WHO HAS A BRAIN THE SIZE OF A PLANET?
A previous CMO apparently.
“Professor Ken Calman, the chief medical officer in England, is said by many “to have a brain the size of a planet.” Before taking up his present post - in 1991 - he was professor of clinical oncology in Glasgow, dean of postgraduate medicine in the west of Scotland, and chief medical officer in Scotland.”
“Health Profile: Challenging doctors: an interview with England’s chief medical officer”
R Smith
British Medical Journal, London WC1H 9JR.
BMJ 1994;308:1221-1224 (7 May)
Education and debate
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The Witch Doctor has no doubt that the former CMO’s brain is indeed exceptional. Not within the same evolutionary stage as a witch’s brain perhaps, but exceptional nevertheless. This being the case, it might be a good time to reconsider some of the views expressed by the man who is now Sir Kenneth Calman in that interview all these years ago, since they may be visionary and relevant now.
“Power remains in the hands of doctors”
“RS: Although you may feel that you still have considerable influence within the Department of Health, I think that doctors generally feel that they don’t have the influence that they once had. Is that true? Does it matter?”
“KC: It certainly matters that they continue to have influence, and influence relates to leadership. I think that doctors must look at the opportunities that are currently available and get involved. Leadership is not just given to you because you happen to be a doctor. You have to earn it. In lots of places doctors have taken the opportunities presented to them.
RS: Do you think that enough doctors have taken those opportunities?
KC: I’d like to see more. Part of my agenda is to ensure that professionals take the lead. But they must recognise that this is the 1990s, not the 1960s, and that means rethinking and changing, which is always difficult. But I see no difficulty with the quality of the medical profession in this country - it’s tremendous.
RS: Many of the issues that doctors face - problems with undergraduate education, staffing and specialist training, hours of work, London’s health services, and poorly performing doctors - have been problems for decades. Why have doctors been so poor at solving these problems themselves without external pressures?
“Leadership is not just given to you because you happen to be a doctor.”
KC: I don’t know the answer to that, but I regularly point out to doctors that they have the power to solve these problems. It’s not for government or the CMO. Look at the problem of senior house officers - the lost tribe. It’s been exactly the same since I was an SHO 30 years ago. Little has changed. Who stopped that change? It certainly wasn’t the government. Look at preregistration house officers - in some places a disaster. That’s not the CMO’s fault.
The message I give repeatedly - and in some ways it’s uncomfortable message - is that much of the power remains in the hands of doctors. Outcomes, audit, and most of education belongs to doctors. I know that there are funding problems, but much could be done by doctors now if they could seize the opportunity.
RS: But they seem fundamentally unable to do so. And that seems to be a problem of doctors the world over. They are too often reacting to other people’s ideas rather than developing their own.
KC: I agree with you. I’ve spoken to several medical organisations over the years and said, “Why are you so reactive to the government’s ideas? What is your plan?” For instance, I’ve seen a report recently from NAHAT [the National Association of Health Authorities and Trusts] on education for general practitioners. It’s very interesting, but why is it coming from NAHAT rather than from the doctors themselves? I know the Royal College of General Practitioners and the General Medical Services Committee are considering such issues at present, but it’s NAHAT that makes the headlines.
RS: You talk about the importance of rediscovering fundamental values, but I think that many senior hospital doctors are worried that exactly the opposite is happening. They worry too that the values of professionalism are being lost and that they are being converted to tradespeople tied down by contracts rather than trusted. Do you share that anxiety?
KC: I recognise that, and I think that we have undervalued the professionalism of doctors. But being a professional is about self regulation and developing a specific knowledge and ethical base. Some of the problems of the past few years are that doctors have not picked up the challenges and dealt with the issues themselves. I value my colleagues very highly, but they have a responsibility not to let things happen to them, and they must take the lead if they are to have the privilege of being a profession.”
“You must be the change you wish to see Mahatma Gandhi
in the world.”
It seems unlikely that both Sir Kenneth and Mahatma Gandhi are wrong about this.
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Sir Kenneth Calman has now returned to his Alma Mater as Chancellor of The University of Glasgow where he continues to promote his strongly held belief in the importance of medical ethics.
Dr Richard Smith resigned as editor of the BMJ in 2004 to work for United Health Group, the largest healthcare company in the United States. He is now chief executive of United Health Care Europe, the European branch of the parent company.
The Witch Doctor - Link to a random page
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LINK TO UK MISSING KIDS WEBSITE
LINK TO MISSING PERSONS WEBSITE
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