Dear Dame Sally…

Jobbing doctor puts some hard questions to the new chief medical officer.

Dear Dame Sally,

Congratulations on your appointment as Chief Medical Officer. I'm sure that the appointment is merited, and I am pleased that you have a background in clinical medicine (haematology) that gives you more credibility with the profession than the last appointee.

You and I will never meet. Your daily existence is about policy, and Parliament: ministers and management; command and control. You have been a made a Dame of the British Empire, and will be showered with honorary fellowships from assorted colleges (including my own college - which makes my FRCGP look pretty paltry).

You will meet with chairs and professors and presidents and CEOs. You will be lobbied ceaselessly by commercial organisations who will have whole departments devoted to this activity. I wonder if this is what you wanted when you were awarded Bachelor of Medicine and Bachelor of Surgery (like me) all those years ago.

You and I will never meet. I am a Jobbing GP in the provinces, and my opinions and views do not matter. No, I am one of the workforce who had just better get on with their work. I am expected to get on with the day job. A drone, a prole.

But what if we did meet, Dame Sally? What would the conversation be?

I would rush down to London - possibly by car or by train (not first class, as I would be paying my own fare), and would have a couple of hours to prepare. You would have everything ready, and would be backed up by civil servants. You would intimidate me with your fancy offices - the shag pile, the pot plants, the brass name badges. It would be on your turf. Your staff would be deferential - ‘Yes, Dame Sally.......No, Dame Sally'.

I would feel lowly indeed. And intimidated.

What I say and think does not matter. You will be busy with meetings and plans and strategies, and supporting what is going on in your department. That's what the last guy did.

But, Dame Sally, you have been in the Department of Health for years. You know what is going on. You are a consummate insider, who has risen without trace, and without enemies. We don't know you.

It will, however, be on your watch when the unravelling of the NHS happens, and when the population look at the mess and chaos that the Lansley reforms usher in, and see the part privatisation of the service that we have been proud of for 63 years, then they will ask ‘Who was the Chief Medical Officer when this was happening?' 'Who was the Lord Carrington when the Falklands were invaded?' ‘Who was asleep at the wheel when the money men wrecked the NHS?'

The answer to this question will not be a here-today-gone-tomorrow politician like Mr Lansley. He will have moved on to well-paid directorships in the City, and will be toasted in Bollinger up and down the square mile.

No, Lansley will not be the Faust who will have to answer for this Mephistophelian pact. The person who will be left to face this awkward position will be you, Dame Sally.

So, as they screw the new nameplate on your door, and your pictures replace those of the unloved and unlamented Donaldson, think on this: What is your role? Are you a mere functionary, tamely rubber stamping the plans for the people who have elevated you to this position. Or are you going to take a long hard look at the plans, talk to patients, nurses, technicians, unions and doctors, and make your own judgement?

What is it to be, Dame Sally? Toeing the party line? Or will you be remembered as the Chief Medical Officer who saved the NHS?

This Jobbing Doctor wants to know.

The Jobbing Doctor is a general practitioner in a deprived urban area of England.