The healthcare market is by no means civilised

Dr Michael Dixon writes that 'The market is never going to go away' (GP, 4 April).

Then Dr Tim Kimber describes the company he operates in a later article in the same edition. An interesting conjunction.

The market, as presently envisaged, did not always exist, but was summoned into existence as a logical consequence of the pervasive Chicago School of Economics hegemony.

I believe that we can have a country, or world, that is both prosperous and civilised. But, if forced to choose, I would choose civilised every time.

The purchase and sale, for profit, of the sick and injured - and let us be under no illusions, this is what we are being invited to engage in - can in no way fall within the compass of the term 'a civilised act'.

If we are as persistent, assertive, influential and determined as those who have brought us to this pass, then we can make the market go away. Nothing is irreversible.

Parliament votes funds for the NHS; the DoH parcels the funds out to SHAs, among others; the SHAs parcel the money out to PCTs, among others; the others parcel the funds out both to others and each other in increasingly Gordian patterns. Finally, the few pence that have survived the journey are actually spent on the patient.

Count the layers of bureaucracy, the negotiating layers, the fees disbursed, the expenses claimed, the consultants and lawyers offering conflicting advice, the man-years spent administrating the whole teetering edifice.

Then consider the forests of trees, the megawatt hours of power, the alliances forged and broken, the psychological costs to those involved, the lost clinical input, the accrued losses in those endeavours that founder, the unacknowledged futility of the whole thing...

How does the patient/tax-payer actually benefit? How many patients does Dr Kimber not see when he is running his company? Would they, perhaps, prefer that he saw them?

Hieronymous Bosch should be here now to record our new Garden of Delights.

Dr Steven Ford, Hexham, Northumberland.

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