Examining Doctors: Medicine in the 1990s by Donald Gould - review by George Stern

George Stern

Ills of the NHS?

Examining Doctors: Medicine in the 1990s


Faber and Faber 148pp £12.99 order from our bookshop

Short and lively reflections about doctoring by Dr Donald Gould. Qualified in 1942, he saw the days before the NHS and the therapeutic revolution: even if you could afford a doctor, he could prescribe little more than sympathy and hot drinks. Dr Gould is now a writer and broadcaster and has had periods as an editor (New Scientist, World Medicine). Medicine is 'an oligarchy, largely immune to external influence': Gould, as a doctor, but one outside this 'duce-dominated system', is uniquely well-placed to talk sense. But as well as giving his own thoughts he has interviewed people across and on the fringes of the medical world, from Wendy Savage to Dr Death and Rabbi Julia Neuberger.

Dr Gould relates as an absurdity that, in the 1940s, politicians believed (or maybe pretended to believe) that the cost of the NHS would actually reduce with time as people became healthier. Actually they were right in a way. In those days people, apart from the well-off, looked wretched rather in the way people in communist countries do now, bent double, toothless, with bad complexions and endless aches and pains. The problems people had then have largely disappeared or are easily dealt with and the cost of treating those problems has probably gone down. Medical costs have increased because other distressing or fatal conditions are now treated which then were neglected.

I hate to criticise a 'best NHS in the world' chap but I wish Dr Gould would not give credence to 'the wise rationing of health care, because the demand is infinite and the supply is not.' Anyone for chemotherapy? Or what about a nice mastectomy? The demand for health

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