Health services in the UK are free for all and they may be some of the best in the world, but they are infected by the sickening application of capitalistic values and the Blears Witch model. This bureaucratic system is the most wasteful scourge in this country. It is so sick that many skilled clinicians have left due to lack of basic standards. So, a significant part of the NHS is now operated by people moving in from other countries where conditions were sometimes worse, sometimes not. They are no less skilled, it seems, but they are dispensable and less likely to balk against the prevailing trends of PCT (primary care trust) bureaucratic bludgeoning. That’s hardly going to be a problem, since the PC PCTs are all about compromise compromise compromise, to fit in with them. If you’re less than PC and differ with the PCT, you’ll find yourself out, or resigned to shutting up and putting up care trust services. So, eastern doctors training in psychiatry and working as SHOs in A&E departments, (some of them in the most racist areas of Lancashire), when helping an English person not to commit suicide, don’t need to worry about whether their dialect is actually intelligible; or whether their beliefs, traditional values and judgments will conflict with psychological processes inherent with a more permissive society. But by all indicators, except the delivery point, they fit the bill, tick the box and make the PCT look inclusive. Anyone who would object to explaining to a Pakistani or Indian doctor why they have an abusive but compulsive sexual relationship with their step-father or step-mother, or that they might be gay, or may want to cut themselves, or cannot stop compulsively gambling, or stealing, or shopping, or eating… or complains that they just cannot decipher the psychiatrist’s whispering responses… is racist. Health care has become the worst kind of political institute. It is a political process, a political hierarchal organisation as opposed to an experienced care-led hierarchal organisation. And worse, a capitalist-led political organisation. This is mainly the auspice of the PCTs. So, the individual PCT has to justify its existence. So, they push their pens to produce as much full-gloss-pamphleted and plasma-screened justification for their existence as possible… more quantifiable justification than practitioners can produce of the results of their patient care. This is not on. So, now the PCT needs to use more money to justify collating the evidence (that is evidence-based practice, incalculable in practice) to justify that the practitioners jobs are as justifiable as theirs. It creates more work, more jobs for the boys, more money, more readable results; so that’s good isn’t it? That’s the theory. Because they can look good and the government can look good at spending public money, even though people are dying of MRSA for lack of basic-wage earning cleaners. Every PCT will duplicate this with their independent in-house evaluations. Or triple it, since every correspondence I receive from them comes in triplicate – envelopes and all, same delivery. That’s two totally unnecessary hectares of forest for every hectare they need to strip. They have become the ‘art critics’ of public health; no longer content with enhancing our appreciation of health care, supporting and informing us of developments and innovations to expand our choices. Health care just could not exist without them because they and the reports say so. Clinicians skills have to be harnessed to fit what is good for the public. They have to be told how, why and when to fit in, by the PCTs, because they’re too busy to be politicians, so they can conform their efforts to what is critically credible and what the government, in their infinite cabinet wisdom, dictates to the public is good for them and what they tell us we told them we want, in all the consultations they railroaded. Meanwhile, back in NHS city, it’s new jobs for the boys, yes, but tasks have to be integrated into already overtaxed positions, to save on wages and expenses. And where does the budget go? If there is one, it goes on new subadministrations; whichever department decides to go independent and pile more work and training on their existing staff, with its individual bureaucracy, equipment, overheads and contract tender. (See chapter – Take the biscuit). “I do not believe all politicians and all commerce executives are psychopaths. I just believe that to handle the things they are expected to handle pushes them towards the same end, since the processes they have to employ to apply such control are psychopathic.”