Column

Now try fantasy teletext

You’ve heard of Fantasy Cricket. You may have tried your hand at Fantasy Football. But what about Fantasy Teletext? What if you could select your own news headlines, based on the sort of world you would really like to live in? Here’s my stab at today’s competition (the day a talented philosopher died).

110: MAIN STORY: SIR KARL POPPER DIES (SEE ALSO PAGES 111-114)

111: INFLUENTIAL PHILOSOPHER MOURNED BY SCIENTISTS, POLITICIANS AND PUBLIC ALIKE

112: THE LOGICAL STRUCTURE OF SCIENTIFIC METHOD LAID BARE

113: SCIENCE DISTINGUISHED FROM NON-SCIENCE

114: LIFE’S TASK TO CLARIFY THE NATURE OF THE OPEN SOCIETY

116: HEALTH NEWS (SEE ALSO PAGES 123-126)

123: PHILOSOPHICAL BREAKTHROUGH IN HEALTH CARE ETHICS FITTING TRIBUTE TO POPPER

124: HEALTH AND DISEASE DEMARCATED

125: THE LOGICAL STRUCTURE OF HEALTH REFORM REVEALED

126: MORAL PROGRESS: AT LAST THE LIMITS OF JUSTIFIED HEALTH PROFESSIONAL INTERVENTION CLEARLY STATED

When you play Fantasy Teletext the further away you are from what actually appears on ‘real life’ teletext on your nominated day, the better your chances of winning the top prize. Here’s what actually appeared:

114: SOUTH AFRICA: MAJOR LOOKS FOR BUSINESS

126: SHOOTING SPREE LEAVES EIGHT DEAD

131: POPULARITY BOOST FOR CLINTON

149: TRAGIC END FOR GERULAITIS

176: PNG VOLCANO: LOOTING AMID DEVASTATION

189: SUE SPOT: CINEMA PAYS FOR SMALL SEAT

194: FILM SPOT: TOP AWARD FOR JACKSON

Not even a whiff of a dead philosopher. I reckon I’m onto a winner... But if I am about to strike it lucky, what does that imply for the rest of you? Think for a minute about the two big questions which drove Karl Popper’s life:

What’s the difference between science and everything else?

How do you tell if you are living in an Open or Closed society?

It is difficult to think of bigger questions, and impossible to conceive of any time in human history when it would be better to forget them than to address them. Now, simply ask a similar level of question on health care:

What is the difference between health and disease?

How can you tell if your health service is being reformed or corrupted?

What is the purpose of health care?

At what point in her professional interventions should a health professional stop?

These are very big questions too, but although a few dedicated souls are addressing them, most people in the health service are unaware that they even exist. Karl Popper answered his big questions. Not everyone agreed with him, but he generated an informed and intelligent debate over decades, and profoundly influenced the shape of scientific activity. The big questions about health care are answerable too — so why aren’t we asking them?

Thinking seriously about what we are doing no longer appears to count for much. It seems to be too much trouble, or it is too hard, or it is derided as ‘elitist’ or as ‘academic navel-gazing’. It may even be criticised for disrupting the status quo.

Serious thinking definitely no longer matters in most parts of the NHS. Think about it: the health service is being reformed, despite the fact that not one of the reformers has offered a definition of reform, and despite the fact that therefore nobody can possibly understand the logic of reform. Rationing is happening though nobody has worked out a justification for it. Budgets are ‘top-sliced’, services are ‘ring-fenced’ — not on rational grounds, and never consistently, but nevertheless by people with degrees in management science. The NHS is in Wonderland.

But when the death of one of the most influential philosophers of the 20th century cannot even make the teletext top twenty perhaps we are better off with our fantasies. Perhaps NHS policy-makers have it right after all.