Seeing the people camping out for the Black Friday promotions put me in mind of that famous quote from Shakespeare ‘now is the winter of our discount tents’. But there’s a lot more discontent in the NHS this winter around the strangulation of a system through funding and the apparent pressure on medics to flex and ‘stop coasting’.
The recent junior doctors’ dispute has centred around what’s fair and what’s safe for the NHS, staff and patients. I won’t rehearse the argument here, you should know it well by now, but here’s a thought you might like from the world of philosophy.
A philosopher called John Rawls wrote the book A Theory of Justice in 1971. It has become The Book on fairness and justice in society.
One of Rawls best ideas in my opinion was that people who did not know what role they would occupy in the system should design the system. It’s a smart idea really, based on the understanding that we all unconsciously create our worlds in our own image.
It’s the reason why medics struggle to understand young ‘buff’ men who work out to get fit but use steroids to do it. We think those behaviours are not congruent, but in their world it is perfectly sensible to get muscly and use steroids, it’s what young blokes do because it’s not about being fit, just about being attractive.
It’s the same as Jeremy wanting a seven-day NHS and the junior doctors knowing they already work a seven-day NHS. The two parties inhabit different worlds.
Maybe it would be really useful for our health secretary and a typical junior doctor to shadow each other for a month.
Then let’s see if the junior would better understand the need to make the NHS better and safer within a fixed financial envelope, and the health secretary would understand that the sheer physical and mental fatigue that existing duties require means that it’s impossible to stretch a five-day NHS over seven days without investment.
That would be justice.
- Dr Chris Mimnagh is a GP in Liverpool co-director of clinical strategy at the NHS partnership organisation Liverpool Health Partners