The three paradoxes of private medicine

Editor—When I was a lad, a visit to the general practitioner cost a guinea (Australian), the radio plays came from the BBC (using Australian actors assuming British accents), England was still Home, at least to the older generation, and my reading was all W E Johns and Frank Richards. During my studies, Davidson, Hutchinson, and Hamilton Bailey painted a world view of medicine (admittedly somewhat Dickensian), which I absorbed and which left me feeling that, somehow, I understood the British way.

I thought I knew a bit about the NHS too, but when I read Longley's lament over receiving some politeness and prompt treatment, I realised that I knew nothing.¹ I was looking into the Heart of Whatness. This is the great British inscrutability. They are Frenchmen with whom we just happen to share a common language.

How, I wondered, can one put into words what the NHS means to Longley and these foreigners? And then I remembered that Dickens had done just that in Our Mutual Friend.² Here, Mr Nicodemus Boffin, a praeternaturally wise and generous working man, has inherited a vast fortune derived from recycling household waste and uses this wealth to do good works. In Boffin's dust mounds great masses of waste and decay are miraculously transformed into gold. I felt much better for having this insight, but I remembered also that ultimately the carts arrived and toiled night and day, until the mounds were all gone.