Leading Article: Melodrama from pulpit and podium

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MELODRAMA ill befits a bishop or a doctor. People expect passion from both but trust the clergy and medics to keep their feet on the ground. In their latest interventions on the NHS changes, neither profession has managed to maintain a sense of proportion.

On Sunday, the Bishop of Birmingham, Mark Santer, condemned the NHS changes as 'un- Christian'. He said ministers had diminished a patient to 'the status of a unit of consumption and exchange'. Mammon seemed to have run amok in the sacred healing temple. Then, yesterday, Sandy Macara, chairman of the British Medical Association, compounded the bishop's tale of woe. With a righteous tone that might normally be reserved for a temperance meeting, he spoke of NHS despair.

Each had a point. As Dr Santer indicated, there are fears for moral values, notably equality, that underpin the NHS. The health service is founded on common acceptance that everyone should be treated in the same way. However long waiting lists become, people draw comfort from knowing that misery is shared. Markets destroy that sameness in the name of securing the gains of competition.

Such change should be accepted once explained if it helps to get a quart out of a pint pot and everyone benefits from improved efficiency. But the market has been rigged to favour more generously endowed GP fundholders. Until that injustice is resolved, many will understandably baulk at greater inequality for the sake of the greater good.

Likewise, Dr Macara had a point. Some doctors are fed up. Consultants face the uncertainties of performance related pay, the horror of managers telling them what to do and the indignity of once subservient GPs being in charge of NHS cash. In the hospital car park, they see leased vehicles for new administrators and wonder whether the changes are worth the expense. Family doctors worry about paperwork and increasing demands. Even once deferential patients are becoming assertive.

Yet all this does not justify Dr Santer's apocalyptic vision of the NHS, nor does it vindicate the pomposity of Dr Macara, who seems to have forsaken a sober bedside manner for the special pleading of middle-class trade unionism. The NHS reforms are imperfect and the Government has only itself to blame for public distrust. There are issues of moral values and staff insecurity that ministers must address. But much is good about the changes. The pulpit and the podium are unwisely employed in such indiscriminate attacks by those who are held so highly in public esteem.