Death by erosion

Paul Seabright

• Medical Choices, Medical Chances: How patients, families and physicians can cope with uncertainty by Harold Bursztajn, Richard Feinbloom, Robert Hamm and Archie Brodsky
  Routledge, 456 pp, £12.99, February 1991, ISBN 0 415 90292 4
• Examining doctors: Medicine in the 1900s by Donald Gould
  Faber, 148 pp, £12.99, June 1991, ISBN 0 571 14360 1
• Some Lives! A GP’s East End by David Widgery
  Sinclair-Stevenson, 248 pp, £15.95, July 1991, ISBN 1 85619 073 0

Two of Britain’s largest remaining nationalised industries – the Church of England and the National Health Service – have recently acquired new bosses who have publicly declared that the Nineties will be a decade of major change. This has set me wondering what kind of reaction George Carey might expect if the plans he had in mind for his own organisation were at all like those being implemented under William Waldegrave. Capitation fees and evangelism budgets for individual priests? The chance for churches to opt out of diocesan control? A division between purchasers and providers so that a diocese can draft in the Jehovah’s Witnesses or the Wee Frees if it suspects that the fare in its own parishes is becoming a little dull? A small minority would no doubt welcome these along with other transatlantic innovations, but for most the sheer, well, commercialism of it all would provoke a delicious shudder of horror.