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Is revalidation the new guillotine?

The NHS and its staff are creating a contemporary narrative not unlike that of the French Revolution, argues Dr Jim Sherifi

When you look back on it the French Revolution was a funny old affair, wasn’t it?

It seemed to go from one extreme to another. At first one could feel some sympathy for the need for change in what was seemingly a backward and corrupt hierarchical society, only for that empathy to change to horror during the ‘Terrors’ of the Jacobin coup, followed by disappointment with the ultimate collapse and reversion to the previous status quo.

However there was a legacy. Ultimately France emerged from the darkness with a whole new system of local government, education and law which are still substantively intact over two centuries later. But in order to do so, many lost their livelihood, and a significant number, their heads.

There might be some consolation in the knowledge that those executed did lay the foundations for the strong and vibrant France of today.

Well, that’s one interpretation. Another less charitable view would be that years of upheaval and suffering produced a result that was replicated elsewhere through far more peaceful, evolutionary processes.

I have a feeling that the NHS and its staff are currently creating a contemporary narrative not unlike that of the French Revolution. After years of murmurings and disquiet, much of what has been established for decades is being overturned and new, untried governance put in its place. The egalitarian philosophy of QIPP is driving the revolution. The creation of CCGs will bring power to the local committees. The petit bourgeoisie, privileged GPs and other doctors will come under increasing scrutiny through revalidation.

The masses, empowered by vitriolic newspaper articles and avaricious lawyers (prominent amongst the Jacobins as well) persistently seek to undermine the professional classes. Protocol-driven doctors within the ranks of the royal colleges demand that you do things their way or be barred from doing them at all.

Even some of the titles and rhetoric mirror that of the French Revolution. The ‘Terror’ was driven by the ‘Committee for Public Safety’, which, in acting to protect the people, executed thousands of perceived enemies of the people. 

Compare that to the GMC and its role “to protect, promote and maintain the health and safety of the public”. Are we about to witness similar, if thankfully less gory times, where doctors live in dread of being stripped of their livelihood? Is revalidation the new guillotine?

Altogether, to my mind at least, the current revolution in the NHS bears far too many similarities to its French counterpart. I have no idea how posterity will regard it but I do know that I would rather be taking a historic perspective than have been a participant at the time.

Dr Jim Sherifi is a GP in Sudbury, Suffolk.

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