Dalrymple writes in the Telegraph on the recent proposal by Andy Burnham, the British Secretary of State for Health, to allow patients the freedom to choose their General Practitioner:
The fundamental contradiction in our Government’s policy is that it wants to introduce the flexibility of the marketplace into a system that is fundamentally Leninist, and getting more so by the day. When you go to your doctor, he is more likely to do what the Government has told him to do to – or for – you than what, as a professional, he thinks he should do.For Americans like me, confronted with the possibility of more government involvement in healthcare, the real news here is: British citizens have been unable to choose their own doctor?! Is this what I should expect?!
He does this because of targets and financial incentives. The Government has, paradoxically, de-professionalised the general practitioner by paying him so much. Few GPs have been able to resist the Queen’s, or rather the Government’s, shilling; and they have been foot soldiers ever since.
If we want real choice, there is no choice: we shall have to pay for it ourselves, and not through the intermediary of the Government or even of insurance companies, for wherever there is a third party involved there is less choice. Those who do not want choice, or cannot afford it, will have to settle for what the Sun Kings of the Department of Health grant them, once the salaries of the people working for the Department of Health have been paid, which is lack of choice.