How a kakistocracy develops health policy

So Matt Hancock, the Secretary of State for Health, has decided that the future of GP practices lies in online consultations, and that face-to-face consultations are now a thing of the past. There are of course advantages to digital consultations, notably from the point of view of saving time. There are numerous drawbacks: patients with complex and/or interrelated complaints, those requiring physical examination, and those requriing very confidential consultations (such as cases of domestic abuse) are obvious examples where digital consultations would not be appropriate. GPs would have advised him that this proposal, like so many others, has pros and cons.

It appears that, after a period of 'following the science' (a phrase that appears to have been mislaid) and of ostentatious deference to medical experts, the government is now reverting, in the area of health policy, to the too familiar 'command and control' model of over-centralised government. Teachers have been familiar for a long time with policy-making by diktat. Of course, all governments have to plan for the future ; but they must do so with some humility. Too many people are making hurried extrapolations from recent events without pausing to reflect that they are making confident predictions about very complex phenomena. Were this government inclined to listen to anybody, it would have said that the question was worth looking into, and that they would be undertaking extensive consultations with all interested parties. However, even though governments' centralised power is in itself an obstacle to effective governance, governments, especially this one, are, despite this fact, ever more desperate to appear 'decisive' and 'bold', in the hope that this is an easy way to gain respect and trust. The opposite is true.