Feminist ideology is so wonderful, isn’t it?

Among a “lethal mix” of failings, the key finding of the investigation into baby deaths at Furness general hospital was a group of “over-zealous” midwives known as “the musketeers” who imposed the natural childbirth approach “at any cost”; refused to call doctors when needed; and colluded to conceal their negligence.

This finding runs counter to an orthodoxy that has governed childbirth for the past half-century. To learn that the rationale behind midwife-led units will now be scrutinised in a review of NHS England’s maternity services is to hear the screeching of brakes on the juggernaut that is childbirth ideology.

Or is this not feminism but the naturalistic fallacy?

74 thoughts on “Feminist ideology is so wonderful, isn’t it?”

  1. Yes, it is. Whenever I hear the word “natural” in this context, I always think of the old idea that women shouldn’t have pain relief because it’s God’s will that they suffer pain as daughters of Eve.

    And then of course there’s the closely aligned Breastapo.

  2. So Much for Subtlety

    But being bullied or cajoled into having a natural birth because of trumped-up risks to “baby” is not what I call feminism.

    No one hates women like other women. I always assumed that this is a passive aggressive form of retribution by those too ugly to maintain a normal family against those women who managed to land a husband, get a mortgage and otherwise live a happy, normal life.

  3. SMFS, I think it’s just arrogance. It’s the matronly assumptiont that she knows what is best for everyone else, particularly the “lower orders”.

  4. Not feminism which is motivated by the welfare of women but by feminazism which puts narrative ahead of evidence. Rather a familiar tactic across the left on a variety of issues. Climate change anyone?

  5. Naturalism I think, my wife had this from an old fashioned Irish Catholic midwife who definitely wasn’t a feminist. Determined she wasn’t going to have a Caesarean, despite what the (female, probably feminist) doctors thought.

    Wife on trolley waiting to go into theatre (complications, not elective caesarean), midwife between her legs claiming the sprog was on its way out by itself.

    All rather undignified and like being stuck in the middle of a trade union demarcation dispute.

  6. So Much for Subtlety

    Ian B – “I think it’s just arrogance. It’s the matronly assumptiont that she knows what is best for everyone else, particularly the “lower orders”.”

    That is what the Specialist for! Lots of people, especially those with lots of education, assume they know best and think the lower orders ought to shut up. Why they think so is utterly irrelevant. It is possession of the Secret Knowledge that matters. But midwives have chosen as their Secret Knowledge a set of beliefs that punishes the fertile and, often, married, while killing babies. It is probably not a coincidence that so many are not the sort of woman of marries and becomes a good mother and wife.

  7. Ian, I agree on arrogance, but that’s true across much of the medical profession.

    With midwives, it seems to be made worse by them not being very bright and so not realising the limits of their knowledge (sounds like Murphy again).

  8. Don’t think the ‘lower orders’ thing is a necessary part of it; our Irish midwife was actually socially deferential. A combination of Secret Knowledge and naturalism seems right though.

  9. So Much for Subtlety

    Richard – “A combination of Secret Knowledge and naturalism seems right though.”

    But it is Secret Knowledge that means they sit there listening to women screaming in pain and doing nothing about it. I don’t know about most people, but if I heard a woman in pain, I would either not do the job or I would give her enough drugs until she didn’t.

    These are women who have a lot of intellectual options and they have chosen the one that makes fertile women suffer and kills babies.

  10. @SMFS

    Re one’s ability to sit and listen to a woman screaming in pain, I think it might depend on the woman.

  11. “These are women who have a lot of intellectual options” – I wouldn’t use ‘intellectual’ to describe the midwives I saw.

    But nor did they seem to be against motherhood or frustrated spinsters. Generally the older ones had them and the younger ones expected to (one of ours was actually pregnant).

    I know I’m drawing on a small sample, but the behaviour of the the ones I saw matched the report and doesn’t seem to fit your explanation.

    But then the senior one I’m mainly thinking of was Irish and so Irish Catholic Jansenism was probably also a factor.

  12. When my son was born for the first 10 days he was losing weight. The midwives insisted that he not be given formula so we didn’t. Every night he screamed for 1 hour.
    After 10 days my wife went to a doctor for a check up he said
    1) Buy formula NOW
    2) Ignore the midwives.
    He started gaining weight and stopped the nightly scream (maybe he was hungry).

    If God willing if I have enough child he/she will get formula from day one.

  13. Dunno if this is feminism.

    But it is quite a common attitude in the health service, among doctors as well as nurses: “you’ll get what you’re given – we know what’s best for you”.

    Which would be fine if they did. But I nearly lost a limb due to the arrogance of a “specialist” who thought he knew better than me on the basis of spending ten minutes of his handsomely remunerated time peering over his glasses at me while spouting patronising platitudes.

    Most of the midwives me and the Mrs have dealt with have been fine. The hippy-dippy breastfeeding consultants are a different breed altogether. Golgafrincham B-Arkers, the lot of them.

  14. bloke (not) in spain

    There’s little doubt a great deal of medicine’s just a branch of witchcraft. With Dad here, just returned from hospital, we’ve had an assortment of health professionals bustling in & out issuing mutually contradictory instructions. Their sense of self regard is bottomless.

  15. We had some excellent midwives. We also had some dangerously crap ones, including one I personally witnessed get confused about diabetes and increase the insulin dose in response to a low blood sugar reading — which would have killed Vic if we weren’t paying attention. One of Vic’s midwives had four kids and cheerfully told us that two of them had been breastfed and the other two had had formula and they were all equally healthy. One of the others was a breast nazi. There were midwives who believed in “natural” above all and others who thought modern medical technology was wonderful. We also had absolutely excellent Southern Irish Catholic midwives. It’s difficult to generalise.

    I think (after studying this stuff a lot close-up and first-hand) the problem is the NHS’s structure. There’s the religious belief in the sanctity of the NHS itself, which leads to their circle-the-wagons, kill-the-infidels response to complaints. There’s the centralisation of control, which leads to stat-driven policy and targets, which lead to this ridiculous attitude of deciding treatment based on how many other patients have had that treatment rather than whether it’s appropriate for the patient in front of you right now — which is what’s happened with caesarians. And there’s the extreme difficulty of comparing medical staff and choosing the ones you trust, let alone getting the bad ones removed from their posts. Of course, anyone who’s worked in the state sector knows that, internally, bad staff are known about, and there is a time-honoured way of getting rid of them without running into union trouble: boot them upstairs. Which might explain why it’s the midwives with the stupid destructive ideas who appear to be setting policy.

    Richard,

    > I agree on arrogance, but that’s true across much of the medical profession.

    Absolutely, yes. I don’t think midwives are noticeably worse than consultants by this measure.

    One thing we discovered: junior doctors are great. They don’t know what’s wrong with you, so they keep doing tests to find out. Certain consultants just know what’s wrong with you, because they’re consultants. Great when they’re right. Fucking dangerous when they’re wrong, because woe betide anyone who questions them.

    SMFS,

    > I always assumed that this is a passive aggressive form of retribution by those too ugly to maintain a normal family against those women who managed to land a husband, get a mortgage and otherwise live a happy, normal life.

    Well, there probably is a bit of that, but no, it’s a far wider problem. Babies and pregnancy are weapons. Most of the “wisdom” that gets promulgated, I have concluded, is designed by women to exert their superiority over other women. The hatred of formula, for instance, is a handy way to make adoptive mothers feel inadequate. Likewise a lot of the shite about “bonding” — it has to happen in the crucial first three hours, apparently, or your child will never properly love you. So, if your child was in an incubator for a few days to save their life, fuck you. Most of this, I find, comes from mothers, and it gets worse the more affluent they are. But of course: the usual British class war: these superstitions are just the maternal equivalent of not being seen dead in Aldi.

  16. Yes, what really irks is the contrast between their self-regard , the absolute certainty that they are right, and the way that they cannot agree amongst themselves (midwives v doctors being just an example of that) and, as a profession, change their whole approach every few years.

    It certainly looks like the same problem as Murphy – they think they’re the experts but are too ignorant or thick to realise how little they actually know. It is such a relief when you occasionally meet an intelligent doctor.

  17. Naturalism definitely. A maternity ward is the mother ship of Woo. Looking back I still can not quite believe that we fell for the TENS bullshit. I was fiddling with that damn machine for hours, whilst my poor wife was in agony (voluntary and silent agony).

  18. Actually it really was my wife’s fault she was in pain for so long; she accidentally kicked the anaesthetist in the bollocks and he dropped all his sterile kit on the floor.

  19. Whenever I read these stories I always contrast them with the experience I get at my vets, a husband and wife couple.

    They are of the “old school” – he only stopped doing his own out-of-hours calls following some health scares (he’s well into his 70s now, but still works long hours six days a week). We once got a telling-off from him for not phoning him on Christmas Day to give him an update on our cat who was receiving treatment – we didn’t want to disturb him but he insisted that it was part of his job. They rely on their experience to make diagnoses and only order expensive specialist tests when needed, and they haven’t been proved wrong yet. Their concern is always the comfort of our pets: they do all they can to keep them pain free and comfortable. They’ve always known when enough is enough, but leave the decision in our hands. Their nurses are totally dedicated to their jobs as well and don’t consider themselves above cleaning up the inevitable messes made by animals, and realise that their job is to comfort and look after both the animals and the owners. The whole practice take a personal interest in us and are always friendly and considerate.

    If I could, I would visit them for my own healthcare.

  20. S2,

    “One thing we discovered: junior doctors are great. They don’t know what’s wrong with you, so they keep doing tests to find out. Certain consultants just know what’s wrong with you, because they’re consultants. Great when they’re right. Fucking dangerous when they’re wrong, because woe betide anyone who questions them.”

    I try and do my own diagnosis before I go to the GP, because I spent months trying to get a problem diagnosed once before turning to the internet and pretty much solving it in a couple of hours, based on the stories from people who had the same symptoms that I did. 2 GPs, a locum and an ENT all got it wrong, all failed to look at all of my symptoms and to arrive at a diagnosis consistent with those symptoms. Instead, they looked at a standard cure for one of those symptoms.

    I wouldn’t mind if they were cheap mechanics. Make that choice, and you get amateurs. But they’re not. These people cost a frickin’ fortune to the taxpayer. I’d rather trust my curious and not-too-pricey car mechanic with a book of anatomy to solve medical problems. But I can’t, because these people have the certificates that he can’t get.

    I mean, look at all this marketing about not overusing antibiotics. What that’s basically saying is that GPs can’t even diagnose when to give patients antibiotics and when not to.

  21. bloke (not) in spain

    Got to endorse GlenDorran, myself. Had to have the dog in the Royal Veterinary Hospital for an op & the treatment he had there got me to wondering how you get yourself covered by PetPlan.

  22. Only very tangentially related via the massive self-confidence of senior medics but may amuse;

    When I were but an inky third former I had the misfortune to come down with pneumonia and duly ended up in St George’s, who eventually got both lungs up and running again. During the process as St George’s is a teaching hospital every so often a gaggle of medical students was lead round the wards to have particularly intresting or instructive symptoms demonstrated to them, and it appeared my duff left lung counted in one of those categories. On one occassion, in perhaps my 2nd month inside, a stethoscope was applied to my side and all the students invited to listen before the consultant started explaining why it had sounded like it did before finisihing “…and the symptom is called aegophony, from the ancient Greek for sounds like a sheep, because it sounds like a sheep’s bleating.” At this point I, who had been listening with as much interest (or perhaps more) as the students pipe up, “Goat.”.

    The consultant looks at me and, somewhat startled, says, “Pardon?”

    I reply, “It’s from the Greek for goat.” He started skepticly to say something along the the lines of “Well, whatever…” but I, with natural penedantry seemingly bolstered by the quite high levels of analgeasia I was on, eas determined the point must be settled. Unbeknownst to him I had completed my first 2 terms of GCSE ancient Greek before falling ill and αἴξ was one of the parts of vocab that had stuck. As it happened, I had had some of my text books brought in to pass the time (I did say inky third-former) and insisted on showing him the word in one of them. I suspect none of the students, whose amusement levels rose with his discomfit, may remember that particular lesson bettr than some others…

  23. TomJ – I hate to butt in, but it behooves me to say: don’t kid yourself. That story only reveals your capricious nature.

  24. @GlenDorran
    According to one of the biographies of Jim Herriot in the past vets could treat people legally.
    I don’t know if it is true.

  25. I mean, look at all this marketing about not overusing antibiotics. What that’s basically saying is that GPs can’t even diagnose when to give patients antibiotics and when not to.
    The question is: when the patient – the customer if you like – asks the GP for antibiotics, but the GP knows that antibiotics are inappropriate, should he prescribe them nevertheless.

  26. GlenDorran,

    You can fire your vets very quickly and find another one, and they get poorer for you doing so.

    it’s also why opticians are generally pretty good.

  27. @JuliaM: Such is my natural that trying deliberately to misspell a word for the local in-joke leads to a finger rebellion and misspelt misspelling. Or I can’t type, a viable alternative hypothesis…

  28. The GP should be able to explain why they are inappropriate and not take the easy option of saying “yeah, whatever”

    If I ask my mechanic to fit new brake pads when my radiator is leaking I would hope he would advise me correctly.

  29. bloke (not) in spain

    Alas, no longer.
    Our workshop premises were next door to a vet & they were my first port of call when i succeeded in removing the tip of a finger with a 5 horsepower industrial woodplaner. And very efficient they were. Cleaned the wound. Nothing to stitch. Razor sharp blades motoring around at 25,000 rpm don’t leave anything to stitch. Applied dressing. Strict instructions from vet, a drinking buddy, above never happened. Animals only sez he. Woof sez I. Whole world of shit, otherwise.
    Couldn’t have done any harm. I’ve since regrown a 1/4 inch of fingertip. Maybe it’s the experience of treating lizards helped.

  30. @GlenDorran, Stigler:

    I think that sick people in Ankh-Morpork generally go to a vet. It’s generally a better bet. There’s more pressure on a vet to get it right. People say “it was god’s will” when granny dies, but they get angry when they lose a cow.

    — (Terry Pratchett, alt.fan.pratchett)

  31. The Stigler, regarding antibiotics, there’s also the fact that when they are needed they are needed.
    Wife has had cellulitis many times, more than one serious enough that they put her on low level antibiotics for at the moment is looking like the rest of her life.
    Being on them has cut infections to around 20% of what they were.
    She is far from the only person on regular antibiotics.

    Had to laugh at a headline I saw in a paper the other day, about how regular paracetamol was bad for you. Considering the alternitives for those of us in pain is heavier painkillers with more side effects and bigger impacts on organs….. think I will stick to the paracetamol.

  32. The question is: when the patient – the customer if you like – asks the GP for antibiotics, but the GP knows that antibiotics are inappropriate, should he prescribe them nevertheless.

    The answer to a customer asking a doctor for antibiotics is “You’re in the wrong place. You need a pharmacy.”

  33. Stig,
    Opticians used to be terrible though, back in the days when the British high street was full of shops offering poor customer service.
    Two things changed: first, the industry consolidated into a handful of big players (SpecSavers, Boots Opticians, Optical Express, and Vision Express); and second, internet competition. Sure, you might claim that your local small-time opticians gives you better service, but shoppers have voted with their feet and prefer the chain stores.

  34. Not naturalism. Not feminism. Just a monopoly screwing over its customers, as it must.
    So use the internet and go private if you can afford it.

  35. Andrew M,

    “Two things changed: first, the industry consolidated into a handful of big players (SpecSavers, Boots Opticians, Optical Express, and Vision Express); and second, internet competition. Sure, you might claim that your local small-time opticians gives you better service, but shoppers have voted with their feet and prefer the chain stores.”

    It wasn’t about consolidation, it was about liberalisation. The UK government liberalised the spectacle making market in 1988 and the likes of SpecSavers and Vision Express entered the market with new technology.

  36. Two things changed:

    Plus, as with dentistry, the kit has gotten much lighter and cheaper. I went to an optician’s in Paris recently and the setup was a couple of small machines hooked up to a laptop. I went to a dentist in Paris a few weeks ago and it was pretty much a self-contained dentist’s chair in somebody’s flat.

  37. Theodore Dalrymple tells a good story from his days as a student doctor – a consultant in his nineties (maybe some exaggeration here, but then again it would be fifty years ago who they did things differently) on grand rounds who would loftily pronounce his view on the case before them and then remove his hearing aid, the matter being settled.

  38. @Stigler

    ‘I try and do my own diagnosis before I go to the GP, because I spent months trying to get a problem diagnosed once before turning to the internet and pretty much solving it in a couple of hours, based on the stories from people who had the same symptoms that I did. 2 GPs, a locum and an ENT all got it wrong, all failed to look at all of my symptoms and to arrive at a diagnosis consistent with those symptoms. Instead, they looked at a standard cure for one of those symptoms.’

    I diagnosed my friend’s cancer. His GP missed, it, the general consultant he saw privately missed it, and the non-oncology specialist he then saw missed it (he’d been referred to this other specialist by the generalist).

    This was despite a) his symptoms being so obvious that I knew them before even googling (persistent cough, terrible night sweats, weight loss, lethargy) and b) him saying to them all ‘Look, I think I have cancer’ after I’d persuaded him that he did have.

    The even scarier part is that he is a QC – you’d think they’d take more care there!

    (He was finally diagnosed with stage 4 lymphoma, can’t remember which one, and to be fair his lymph nodes were not significantly enlarged – it was in his bone marrow, which is much rarer, and harder to locate. Happily he is eighteen months in remission now. But it was close.)

  39. I love how the article ended with the word ‘neo-liberalism’. I almost thought the word wasn’t going to appear. But the author got it in just in time. (Or perhaps the Guardian computer inserted it after the article was submitted.)

  40. I diagnosed my friend’s cancer. His GP missed, it, the general consultant he saw privately missed it, and the non-oncology specialist he then saw missed it (he’d been referred to this other specialist by the generalist).

    One of my pals had esophageal cancer, and his doctors missed it, mainly because it is almost unheard of in people of his age. But he had difficulty swallowing, which should have been a massive red flag. Instead they said it was a bad back and sent him to physiotherapy. They finally found it when he was unable to consume even a yoghurt and he was rushed to A&E and they shoved a camera down his throat. By that stage almost a year had passed and it had spread to inoperable regions. He is still with us, but he’s pursuing a medical negligence claim against the military doctors.

  41. I agree with everyone about vets: way better. I can never understand why doctors look down on them. I mean, doctors can only treat one species. Fucking lightweights.

    PaulB,

    > The question is: when the patient – the customer if you like – asks the GP for antibiotics, but the GP knows that antibiotics are inappropriate, should he prescribe them nevertheless.

    No. Next question.

    Yet they do. And they blame the patients for this.

    Stigler,

    > it’s also why opticians are generally pretty good.

    I had an eye problem and my GP, as usual, could give me an appointment at an awkward time in a couple of weeks, and I thought, hang on, why not go to my optician? So I did. They saw me immediately, diagnosed the problem, told me which medicine I required, but then said that I was going to have to get my GP to write a prescription as doctors have successfully got it made illegal for anyone but them to write prescriptions. Opticians can’t prescribe eye medicine because they’re not qualified? And the NHS is overloaded? Truly, we are run by fuckwits.

    Andrew M,

    > Sure, you might claim that your local small-time opticians gives you better service, but shoppers have voted with their feet and prefer the chain stores.

    I think you’re conflating the purchase of glasses with eye tests.

  42. And we should remember that it was Peter Risdon (yes, of Guppy and Boris fame, also of commenting here and blogging around the place fame) who actually broke the opticians monopoly.

    Hurrah! for Peter!

  43. The question of prescription would of course be solved if people were simply free to purchase whatever medicines they desire, rather than having to ask a doctor for them.

  44. > The question of prescription would of course be solved if people were simply free to purchase whatever medicines they desire, rather than having to ask a doctor for them.

    In the case of antibiotics and antivirals, that is an enormously bad idea. They only work properly if their use is tightly controlled.

    Not that doctors are tightly controlling their use, but hey.

  45. I believe it is still illegal for an optician to advertise on the basis that they are cheaper than other opticians. “Should have gone to Specsavers” is an absolute masterpiece of a slogan, as it gets around that law so very neatly.

  46. Sq2,
    Yes I’m conflating the two, but it’s nigh impossible to find a high street ophthalmologist which doesn’t also dispense glasses. It’s also nigh impossible to buy glasses (or contact lenses) without a prescription from an ophtho. So in practice it’s the same shop, subjected to the same competitive pressures. Few people buy their prescription from one shop then get their glasses from another.

    I’ve had a referral to the eye hospital written by a Boots ophthalmologist, which rather surprised me: I assumed NHS GPs were the gatekeepers for the rest of the NHS, and surely a private doctor couldn’t open that gate. Would have spared me a few hours if the ophtho had been able to write the prescription though. And it still seems strange that you need a referral to access “urgent care” at the eye hospital. Strange definition of “urgent”.

  47. SQ2 – as a thirty year speccy twat, I’m amazed that everyone doesn’t go to Specsavers. They’re half the price of the others when the lenses are all from the same manufacturers,

  48. Bloke in Costa Rica

    I’m not sure why doctors feel themselves justified in elevating their status to that of minor deities. Outside of surgical stuff, most medicine is just remembering lots of things and having the nous to spot what a given set of symptoms entails. There’s the “if they get it wrong then people die” aspect, but you could say the same about civil engineers.

  49. “…most medicine is just remembering lots of things…”

    At Uni I was friends with quite a few med students. The girl who was by far the brightest of them decided to do a two year science elective because she was so bored by all the rote learning.

  50. BiCR. Where did I read recently the rather good observation that civil engineers have saved considerably more lives than doctors.

  51. Surreptitious Evil

    He is still with us, but he’s pursuing a medical negligence claim against the military doctors.

    Military doctors are great at treating the conditions found in fit 20-40 year old blokes who have a habit of playing violent sport and are occassionally shot or blown up. The last few years may have made them a little better at treating similar for girls, but I wouldn’t hold my breath.

    Expecting them to recognise anything else – from stroke, to cancers, to anything complicated is, well, “brave”. Hopefully, there is still something that can be done for your mate.

  52. My experience of the NHS’ doctors with my father (who is no longer with us) wasn’t perfect. My father started to shuffle, had difficulty with his hands, and a few other symptoms.

    My sister who had a couple of years medical training at uni before going off to do something else looked up the diagnosis on the internet and discussed it with her medical friends. She came up with a possible disease.

    We still went through the tests the doctors suggested because my sister’s opinion wasn’t 100% confident. But the tests took ages and even for simple tests my dad had to wait months and then weeks for the results. They did the tests for the obvious diseases like Parkinsons even though the symptoms weren’t a match. That wasted time.

    Efficient, best medical system in the world? My arse!

    Finally after two years the doctors came up with the final diagnosis. Surprisingly it was the same one which my sister had found. It didn’t make much difference in the end as it was terminal, except that we knew what palliative care was required.

  53. Midwives in the Netherlands cover most births. Cochrane review shows they have lower morbidity and mortality than doctors. Why? Because they deal with all the low risk cases where doctors would be too keen to intervene and leave all the high risk cases to the medics.

    In this country we get f***ing musketeers and La Leche obsessives who screw the pooch. Bless the 21st century!

  54. bleeding marvelous – so many medical experts in the comments. Pity you are not in charge – people might start living longer.

  55. So Much for Subtlety

    Ian B – “The question of prescription would of course be solved if people were simply free to purchase whatever medicines they desire, rather than having to ask a doctor for them.”

    There is a problem of evolving resistance if antibiotics are used too much. Also we may have lost an entire species – young children used to get some types of diseases in the 50s that were treated with antibiotics and now they don’t.

    However I don’t think many people will lose sleep over rheumatic fevers. The solution to resistance is more and new drugs. Nice of the government to stop that isn’t it?

    The bigger problem, I think, is sick notes. Should the doctor give a patient a sick note if he demands one. Even if he is plainly faking. It seems more and more doctors will. Professionalism be damned.

  56. @ SMFS
    Some doctors give sick notes when a patient doesn’t ask for one. So it’s not just a lack of professionalism – some of them think anyone who is mildly unwell shouldn’t go to work. In my personal experience of women doctors (since I grew up – the only time I saw the woman GP in the practice when I was a child she was sensible) they tend to think I should I should be sitting at home wrapped in cotton wool instead of working if I have a minor bug while male GPs are more reasonable.

  57. Bloke in Costa Rica

    @magnusw: “Where did I read recently the rather good observation that civil engineers have saved considerably more lives than doctors.”

    Sanitary engineers, anyway.

  58. “Few people buy their prescription from one shop then get their glasses from another”.

    Oh, that’s what I did. Eye test at a very good local opticians, discovered that his cheapest pair of specs was £90, took the prescription and ordered some online from Hong Kong for a tenner.

    Is that not what people do? I’m new to this, but it seemed sensible.

  59. John77 – “Some doctors give sick notes when a patient doesn’t ask for one.”

    The only time I had a sick note from my doctor was after being smashed off my motorcycle by a grossly incompetent driver (seriously, ‘losing control’ and hitting a stationary vehicle waiting to turn into the road you’re on *from the other side* in a 30mph limit takes some doing); once I could walk on (borrowed, not prescribed) crutches I was back at work because being home sick was *boring* and I knew the longer I stayed away, the bigger the bow-wave would be when I returned.

    But that was twenty years ago and it’s already a different world where being ill is a badge of pride rather than an inconvenience to be minimised.

  60. Richard,
    In the good old days before Thatcherite neo-Liberalism, your eye test remained the property of the tester, so you were not able to take your prescription elsewhere.

    We’ve nearly caught up with the likes of Cyprus now.

  61. So Much for Subtlety

    john77 – “Some doctors give sick notes when a patient doesn’t ask for one. So it’s not just a lack of professionalism – some of them think anyone who is mildly unwell shouldn’t go to work.”

    That is not quite what I meant. I mean if you are plainly not sick but want a note, doctors will give you one.

    There was an interesting article written by an American doctor about a woman who wanted to “retire” at 30 something. That is, she wanted him to certify that she was too stressed to work so she could go on Disability. Only I have not been able to find it. Googlefu fail.

  62. “bleeding marvelous – so many medical experts in the comments. Pity you are not in charge – people might start living longer.”

    I’m not claiming to be a medical expert. All I’m asking is that medical “professionals” do their job.

  63. So Much for Subtlety

    Jack C – “In the good old days before Thatcherite neo-Liberalism, your eye test remained the property of the tester, so you were not able to take your prescription elsewhere.”

    Thanks to Blair, now every medical record taken by your doctor belongs to the government and will be available on a vast database for any government snoop to investigate at his leisure.

    On unrelated news, I could not find the article I referred to earlier but I did find this one:

    http://thoughtbroadcast.com/2011/09/04/how-to-retire-at-age-27/

    Keisha is a generally healthy 27 year-old. She graduated high school (something rare in this community, actually) and took some nursing-assistant classes at a local vocational school. She dropped out, however, because “I got stressed out.” She tried looking for other work but then found out from a family member that she could “apply for disability.” She applied and was denied, but then called a lawyer who specialized in disability appeals and, after about a year of resubmissions, received the good news that she can get Social Security Disability, ensuring a monthly check.

    How is Keisha “disabled”? She’s disabled because she went to see a doctor and, presumably, told that doctor that she can’t work because of “stress.” That doctor probably asked her a series of questions like “are you unable to work because of your depressed mood?”, “Do you find it hard to deal in social situations because of your mood swings?” etc., and she answered them in the affirmative. I’ve seen dozens—if not hundreds—of disability questionnaires, which ask the same questions.

  64. I’m also not claiming to be a medical expert – just relaying an experience. But it did happen – lots of doctors didn’t spot what I did. I think this is because I looked at the symptoms whereas they looked at the apparent absence of one symptom and probability.

    One of my daughters is planning to go into medicine – I’m encouraging her (though I’d rather she married a nice chap and had kids) but the fact is some sort of Google diagnostic service allied to an instant bloods checker is going to make them almost redundant.

  65. By the way – check out Murphy on Jeremy Vine making his ten year old daughter a director, thus avoiding tax.

    Murphy is highly understanding and emollient – candidly I think he will be a guest on Vine’s show very soon. Possibly a resident tax expert gig awaits.

  66. The question of prescription would of course be solved if people were simply free to purchase whatever medicines they desire, rather than having to ask a doctor for them.

    Which is how it works in Thailand. But this has problems, as SQ2 points out.

    So, the solution is for doctors to be permitted to prescribe antibiotics BUT patients are free to go to multiple doctors easily. So if a patient wants antibiotics, a doctor is free to refuse them but the patient is free to find another doctor. If he can’t find any doctor to prescribe them, there’s probably a good reason why. The UK has the worst setup whereby a doctor is pretty much playing the role of a pharmacist in writing a ‘scrip in 30 seconds for whatever the patient wants, or he’s deciding what’s best for the patient leaving him with little practical chance of getting a second opinion.

    So, if doctors want to retain the monopoly on prescriptions, there should be a free market in doctors. Like in France.

  67. “One of my daughters is planning to go into medicine (though I’d rather she married a nice chap and had kids)”

    Isn’t that why nice girls into medicine any more?

    I suppose there’s too many girls doing it now, so not enough doctor husbands to go round.

  68. Tim Newman

    Being able to buy antibiotics over the counter here in Thailand is a boon for me. 80p at the same shop you buy pig medicine.

    In the UK pharmacists are easily qualified to tell if you need antibiotics. GPs would be a lot less overworked if they didn’t insist on hogging other peoples jobs.

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