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No Margin for Error A tolerance for margin of error for the medical profession is, for obvious reasons, much less than other professions. Rail Track has a diabolical record of incompetence and indeed an unacceptable casualty list. And yet the sacked chairman is to receive £3m payout. This is more than the average doctor or surgeon could earn in several life times. In my attic I have stored many silver, gold and platinum discs recognising my successes in the record business. There are no trophies that recognise my mistakes, which were many; and would have been an unacceptable ratio had I been a doctor. In business, the accepted philosophy is that provided your successes outweigh your failures then you are to be awarded a considerable income plus the freebies that go with it. None of the above excuses the secret societies that attempt to hide incompetence and arrogance which applies to the medical profession as indeed it does to cartels in other professions. Indeed, thirty-nine years ago our second child was delivered at home by an arrogant midwife, whilst the local doctor, who should have been in attendance, let her get on with it whilst he finished his drinking session at the local pub. The result was that our daughter's head was crushed through having to get through a restricted opening. This caused considerable damage to the eye muscles. Under the initial supervision of consultant Sir Benjamin Rycroft, our daughter had three major eye operations before her fifth birthday. She was left with vision in one eye only, with restrictions to lateral and vertical movement. My wife and I had to deduce this information by certain comments made by Sir Benjamin and other eye surgeons. In those day it was the practice for the medical profession to keep such facts from the patient. We chose not to make a fuss as the damage had been done, and to try bring our daughter up as normally as possible. She is now a psychiatric nurse at F grade level and is a happy and balanced woman. Although her vision is not the same as others, she knows no difference and copes adequately with driving, reading and indeed her job. Despite this experience, I have every sympathy for the health service in trying to cope with a very difficult situation, brought about by successive governments. The government should now take bold steps and stop pretending that health should be free at the point of delivery. Let them remind the public that health is a commodity alongside holidays, homes and cars and other lifestyle luxuries, and should be priced accordingly. Let the government for example introduce weighted NHS premiums, where those who choose to smoke, drink and eat to excess pay an excess insurance premium accordingly. If people drive badly notching up penalty points, the insurance companies weight their premiums accordingly, and whilst this is not liked by those bad drivers, it is accepted. The government could then reduce taxes on tobacco and booze and make up the revenue on NHS premiums. This will have the effect of focusing peoples minds, and there would be some stigma in loaded premiums. The weighted premiums would apply to self-inflicted and not genetic illnesses. Indeed there would be more money to treat unfortunate kids who have to rely upon a generous benefactor to send them abroad for an expensive operation. If Dr. Pal and her colleagues would devote their considerable energies and genuine concern way from the inevitable negatives of the NHS and focus their attention on radical ways to improve it then I feel more will be achieved. In any event Dr. Pal and I are sincere in our aims, but our approach is different. Denis Knowles
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