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Medicine and mandates

They say that history doesn’t repeat itself, but it rhymes.

This morning, I’ve been reading two articles where it strikes me that there is a particular resonance in the themes.

The first is Florence Sutcliffe-Braithwaite’s remarkable account in The London Review of Books of the NHS infected blood scandal: ’We’ve messed up, boys’. This is the first thing I’ve read about these events that allowed me to grasp the totality of the tragedy. It’s a remarkable piece of writing, even by the exceptional standards of the LRB.

The second is Devi Sridhar’s editorial in The Guardian Weekly about the way politicians used scientists in the response to the COVID-19 pandemic. This isn’t quite such a must-read, and I don’t entirely agree with Sridhar’s views but fully support her conclusion that we ought to reexamine the power and independence of Government advisors. This discussion has been bubbling away in public health circles since the creation of Public Health England, which many saw as reducing the independence of scientific advisors.

Doctors and politicians both have essential parts to play in the management of public health crises. Crises require both technical expertise and democratic oversight. Doctors sometimes tend to dismiss the role of politicians by thinking that only technical decisions have weight. Politicians sometimes ignore expertise, preferring their own views or feelings about the right path. The balance isn’t easy to get right, and both doctors and politicians are eminently capable of getting things wrong.

There’s much to ponder in Sutcliffe-Braithwaite’s piece, of which this is only a very minor part. Yet, when reading the two essays in sequence, the spectre of the problematic relationship haunts both crises.

This post was filed under: Health, Politics, Post-a-day 2023, , , , .

Requisitioning ice cream vans

A couple of weeks ago, I made passing mention of the 1984 BBC drama Threads, the chilling one-off film that dramatised the aftermath of a thermonuclear explosion in the UK.

I know I’ve already recommended one article from the latest LRB, but Florence Sutcliffe-Braithwaite’s essay on Britain’s preparations for nuclear war during this period is well-worth a read.

The advice given to medical staff ran from the ridiculous to the sublime. Staff at ‘casualty collecting centres’ were told to siphon off patients whose deaths seemed inevitable to a holding area, though they mustn’t describe these patients as ‘moribund – expecting to die – but expectant, meaning expecting to get away to hospital as soon as possible’. A lecture on nursing after an attack warned: ‘There will be no place for grumblers.’ The government contemplated requisitioning ice cream vans, using their chiller cabinets to store blood and medicine.

I particularly liked the description of local Government push-back against national Government:

When the radicals on the South Yorkshire Fire and Civil Defence Authority were forced by the Thatcher government to make plans for nuclear war, they responded by publicising plans so detailed and lurid that they functioned as anti-nuclear propaganda. Protect and Survive advised readers, grimly enough, that ‘if anyone dies while you are kept in your fallout room’, you should ‘move the body to another room in the house. Label the body with name and address and cover it as tightly as possible in polythene, paper, sheets or blankets.’ The South Yorkshire plan warned that ‘the bag should not be too tightly sealed, as pressure of the gases produced by a body decomposing is likely to rupture the bag and the resulting smell is likely to create unnecessary offence.’

Wither any national Government that forgets that local Government has democratic legitimacy, too.

The image at the top of this post was generated by Midjourney.

This post was filed under: Post-a-day 2023, , .

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