Doctor in the World

Doctor in the World opens with personal experiences of the socialist NHS in England and Wales; in developing countries in Central America, Africa and East Asia; Medicare insurance schemes in Canada and Australia; then back to the NHS in its hybrid public/private and internal market form.

It is an anecdotal record of medical care in many different places around the world. A country’s government has an impact on the health of its people and so geopolitical backgrounds that affect medical services have been included.

Finally, the results of WHO and OECD surveys from many countries are compared against the background of phenomenal advances in modern medicine.

The stories of world health will interest anyone involved in medical care, anywhere in the world.

After he qualified in Medicine in London in 1961, Dr Baddeley worked in many health care systems in different parts of the world: Central America, Uganda, Ghana, Thailand and China. His longest experiences were of the National Health Service in England and of the Medibank/Medicare universal health insurance schemes in Australia. Over the second half of the twentieth century, he experienced the enormous advances in medical science and technology, especially in his own specialist field of clinical radiology.

His most glaring discovery was the gap between the availability of adequate care for people in developing countries compared with those in North America and Western Europe. The gap only widened as medical technology and therapeutics flourished in the West and as developing countries were left behind. The disparity increased despite the best efforts of the World Health Organisation and medical aid programs from western countries. He participated in several such programs and was aware of their limitations caused by lack of basic resources.

In 1978, the WHO set a target of Health for All the People of the World to be achieved by the year 2000. At the turn of the century, the Director General issued the Year 2000 World Health Report that ranked the health care systems of 191 countries. The report confirmed the world’s failure to reach the 1978 target. At best, only one fifth of the world’s population had adequate primary health care, adequate hospitals or public health systems. Not all the deprived people were in the developing world.

For the last ten years of his medical career, Dr Baddeley worked in west London as a Clinical Director in an NHS Hospital Trust. Here he experienced, at first hand, the transition from the original Socialist-style NHS to the hybrid, public/private Internal Market NHS. Though his admiration for the principles of the NHS, the doctors, nurses and paramedics who worked for it was undimmed, he came to realise that the British NHS was not the best health service in the world.