to be to emulate Burke and Hare, and to ensure that any living structure must be destroyed before it can be studied. Charles Moore dealt magnificently with the proposed destruction of Barts (Another voice, 9 January), and of any other 'centre of excellence' now held to be obsolete. Those who came to work in the NHS in 1948 — I am an octogenarian retired provincial NHS surgeon — whatever their political affiliations, tried to keep on the tradition of service to the sick, despite the frustrations of inefficient administration. The NHS, once 'the envy of the world', relied upon the goodwill of those who worked in it. Now there is neither goodwill nor efficiency. Barrow-boys, promoted to be managers, have no concern for the sick, but only for 'cost-efficiency'. They are paid a bonus for the damage that they do, and if they are not kept in check will ensure a return to the days of cut-throat competition between doctors which so many of them, who still have a vocation for useful, inter- esting and satisfying service, thought had been happily left behind.
Theodore Dalrymple (a pseudonym?) must be a real doctor — a rare civilised voice crying in the wilderness against the forces of Mammon, Bureaucracy and Blar- ney. Magna est veritas, et praevalebit eventually, I hope.
Michael Reilly Magnolia Cottage, Harrowbeer Lane, Yelverton, Devon
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