Thursday, 12 December 2013

GPs vs UK Vice-Chancellors:- Is It All About Money?

Today, the UK news reports about GP failings. We need to think about Publicly Funded Services a little more deeply. In the October 2013 issue of Chemistry in Britain,(RSC Publication p. 13), there is an article about slashing Croatian University Chancellors' pay by 30% because Mico Tatalovic says "...chancellors are, in reality, people bored with their primary scientific & educational work, whose main motive for staying at their function- sometimes longer than is allowed by law- is a big salary".

Did you know Vice Chancellors in British Universities earn much larger salaries than GPs? At the non-Russell group University where I used to work, our Vice Chancellor earns £205,000/-ish per annum. In her safe and risk-free job, there is no possibility of litigation, because she does not deal with life and death. Her role is administrative and ceremonial, complete with robes, processions and trumpet fanfares at Congregations. Under her management, the University has dropped, internationally, 17 places in one year (2012-2013), amongst the subset of newer Universities (see Telegraph article by Edward Malnick; "Modern Universities are Losing Out to their Rivals in the Far East"). The drop would be even larger if all Universities were taken into account. Despite this disgraceful performance, there is no requirement for public accountability and the trumpet fanfares, honorary accolades, robed processions, expensive wining and dining continue unabated, courtesy of the public purse.

In the UK, GPs, face life and death decisions several times a day for long hours and can face litigation for iatrogenic events and inadvertent malpractice. Even though we have a free Health Service, people in the UK feel they are entitled to an US-type accountability from the NHS. The question is whether this expectation is reasonable. Do we have the money to deliver defensive medicine? A little intelligence applied to this issue will tell us that the NHS in 2013 is required to deliver a several-fold increase in public service compared to the NHS that was created 60 years ago. In 1950, it was tax-payer funded penicillin and bandages. Now it is tax-payer funded cancer drugs, well-person clinics, screenings of all sorts, extremely expensive cutting-edge technology applied from cradle to the considerably-delayed grave.

Basic Economics 101 teaches us that we have "unlimited wants and limited means". It is foolish to expect perfection from all GP surgeries. Mathematics & statistical treatment of data teaches us that there is a normal Gaussian bell-shaped distribution curve for most things. Some GP surgeries will statistically fall under the left lower part of the curve; they are the less good ones. There will be excellent ones that fall under the right side of the curve. The Media needs to learn what balanced reporting is. It is NOT describing the groups of GP Practices that lie on the left or right of the Bell-curve, but instead the ones that fall under the middle i.e. the majority. If the majority (and here we need some percentages derived from raw data) do fall within the dome of the curve, then there is no story and the temptation to create one should be resisted at all costs, because it lays bare what we already know, courtesy of the OECD findings; i.e. that we in the UK, are not so great academically, at Mathematics.

Given any nation's limited means and the people's unlimited wants, a day will come, when we may all have to pay privately for medical treatment & University education; when that happens, Vice Chancellors in non-Russell group Universities will earn a whole lot less and GPs will earn a whole lot more.

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