Why the NHS reforms are like dangerous pseudoscience
This is supposed to be a blog about medical stuff, not about politics, so I hope you'll forgive me writing about the Health and Social Care Bill that's currently going through the UK Parliament on two posts in a row. The bill, if passed, will have a huge impact on the way medicine is practiced here in the UK.
There is a serious disagreement at the moment between the government, who think the Health and Social Care Bill is a fine and noble thing, and most of the medical profession, who think it's a disaster in the making.
Well, people often disagree about things. On the whole, I think disagreements can be divided into 3 categories:
- Some disagreements arise when there really is no "right" answer. Your position depends on matters of opinion, or judgements about the importance you place on competing things. An example might be an argument about whether it's right to raise taxes to pay for increased welfare benefits. The answer simply depends on your opinion on the relative merits of looking after vulnerable members of society versus allowing taxpayers to keep their own money.
- Sometimes there is a right answer, but it may not be clear what it is. Some discussion is therefore necessary before getting to the right answer. Many scientific disputes are settled this way. An exploration of relevant evidence and arguments should in the end lead to agreement.
- Sometimes, someone may put forth an argument which they know to be wrong, but they do so anyway because they have something to gain from it. Much pseudoscience is in this category. Homeopathy practitioners, for example, if they have studied the literature on homeopathy, know that homeopathy is just a placebo. If you point this out, however, you're not likely to be met with rational counter-arguments. You're more likely to be met with either ludicrously flawed arguments that attempt simply to mislead or distract, or, if you're arguing on an online forum, to have your comment deleted. It's the equivalent of a small child sticking his fingers in his ears and shouting "la la la I'm not listening".
Today, the government are holding extensive talks about the Health and Social Care Bill, but have excluded representatives of the medical profession who disagree with the government from those talks.
To me, that puts the government's arguments firmly into category 3. If they were discussing the bill from a position of intellectual honesty, why would they not want to listen to critics? The fact that they do not shows they know they have lost the argument, but they don't care, because they want to go ahead and implement the bill anyway for their own reasons.
What those reasons are is a mystery to me. However, it does seem noteworthy that there are many politicians who have business interests that would do very nicely out of a more commercially oriented NHS.