Counter-elites and the shortage of doctors in Britain

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It’s been a boring old week or three here in Britain. I mean, it’s true that the government wants to fix the doctor shortage by shortening the time they spend studying medicine, but other than that we’re all just sitting here watching daytime TV and waiting for something to happen. 

Okay, we’re not supposed to call it TV. It’s the telly, but I’ve never been good at following the social cues, and whatever you call the thing, once you leave the safe harbor of the BBC it’s full of ads for incontinence underwear and chairs that can lift you to the heavens without any effort on your part.

But forget the ads. Forget daytime TV. I haven’t really been watchingit, even if everyone else has, so I’m only guessing at what they’re selling. What I want to talk about is medicine. It’s been in the news and if all goes according to the government’s plan, medical students will study for four years instead of five, but don’t worry, it’s all perfectly safe. The change will be accompanied by a simplification of the human body to make diagnosis less confounding and repair more efficient. 

A rare relevant photo, but you’ll have to read to the end to find out why: Gay Pride celebration in Bude, Cornwall

Why does that seem like a good idea to anybody? Because we’re short some 9,000 doctors, although (as the Japanese paper I’m linking to says, that’s surely an underestimate.

It also mentions an overall shortage of 124,000 people in health care.

Why do I have to go to Japan for data on the UK? Because that’s where I found it first and it’s not 8 am yet, so what the hell. 

The government’s also proposing a medical apprenticeship program to shovel new doctors into the system. Details seem to be scarce, although letting me know what’s going on isn’t anyone’s top priority, so maybe the details are out there but haven’t filtered down to my level yet. Either way, I’d love it someone would reassure me that they won’t be taking kids at sixteen, introducing them to the aorta and the colon, explaining why they shouldn’t mix them up, and then letting them practice stitching people back together.

The British Medical Association’s first reaction was–and I’m paraphrasing heavily–”Excuse me, but we’re a little short-handed just now. Who do you think is going to train these people?”

Its second reaction was to head for the pub in search of solace.

The government plans to deal with the shortage of nurses in pretty much the same way. Apprenticeships. The word has such a roll-up-your-sleeves, get-down-to-work sound. How could it possibly go wrong?

The government doesn’t plan to increase anyone’s pay so it keeps up with inflation or figure out why–it’s mysterious, I tell you–people have been leaving the medical professions in droves. It doesn’t plan to pour enough money into the National Health Service to make up for what it’s taken out. Because where’s the fun in that?

 

Elite overproduction

The plan to magic up extra doctors and nurses is–bear with me and the connection may make sense–related to a theory I read about recently: elite overproduction. This comes to us from Peter Turchin and his book End Times: Elites, Counter-Elites, and the Path of Political Disintegration, which I’ll confess to not having read yet. What I did read was a longish and thought-provoking review. I’m linking to it. It’s worth your time.

Okay, it’s your time. What do I know about how it’s best spent? But the review’s from a British newspaper even if Turchin isn’t, so I’m still including a bit more Britain-based news here. Almost.

What Turhin argues is that rich families and elite universities are churning out more wealthy graduates than society has a use for. That means people who were expecting to be senators or MPs or CEOs get shoved aside in favor of–well, it’s hard enough if they get shoved aside by someone from a more or less identical background, but if it’s by some outsider that really stings. So since they couldn’t merge into the elite–since someone else stole the place that was rightfully theirs (and if you doubt it was, just ask them)–they become counter-elites: they channel the discontent of people who don’t have their wealth or connections and who have much better reasons to be pissed off, at least in my all-important opinion. Think Donald Trump. Think (if you’re in Britain) Nigel Farage. Think Boris Johnson. Think all the shouting by people who look to us like members of the elite about what’s wrong with the elite.

Is the surplus elite to blame for the National Health Service being so battered? Not entirely. The process started some time ago, by a section of the elite that swore taking money out of government services would make them more efficient, as would outsourcing government responsibilities to private companies. 

I seem to remember them saying, “You can’t solve a problem by throwing money at it.” Which may be true, but they’ve shown us that you can absolutely make a problem worse by taking money away from it. 

After they outsourced and took money out, though, the counter-elite came along to tell us Britain’s problems–exacerbated, remember, by taking money out, etc.–could be solved by leaving the European Union, which was keeping money from going to the NHS. So we left, and oddly enough money didn’t flow into the NHS. It not only didn’t get better, it got worse.

So they changed tunres. It was because of the immigrants coming here and using our services. What we needed to do was get rid of the immigrants, and we could if only the tree-hugging, immigrant-loving, avocado-eating courts and lawyers would get out of the way.

Meanwhile, funding’s fallen further and further behind inflation.

Sorry, I’m not managing to be funny about this, am I? 

The point is that raging against a combination of the most vulnerable and the elite gets people elected. Three rasberries for the counter-elite. On the evidence I’ve seen so far, they’re anything but competent. On the other hand, they’ll always find someone to blame. They’re very good at that.

 

Enough of that. How about a bit of Covid news?

Let’s not get too excited about this, because it hasn’t gone into clinical studies yet, but a drug called NACE2i shows promise as both a Covid preventive and a long-Covid cure. It keeps the virus from replicating and protects against reinfection. 

Professor Sudha Rao talks about it as boosting “the effectiveness of existing vaccines, providing long-lasting protection against any variant of the virus that tries to enter the cells.”

And long Covid? 

“We uncovered the pathway that the virus uses to induce the persistent inflammation which causes organ damage found in long COVID. This study shows our drug prevents that inflammation and even repairs damaged lung tissue in pre-clinical models. It is both a prevention and a treatment.”

How does it do that? According to the article I stole this from, it reprograms “the hijacked ACE2 receptor, which disarms the virus and stops it replicating. The reprogrammed ACE2 receptor is returned to the cell surface where it acts as a lock that prevents the virus from entering the cell. This process also reverses the inflammation COVID-19 causes in the lungs.”

But again, it hasn’t gone into clinical trials yet. We’ll see what happens.

 

Of airlines and pastries

Ryanair has managed to offend the government of the Balearic Islands. Two passengers got on board with an ensaimada each–a local, spiral-shaped pastry that tourists load up on as gifts for family members and cat sitters. 

Ryanair charged the passengers £45 each for going over the hand luggage limit. The passengers replied with some version of “are you kidding me?” and gave up their ensaimadas. Somehow or other the fuss went public and escalated into a flap about what’s hand luggage and what isn’t.

That led to Ryanair meeting with a collection of important people and announcing that it never had charged anyone for carrying pastries on board. Never. Not once. It hadn’t even dreamed about it. The people had hand luggage. You know: suitcase-y things. They were charged for those.

Whatever. Passengers can now officially bring up to two ensainadas on board without paying extra and the world is a safer place to live in.

 

Living in interesting times

You know that recent US Supreme Court ruling that makes it legal for businesses to refuse service to LGBTQ clients? Well, the request for service that the case (sort of) rests on may never have happened.

The denial of service started–or so the story goes–when a gay man asked a website designer to design invites and possibly a website for a gay wedding. The designer refused, citing her religious beliefs. 

What wedding needs a website? Beats me, but then there’s no amount of money that can’t be spent on a wedding, and LGBTetc, people can be just as silly about this as straight people. So paying someone to set up a website? Sure, why not? 

The interesting thing is that the man who requested this–his first name is Stewart and he doesn’t want his last name loose in public–never contacted the designer, although she listed his name, email address, and phone number. He’s not only straight, he’s already married. He doesn’t need wedding invites, never mind a website.

Does that invalidate the ruling? ‘Fraid not, but it does make the claim that Christians are under siege by hordes of gay people clamoring for wedding cakes and napkins look a bit silly.

40 thoughts on “Counter-elites and the shortage of doctors in Britain”

  4. Same sort of medical shortages going on over here, and finally, finally, after the medical profession (nurses, doctors, specialists, etc) screaming at them for years, the provincial government numpties who have the power to change these things, decided that in the interests of providing a better service for their beloved constituitents, (aka get re-elected) they’ve changed the draconian residency/citizenship rules that prevented anyone who wasn’t, well, white and male, from practicing their craft.
    They expressed great shock and horror, I mean great delight, when the website set up to expidite this process recieved literally thousands of applications in the space of 24 hours, mostly from not-white and not-male people.
    Funnily enough the sky did not fall, the universe did not end, when this occured.

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    • Lunacy. And I should’ve thought to say in the post that refugees with medical degrees of one sort or another aren’t allowed to work while their papers (and their own selves|) sit in limbo for years. I have no idea how many there are, and I doubt anyone else does either, but it is truly insane.

      I’m glad they’ve changed the rules, at least slightly, even if it’s not because they’re horrible rules but because they’ve discovered a need of their own.

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  5. It is so discouraging to read that the thought-free policies being carried on over there are similar to what we are seeing. We are also experiencing a shortage of social workers and teachers

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    • We’re absolutely short of teachers here. I keep reading about schools not being able to find anyone to teach [ fill in the blank ]. I’m less sure about social workers. We may not be short of any because the government’s cut funding to so many agencies that might even make a gesture in the direction of helping anyone.

      Thought-free? That seems to be the current version of free thought. The Conservatives have demonstrated a remarkable shortage of talented leaders.

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  7. It seems that in listing someone in her lawsuit that she didn’t actually have that interaction with, she’s gotta be breaking some sort of law. Please can we prosecute her for that?

    We have a teacher shortage in the US, but I don’t know about a doctor shortage. That’s downright scary.

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    • It is scary. And I didn’t even get into the shortage of nurses.

      I don’t know if she broke some sort of law. She was, surely, lying to the court–to multiple courts as it progressed up the chain–but the prosecute that we need a prosecutor in the right county/state/whatever who’s interested in prosecuting. If anyone is, I’ll drink to it. Although it’s complicated. Someone did contact her, and she may not have done that herself. My best guess is that some helpful rightwing individual or organization gave her the amunition she needed. Did she know it was a fake? And if she did, could anyone prove it?

      What the hell, I’ll still drink to the prosecutor who takes up the case. That’s not admissable in court and I’m drinking–oh, I don’t know, lemonade or water or something wild like that, but what the hell, the spirit’s still there.

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  8. It could be worse. The minister for immigration, a man married to a woman whose grandparents were holocaust survivors, could have decided that murals of popular cartoon characters on the walls of a child migrant detention centre (read: concentration camp) were too welcoming and ordered them be painted over.

    Oh wait…..

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  11. Here nurses are in demand, in fact any kind of nurses, they may be specialised for hospitals, older people, etcetc. I know some people of this profession, who quit after the years of covid, simply because they were, well, “used up”, “verheizt” is the German word. Burnt out, depressed. There was this oh so great action when the public should applause nurses on their way to work. For many this was only cynical – A better equipment, and proper pay they needed, and still need !

    So the glorious head honchos came up with the idea to import nurses – and because heavy unemployment in Spain, why not recruit Spanish nurses ?
    And they came. After one year they went back, singing ugly songs. A gouvernment etiquette recently gave two reasons – 1) These Spaniards only used the year in Germany to better their prospects in Spain. 2) They did not like the weather.
    I kid you not.
    Spanish nurses have a different training / education, they are allowed many more things, things a doctor must do here. The Spaniards were expected to wipe German arses and keep quiet. The Spaniards expected to work according to their qualified training and being treated fairly, they did not expect the German hierarchy.
    The whole thing crashed and burned, so they went back. But officially they did not like the weather.

    And because head honchos are dumb by nature, and learn nothing from mistakes, some minsters lately jetted around the world, and “recruited” people in Africa, Southern America – why these people should come to Germany, nobody knows.

    I only know that we must call Mumps for Crap against the gay hordes : They will teach these perverted cakers, tah !

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    • Except, as far as I know, for the Spanish nurses, that sounds very familiar. The British system’s used to consider it perfectly sensible to–I’m tempted to say “loot” the world for nurses, for doctors, for whatever skills we haven’t bothered to invest in training people here to fill. Now, though, that the Conservatives have decided they can get elected by blaming everything available on immigrants, they can’t do that anymore. They are at least consistent. Even when they lose out by keeping immigrants out of the country, they go right on doing it.

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      • Still happening, Ellen. Our local Acute hospital keeps on with International recruitment of nurses. My last mammogram was done by a beautiful black woman with the gentlest hands and a strong sub-Saharan African accent. I could not have wished for better care but the patients in Siera Leone who supported her training may. Meanwhile low pay means UK trained nurses seek jobs in the private sector or emigrate. Freedom of movement, migration and sharing skills enrich us all, but UK health services outside the big cities depend on nurses and doctors from overseas in a way that is less positive.

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        • The only reason this surprises me is that I thought the Home Office (otherwise known as the Department of Cutting off Its Nose to Spite Its Face) had made it impossible for nurses from overseas to move here. They don’t make enough money to qualify–or so I thought.

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  12. The irony of “you can’t just throw money at the problem” is that the private finance/privatisation solutions offered instead turned out to be all about just throwing money at the financing institutions. Just look at the water companies: how typical of the privatising fanatics to sell people shares in their own s…ewage, dump it in their local waterways and then charge the consumers extra to clean it up (well, I exaggerate a bit – but not much).

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    • Not much at all. And they certainly threw money in all directions at the start of the pandemic, with precious little thought about what they were buying with it. I’d have said “throwing money at their cronies,” but I’m sure the finance institutions got into position as well.

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  13. That Turchin link was very enlightening, thanks (I think). ;) The focus was on the US (with Britain cited as in second place), but I can’t help thinking the “wealth pump” is now a global phenomenon. We’re in a new scenario from any of those in the analysis of historical crises, therefore – never before has the world been socially connected, and that social connection manipulated by elites; never before have we had the existential crises of global warming, billions of people coming out of poverty; and never before has there been nowhere for the excess elites to go and run a distant part of the empire instead of competing on their home turf, because everywhere is “here” now, or if “there”, it has its own excess of elites. Here’s hoping for “voluntary downward social mobility” as the sea levels rise and the forests burn. It’s awe-inspiring to imagine what we could do to save the planet with all the gazillions squirrelled away by the greedy. Massacre is my second favourite option, but they probably have private armies of robot warriors by the time we get round to that.

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    • And I thought the scenarios that run through my head were grim. I hadn’t thought about private armies of robot warriors. Silly me.

      I’m glad you followed the Turchin link. I was hoping someone would.

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