General Practitioner Education in Northern Ireland – The use and misuse of power

The Ulster Medical Society, through its Journal, is no stranger to historical papers and treatises. While of considerable interest such pieces are usually descriptive and occasionally hagiographical. Significant personalities are described but rarely " warts and all ". To be fair Dr Robin Harland does not venture on to such territory. His is an unusual but very successful approach to recent medical history. He has adopted a rigorous framework from a famous sociologist – not the usual starting point for doctors. The concept of power in its various guises is the focus point of Dr Harland's account of events. It is made even more interesting by the kind of involvement (usually moral or calculative) that the characters and institutions described find themselves in. Just because the author is scrupulous in his focus on power and its uses rather than personality does not stop the reader from " colouring in the background " – especially if they worked during the latter years of the period (1920-1990) described. It also becomes obvious, as one reads this essay that Dr Harland is both industrious and scholarly in his marshalling of events. He is careful to set what could be a provincial, or even parochial story, in the almost (for a doctor and educationalist) tumultuous events within the medical profession during the period he describes. All the usual suspects are assembled, but no partisan position is taken. People, institutions and events are examined in an accessible way. A large range of significant sources are well used in pursuit of this thesis on power. The pace and sweep of the work is brisk but the main issues that preoccupied the profession – be they consultants or general practitioners are described in a UK context. In addition, relevant government sources are identified. The interaction of government policy with an evolving awareness of the need for (and not just the ownership of) training, continuing medical education and more recently continuing professional development was as contentious then as it is now. Dr Harland's hypothetical approach – where the competition for power and the struggle for control are seen as inevitable – is best illustrated as he describes prominent individuals, some of who are still alive. Such figures are no less human for being set in the events of their time. Indeed such events are no less important for us still – given the discernable changes in medical education …