“For a successful technology, reality must take precedence over public relations, for nature cannot be fooled.”
This morning I read an article in the New York Review of Books: Freemon Dyson reviewing two books about the physicist Richard Feynman. Dyson relates one episode towards the end of Feynman’s life. Feynman was invited to be part of the NASA commission investigating the space shuttle Challenger disaster of 1986 (the shuttle broke apart a minute after take off, resulting in the death of the 7 astronauts on board). Feynman was ill with cancer at the time, and did not have long to live: ‘He undertook it because he felt an obligation to find the root causes of the disaster and to speak plainly to the public about his findings. He went to Washington and found what he had expected at the heart of the tragedy: a bureaucratic hierarchy with two groups of people, the engineers and the managers, who lived in separate worlds and did not communicate with each other. The engineers lived in the world of technical facts; the managers lived in the world of political dogmas.’ Feynman found that these two groups had very different views of the levels of risk: the engineers estimated the risk to be one disaster in every 100 missions; the managers estimated the risk as one disaster in 100,000 missions. There were two main causes of the disaster: a probable direct technical cause (a rubber O-ring seal which malfunctioned at cold temperatures), and a cultural cause. ‘The political dogma of the managers, declaring risks to be a thousand times smaller than the technical facts would indicate, was the cultural cause of the disaster. The political dogma arose from a long history of public statements by political leaders that the Shuttle was safe and reliable. Feynman ended his account with the famous declaration:
“For a successful technology, reality must take precedence over public relations, for nature cannot be fooled.”‘
I am very happy to have found this sentence for it helps to clarify the situation which confronts us with the issue of GP practice boundaries (and of course the many other complex issues surrounding the NHS, and the so-called ‘reforms’).
Can we please allow reality to take precedence over public relations? Can the politicians and DH please do a sensible and honest and public RISK ASSESSMENT of the complex technology that is UK general practice, and the function of practice boundaries? And of the technical problems which come into play when people live at a distance from their registered GPs?
New York Review of Books article (unfortunately, you cannot read whole article without a subscription)
Challenger Disaster (Wikipedia; a salutary read)