The Thief of Time

Monday afternoon:  I’ve just listened to Mrs May’s statement to the House (given against a background of braying and carping so incessant that Mr Speaker had to interrupt twice to restore order) announcing that she has decided to defer tomorrow’s “meaningful vote”.

In my own professional life in medicine, while reflection could often be helpful in solving a problem, I don’t recall procrastination as ever being a useful diagnostic or therapeutic tool.  Actually, in emergency medicine, it just isn’t an option.  Procrastination comes from the Latin cras, tomorrow.  MananaManana is too late.  Time, specifically “the golden hour”, is the defining entity of emergency medicine.  You see a patient, you take a careful history, you conduct an equally careful physical examination, maybe you order a couple of highly specific tests designed to answer a specific question and not merely to kick the problem into the long grass; then, sooner rather than later, because maybe the situation is deteriorating and in any case loads of patients with equally difficult problems are pouring through the front door, you have to make a decision, and run with it.  You have to make a diagnosis, construct a “formulation” as to how the diagnosis uniquely affects the patient, and then you have to devise and implement a plan of management.

Maybe you make the wrong decision and achieve an outcome somewhere between less than ideal and absolutely catastrophic.  Then you are up in front of the General Medical Council which takes a week to mull over an episode you were constrained to conclude within fifteen minutes.  I’ve heard it said that with respect to a UK – EU divorce deal, two years was always going to be cutting it tight, but you will readily appreciate how odd this sounds to an emergency physician.  The government has a track record for imposing its will on various professional groups and getting off-side with them.  Mrs May who is now PM got off-side with the police when she was Home Secretary, Mr Gove who is now Environment Secretary got off-side with the teachers when he was Education Secretary, Mr Hunt who is now Foreign Secretary got off-side with the doctors when he was Health Secretary.  Then they all elided seamlessly into their next job.  But I wonder if Parliament and the body politic, the Westminster Bubble and the whole political system, realises the extent to which it is currently being weighed in the balance by the electorate, and found wanting.  Parliament might make a decision which is wrong, and harmful, in the eyes of half the people, or she might make another decision equally wrong, and harmful, to the other half; but if she fails to make a decision at all, then the entire electorate will be entitled to ask whether they are worth the candle.

Being disillusioned with the political class is not good.  Mr Trump got elected because the great American people were disillusioned with the Washington élite.  In Paris, les gilets jaunes assembled aux barricades because they say M. Macron is a toff who doesn’t know the first thing about how real people live, and struggle.  The UK has a ruling class that is predominantly public school and Oxbridge educated.  People will look at what is going on in Parliament just now and conclude that maybe PPE at Oxford ain’t all it’s cracked up to be.  After all, if the ruling class can’t even get together to make the wrong decision, and thus end up making no decision, I think we have to consider whether they are worthy of our respect.  You expect your surgeon to be a trained surgeon, you expect your airline pilot to be a trained pilot, but what sort of training should a politician have?  Maybe it would be better if we elected mature adults who had proved themselves in various other walks of life, who were of independent mind, who weren’t frightened of losing the next election, who felt they had something to contribute, and who volunteered to stand for one term only.  I can’t imagine they would make any bigger hash of it than that which we are currently witnessing.

Westminster needs to be put into special measures.

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