Proud to be a lawyer ???

[IanA2]

Zod said:

Breadvan72 said:

When I started at the Bar in the mid 1980s it was considered rather bad form even to have a business card, and touting of all forms was frowned upon. Of course, people did network (that word was not yet in use) in informal ways, and even then there were occasional beauty parades, but it was all very low key. Nowadays my chambers employs a team of professional marketing staff, and I am on constant three line whips to turn up to assorted schmoozefests (Attending these, I feel that I might as well hang a sign from my neck saying "will work for canapés"). Our marketing, however, is directed at solicitors and in-house lawyers, and we don't have billboards or adverts in local media. I agree that allowing pretty much unlimited advertising was a bad idea, as was allowing conditional fee agreements (and now even worse, US style contingency fees in which the lawyer takes a stake in the action).

Clients at the upper end of the market tend to be sophisticated, hard bargaining, and often not very loyal -they shop and switch all over the place. Clients at the lower end of the market tend to be vulnerable to being schmoozed and bamboozled by shady operators, and of course may be foolishly looking for something for nothing - the good grifter always finds his mark.

Edited by Breadvan72 on Saturday 28th June 09:05

I just checked my diary for tomorrow. It has an event from 8.30 to 13.30 marked "Compulsory for Corporate Partners", entitled "The Fundamentals of Selling", to be given by a man called Kevin from some organisation I've never heard of. It's depressing. The best marketing I do is doing a good job for clients.

As for pride in being a lawyer, Julian64 probably put it best; it's not particularly a question of being proud, but of feeling that what I do is worthwhile and allows me to look my kids in the eye.

That there are ambulance-chasing spivs around (most of whom are not actually lawyers) is not my responsibility.

Which is a damn sight more than some of the spivvy so called CEO's of dodgy Trust's can do.

[Osinjak]

ATG said:

Sorry, I probably went off half-cocked. I would never suggest that the NHS is sacrosanct nor that it or its employees should be anything other than accountable for their actions.

My concern is that there is a tendency amongst many right-leaning people (and that's my political persuasion) to take a hopelessly simplistic view of the applicability of market mechanisms and will distort their view of almost any system until they can say "open it up to the market". Healthcare is a great example of this. There is no effective market here to be set free; the basic mechanics of price determination are fundamentally broken in the demand and supply of healthcare, regardless of whether the provider is in the public or private sector. The patient is not a "rational economic agent" in the usual sense when they need to receive care. Their demand is not usefully elastic. You don't decide you'll have both legs amputated because there's a cut-price (geddit?)deal on. And private sector medicine is almost always intermediated through insurance which in itself is a great way of dislocating market forces (see cost of repair and car insurance).

Even when people don't create flimsy pseudo-markets, there's also a great tendency to try to sound "businessy" and use the language of free markets to describe system inappropriately. For example, IT depts in both private and state organisations often call their users "customers" and this is almost always unhelpful because it misrepresents the relationships that actually exist. In a true market there are multiple potential providers in competition with each other to secure a customer's business, and the customer is in competition with all of the providers. It is an inherently adversarial system; that's what makes it work. If a system doesn't have that type of competition at its heart, then we shouldn't expect free market competition to deliver efficiency, and pretending that we are in a free market by labelling people "customers" just helps us dodge the really difficult questions about achieving efficiency in the absence of true market forces.

You raise some really interesting points and I agree, the principles of a competitive market don't work well in the NHS, in any health system in fact. Interestingly, you've taken an advocate's standpoint particularly when talking about patients and the choices of healthcare that they make. As you say, in a perfectly competitive market, there are multiple suppliers with well-informed customers, the market is termed atomistic and firms are known as price takers. This means that for consumers in particular they understand what they're buying and are not likely to get ripped because there are so many suppliers who can't afford to price them out of the market. This simply doesn't exist in the UK health system (and I can't think of another health system that does work like this, let alone any other business). We have agents (doctors) the market is restricted and the market is also considered to be in a perpetual state of failure because it's not perfectly competitive as described earlier.

So what? Health economics recognises that applying market principles to healthcare, at a macro level, is not without risks and its detractors are vocal - very. But there are other aspects, not least the efficiencies associated with economics, economies of scale, equity and access, all economic principles and frankly they are all too much to go into here. You're also right about the demand if a little skewed. You're absolutely right to say that just because there's a price cut I don't need to have both legs chopped off but the demand is still there, it still has to be provided and even though I didn't want it, I still had to have my wisdom teeth whipped out when I was 17 (a thoroughly miserable experience). You mentioned elasticity, another economic principle. This applies to how responsive the demand is in relation to a change in price as opposed to changes in demand itself. For example, you would probably pay anything for insulin if you were an insulin dependant diabetic (inelastic) and be reluctant to pay anything over £x for a branded tube of toothpaste (elastic) when the next brand is x pence cheaper - all other things remaining constant.

I think there is a place for some market principles in the NHS but as it stands now, the NHS in England is a bloody mess. The lasted wheeze to report GPs who fail to spot cancer is a wonderful example of how to get it wrong, just stupid. I don't like the way the NHS is going, I was having a chat with Lord Nigel Crisp the former NHS Chief Exec (check me out) last week about it and he wouldn't be drawn on the future shape of the NHS which just tells you what he really thinks. He didn't like the current shape one little bit but acknowledged that something has to give because the NHS can't keep up with the changing and increasing demand on its services.

As for corporate speak, don't get me started. I loathe it and it's liable to send me into a disproportionate rage.

Edited by Osinjak on Monday 30th June 21:29