Don't we deserve offices?

Observations on doctors

I don't think I would have been very pleased if my neurosurgery had been postponed because the surgeon who was going to carry it out was accused - wrongly, as it turned out, in the recent, highly publicised case in Nottingham - of taking a bowl of soup to which he was not entitled from the hospital canteen, and then suspended from work. But this is precisely the kind of petty humiliation that consultants in the NHS now expect. It is the revenge of the untrained and superfluous upon the highly trained and the vitally necessary.

The other day, my wife, who is also a hospital consultant, saw the plans for the building to which her patients and staff will soon move. The one member of staff for whom no office space had been set aside was herself. Everyone else was catered for in this respect. When she asked if it was a mistake, no answer came.

But at least she was permitted to see the plans, which is more than can be said of the medical director of a large new facility in our hospital. He told me the other day that he happened to see the plans of the new facility on an administrator's desk. This produced a state of panic in the administrator. "You're not supposed to see them," he said, as if the medical director were the interloping agent of an enemy foreign power in the Ministry of Defence. The medical director took them away none the less, but received increasingly desperate requests for their return.

This is all part of the new NHS: doctors are to be excluded, wherever possible, from decision-making. They are unreliable; they are trouble-makers; most of them make very poor apparatchiks. Sometimes they even think of the patients' rather than the corporate structure's welfare. They will never be team players.

Still, had they been consulted earlier, they might have prevented a local psychiatric unit from being built with glass French windows leading directly on to the car park 20 feet below - not a very good idea, even for patients without psychotic illnesses and suicidal ideas. However, rectifying the error after it had been made played a small part, in Keynesian fashion, in stimulating our economy.

In the course of my duties I, too, recently moved into a new and very expensive purpose-built facility, upon whose design no doctor had been consulted in advance. I discovered, not to my surprise, that no place had been set aside for the doctor to examine his patients, let alone an office for him to sit in; indeed, the design made telephone calls (an essential part of the doctor's work) very difficult for him. Needless to say, such difficulties did not exist in the administrative offices.

We live in an age when satire is really prophecy. In the TV series Yes, Minister, an episode showed civil servants and the administrators of a hospital looking forward to the day when patients - the fly in the bureaucratic ointment - would cease to exist, so that the hospital could be administered in perfect peace, without interruption. The abolition of patients is still a utopian dream, but at least the doctors can now be disregarded completely.

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