The upside of patriarchy and war

Needlessly and childishly provocative title aside, have a read of bits of these two letters that appeared in the FT earlier this year.

"When I joined the Australian Commonwealth Public Service in the 1970s, those in the senior positions (invariably male) had often started their working life during the Great Depression before serving in the second world war. Upon demobilisation they had patiently worked in a seniority-based promotion system for a modest salary in return for security of tenure and a superannuation scheme. By the time I left the service in the mid 1980s they were to be replaced by an increasingly university-educated mobile meritocracy on short and long-term contracts willing and able to transfer in and out of private enterprise. Since then many of the traditional areas of government service delivery (in Australia at least) appear to be constituted by web pages advertising mission statements and core values supported by call centres. Service is no longer a personal virtue but a commodity to be delivered."

Paul Stockley, Jan 31

&

"Pre-1974 there was an overall 17 percent quota limit on female medical students across the UK. The male-dominated profession was led by men who had been the backbone of military medicine during the second world war. We, their trainees accepted and enjoyed the challenge of long hours and the camaraderie of hospital mess life. Central to the "can do" philosophy was the continuity of care for every patient by a designated consultant team from admission to discharge. Society rewarded and respected this arduous work rate....
"What do we now face? The consequences are clear. Whereas my generation achieved consultant status after approximately 30,000 hours of broad and intensive training, the plan from April 2009 indicates that 6,000 hours is acceptable. imagine the outcry if airlines cut pilot training to 20 per cent of what was previously considered acceptable."

David Skidmore, Jan 5

There is of course the risk of rose-tinted spectacles. If things were that good, why did we need the civil rights movement, second-wave feminism etc. But in important ways, I think Stockley and Skidmore point to what has been lost (or stolen) along the way.

• an ethic of social solidarity/noblesse oblige
• an understanding that quality take time, diligence and patience and that the current "corporate culture"(sic) of karoshi and turbo-Taylorism has (steadily more visible) consequences

So, what is to be done?

"But people die in Nursing Homes"

My best mate, "Dr Dave" was down for a visit. Somewhere in the haze of curry, porter and Aliens (the movie that is), we got to talking about death and euthanasia and all that stuff. Inspired by the recent documentary of a guy with MND taking the sensible steps. Or sensible sips, I suppose.

Dave related a story of how he had recently done a home visit, and ended up diagnosing someone with dementia, and then having a conversation with this person's spouse.

Dave: Well, if it gets to the stage where you find it difficult to cope, um... there can be social services input, home care etc. It may become necessary- if it all gets too much- to put [patient] in a nursing home.

Spouse: But people die in Nursing Homes.

Dave: " " [speechless]

Now, patient and spouse both in their late 70s...

WTF?

Did they not see what had happened to their parents? Their aunts and uncles? Their friends, by this age, FFS? Don't they get how life ends?

Me, I blame the War. When I qualified as a health care professional, there were still a few around who'd fought in it. They were, on the whole (without sinking into all that Greatest Generation guff), phlegmatic and realistic. They'd seen friends die, and they knew how life ends, and that they'd had 60 years or so that others hadn't. But those lot are mostly gone, so the people doing the dying now grew up in the 40s and 50s, and the war was a bit of a game, but rarely life and death.

Oh, and I also blame the Death of God. For the Victorians, death was no taboo, sex was. With fewer of us believing in a hereafter, those taboos have switched.

Best book I ever read about this- "The Denial of Death" by Ernest Becker.

Enough cod-sociology for one day I think...