Patients are not commodities

In November 2009 my Patient Participation Group won an award for a proposal to set up an information center. We collected our award from David Haslam (now ex-president) at the Royal College of General Practitioners AGM. My patient, Stewart Harvey-Wilson performed this poem on stage in spite of Dr Haslam’s brief protest. It was intended not to attack managers but to warn doctors that patients should not become commodities. It was a warning of what was to come. But were they listening then and more importantly, are they listening now?


Survival of the fittest is the case we have to plead

We stand on Darwins’ ladder and our goal is to succeed

The Spirit that is Management informs our every task

What do we do exactly? You only have to ask.

We are the prince of process; The fisted hidden hand

With slightly sweaty fingers and a smile a tad too bland

With powerpoint we state our case; in managegabble speak

We’re here to gouge out value, quantify and tweak.

We are doctors of the dismal science

Kings of business plans

Save a bit on hygiene and we’ll send you more bedpans

The timer set for patients should be just like boiling eggs

Don’t waste time on the dying; don’t waste time setting legs

Each minute is accountable; each decision in a flash

Human values can’t be counted so we’ll have to stick to cash

We’ll talk in any ballpark; each flagpole we’ll salute

We’ll cut the waste and trim the fat; in this we’re resolute

With a firm grip on the pursestrings we’re rationing heartbeats

It’s such a shame that patients can’t sleep on balance sheets

If we don’t describe the target; if we don’t define the goal

It’s like we’re tipping money down the blackest of black holes

The further we look into it the less we understand

Why can’t patients be predictable? It all seems badly planned

So survival of the fittest is the system that fits here

And we’re here to make you fit right in or simply disappear

The ebb and flow of life is naught to flowcharts everywhere

And the empty hand of process choking off the air

George Stone 2009

3 responses to “Patients are not commodities

  1. Managers are patients too. As an NHS manager I’ve been battered by sentiments such as these for the last year from politicians to rabid newspaper cif commenters. Well, we did our best. It’s all yours now, look after it.

    • Dear Jean, I did say at the begining that the poem wasn’t an attack on managers, but a plea not to treat patients as commodities. I have no desire (nor do most GPs) to manage, I think that managers, more so now than ever, have an undeserved pariah status and I’m horrified by the haemorrhaging of talent from our PCT

  2. Thank you – it just shows the strength of the poem that it got under my usually thick managers skin. If any good comes of this latest upheaval, it will be the development of a much more mature relationship between managers and clinicians as we both strive to protect all that is good about the NHS. Excellent blog by the way, I’m generally in complete agreement….

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