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Monkey business


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Friday, 26 February 2016

Monkey business

Another typical week in the health service, with junior doctors hatching plans for further industrial action, hospital finance directors working out plausible fibs to tell Monitor, GPs up in arms about everything and the Department of Health pretending that the latest NHS staff survey is full of encouraging signs.

Among all this business as usual, few people have spotted the significance of the really big NHS story of the week.

The news that an Irish doctor delivered a baby gorilla by caesarean section at Bristol Zoo led to a spate of feelgood reports in the media. We’re all suckers for stories about hairy primates, particularly when they happen to be gynaecologists.

Editors were so grateful for an alternative to coverage of the Brits, the Brexit saga and the schoolboy spat between party leaders over who has the best mum, that they stopped digging as soon as they got to the headline story.

Here are some of the angles they missed.

By his own admission, the doctor had never performed a similar procedure on an ape. He even bragged to the papers that he “read up about gorilla anatomy” that morning. What would the Royal College of Surgeons have to say about such a casual attitude to training?

The case raises other questions. What was the mother gorilla’s residency status? Was she entitled to NHS healthcare or was this another cynical example of health tourism?

Is the doctor qualified in veterinary medicine? Is he licensed to practice in the UK? Was the gorilla’s GP consulted? Where is the evidence that a proper referral process was followed? Where is the animal registered as a patient and which commissioning authority will be expected to pick up the bill for treatment?

While we leave the GMC and NHS England to investigate these important matters, let’s turn to the wider implications.  

What will the secretary of state do? He has two reasons to be concerned: first by the incursion of publicly-funded healthcare into territory dominated by private veterinary practice, and second by the economic implications of opening up the NHS to the rest of the animal kingdom.

More important than any of these is the question about what this means for our internationally acclaimed bureaucracy. Here at least the news is mainly positive.

We would need to employ thousands of extra civil servants to cope with the task of reclassifying patients to include non-humans, drafting primary legislation and reforming existing regulation. We would need a new NHS Constitution, a new charter for social care, revised equality and diversity rules to include endangered, marginalised and seldom-heard species and the creation of new bodies to oversee finance, quality, safety and clinical practice.

The much maligned Care Quality Commission could look forward to an expanded role and exciting new challenges to alleviate the daily grind of closing care homes. The job of a CQC team asked, say, to inspect the lions’ enclosure, would arguably become slightly more dangerous. On the plus side, feeding time would be a good deal more entertaining for the rest of us.

The baby gorilla affair raises big questions about the scope of “whole systems” and the limits of integration. It makes it hard to resist the conclusion that universal healthcare must extend to the entire population, not just to homo sapiens.

What started as a heartwarming story about ad hoc maternity services at a West Country zoo promises to be the thin end of a very hairy wedge.

Editor: Julian Patterson 


Harry Longman
Harry Longman says:
Feb 26, 2016 03:31 PM

Vintage Patterson. Stand back Ukippers, the NHS is now open to the entire animal kingdom.

trevor jenkins
trevor jenkins says:
Feb 26, 2016 04:18 PM

So will Mummy Gorilla get her £3000 to spend on maternity care that she needs? And wasn't it lovely to see that Choice can be extended to Gorillas as to whether a Veterinary or a Medical Practitioner performs one's caesarian section?

I was disappointed at the Editor's significantly judgemental attitude that the term "patient" does not already inclde species other Homo Sapiens. Vets may now be Up-in-Arms with GPs. What do they call their Service Users? Does this now require the term "Speciesist" to be invented in order to be inclusive acros the spectrum of Equality and Diversity?

I got the impression the Gorilla went Private, so none of the above or the blog is relevant.

Jeff Hudson
Jeff Hudson says:
Feb 26, 2016 06:04 PM

Someone needs to be VERY careful when they explain this to the politicians and their associated Thought Machines or we risk misunderstanding and find policy changes lead to people being operated on by monkeys. A particularly interesting idea given it would cut the wage bill to peanuts and bananas.

Anonymous says:
Feb 29, 2016 09:51 AM

What about the implications for the interpreting services?
Every General Practice will now require an Animal Behaviourist to interpret for the GP. Hundreds of Desmond Morris's will be required - I see a job opportunity here for unemployed Zoology graduates.