PROBLEM
1) A state monopoly in medical care has resulted in the gradual loss of a professional ethic which was always ultimately inspired by the profit motive. With no financial incentive to behave nicely towards patients, many doctors and nurses have simply stopped doing so.
2) This lack of incentive extends to delivering medical services to a high standard of quality and efficiency. Why bother? Just so your colleagues will respect you? But their respect no longer depends much on this, and anyway peer pressure isn't sufficient to generate quality or efficiency, as we know from our experience with nationalised industries.
3) Because of an irrational fear on the part of most people that the abolition of the NHS would entail a complete loss of medical care, it has become impossible even to discuss this option. Tinkering at the edges by means of 'internal markets' and similar has simply made things worse.
4) For the foreseeable future therefore, we are stuck with a medical system which will get progressively worse, even with more and more money being pumped into it. Although patients are usually unable to assess the technical quality of what they receive, they are astute enough to notice whether they are being treated like (a) paying hotel guests or (b) prison inmates.
SOLUTION
Train staff to "smile" more at patients.
THE government is considering a new scheme to improve the National Health Service: encouraging doctors and nurses to smile at patients. The proposal was presented at Thursday’s cabinet meeting as the culmination of six months’ work by the brightest minds in Downing Street. A cabinet source said: “One of the things that came out of the focus group discussions was that they didn’t feel nurses and so on gave the impression that they cared enough. They felt, for example, that they should smile more.”Because, of course, what matters in a mediocracy is not caring, but looking like you care.
Ministers were told that a MORI survey had shown people remained dissatisfied with public services despite the billions of pounds Labour has spent on them. Ben Page of MORI told ministers the public wanted to see nurses smile more and to “give the impression of caring”. (Sunday Times)
Update
Ben Page has left a comment saying the Sunday Times article is a calumny of the facts, and that MORI will be publishing the full report next month. I look forward to reading it, and will comment again when I’ve seen it.
Page says that “the public want to see tenderness and compassion in the delivery of public services”. No doubt patients would like to be treated with more respect and politeness, but the question is whether this can be achieved in the context of a state service, in which there is effectively no consumer power. It’s a little like saying: “parents want comprehensive schools to provide an environment in which their children can flourish”. Sure they do, but it ain’t gonna happen, however aware the government is of the problem.