ALL of that we read and hear on the subject of health care now seems to have degenerated into a never-ending discussion of finance, from the amount of savings that the CCG is required to make to keep NHS England happy to which life-enhancing treatments can be discarded to balance the budget.

The composition of the clinical commissioning group is heavily weighted in favour of general practitioners whose specific precious knowledge and experience is seldom called upon; I wonder what does it feel like to have chosen a profession whose core activity has always been ‘the care of patient’ only to find that you are relegated to being nothing more than a low-grade business person operating at the behest of Simon Stevens as he strives to meet the impossible target of providing health care with an ever-diminishing amount of money.

The nature of the relationship between the physician and patient has been highly valued by the patient and protected by the physician.

The modern version of the Hippocratic Oath prepared in the 1960s by Louis Lasagna and used in many medical schools states in simple and moving terms the commitment the doctor makes to his patient.

Read the wikipedia version and ask yourself how much under threat is that doctor/patient relationship in the light of a business model National Health Service.

If you are given to spending money on books buy yourself Being Mortal - Illness, Medicine and What Matters in the End by Atul Gawande, a humane surgeon, who reminds us what the practice of medicine should be about.

Central to his book, which focuses on the last part of our life when we are at our most vulnerable, is the belief that the good physician is in a relationship with his patient, he listens to what is vital to the patient as he approaches his death giving the patient and family the time and understanding that supports this short precious time they have together.

Now, ask yourself, in what way do the unending dictats that pour out from NHS England and the numerous other NHS management groups go any way towards promoting and supporting such a fundamental tenet.

The National Health Service belongs to us, we have never lost our belief in its value and we are not deceived by the government lackeys; we know what matters in the end.