Yesterday it was reported that [more] that Prof John Ashton, a county medical officer for Cumbria, had been called by his Primary Care Trust (PCT) to attend a hearing. This had, apparently, been arranged to consider if he had broken the NHS code of conduct by appending his signature to an letter criticising Lansley's proposed NHS reforms. It seems that someone thinks that having a political opinion is not a privilege NHS employees enjoy and it started off another round of #iamspartacus on the twitters.
However, in the News and Star, a local Cumbrian newspaper, Prof Ashton is quoted as saying:
[Prof Ashton] stressed it was his professional – not personal or political opinion – that the reforms will cause irreversible long-term damage to the health service.
I am not sure what it is that makes Prof Ashton's opinion on these matters in some way a 'professional' one, as distinct from a personal or a political one. Indeed I don't think a professional opinion on these reform either needs or can be differentiated from a personal opinion and it certainly cannot be said to be apolitical. However I do not think there is any need for Prof Ashton to deny his professional opinion on NHS reform is in no way related to his personal or political opinion. They cannot and should not be separated. Certainly when he is speaking in a professional-political capacity then his 'mode of expression' might be somewhat different to when he is speaking in a purely personal-political capacity but professionals cannot, in some way, be deemed or demanded to be apolitical.
Whilst the NHS Medical Careers website itself has a page listing 'Medical Politics and Ethics' as an option we should not understand the capacity to act in a political manner to be formally restricted to NHS officials, professional institutions or their leaders. Rather all medical professionals should understand themselves as political actors. It is then up to them if, how and from what perspective they wish to engage in professional-political activities. They may choose not to. They could even do so in support of Lansley's reforms (although I wouldn't expect any of them would subsequently be asked to attend a hearing).
As I argued in the JME [.pdf], the medical profession is unavoidable a political institution and removing medical professionals from political discourses about the institutional forms of healthcare and medical practice impoverishes the quality of the debate. I said as much during an interview with the American publication MD Magazine during the debates over 'Obama-Care'. Indeed I think a medical professional might justifiably think they have an ethical, and even professional-ethical, duty to engage in political discourse and debate. As such I also think we should teach 'medical politics' as part of undergraduate medicine. We should at least introduce a basic perspective on the medical profession as a political actor and some of the ethic-political debates around its institutionalisation.
If UK medical professionals are being prevented from speaking in a professional-political capacity by an NHS code of conduct then that code of conduct is fundamentally flawed, unethical and should be amended with alacrity.