The Politics of Medicine

From the title alone you know - this is going to be a sexy one. Strap in.

The GMC says doctors should stay “relatively apolitical.”

We’re supposed to be impartial — especially in the UK, where the NHS is taxpayer-funded. The idea is that we must work with everyone, from every political stripe, to keep the system running. That we must remain neutral, professional, above the fray.

I get the reasoning. I even agree with the principle — to a point. But here’s my take:

it’s impossible to be truly apolitical — especially in medicine.

Now to be clear, we're talking Frontline here. I've been in meeting panels for Off-shoot Medicine adjacent organisations and NGOs who were fretting over their organisations stance on Anti-semitisim in the Labour party when, lets be frank, no-one gave a sh*t what they, specifically, thought about it - let alone the Labour Party or anyone remotely Jewish.

Healthcare though is political.

Working in the NHS is political.

Even hating political and staying out of it is a political act.

You don’t get to opt out just because the guidance says so - you don't get to avoid the house-fire by putting a Duvet over your head and humming "Don't Worry, be happy" to yourself.

If you care about how the system works (or doesn't), then by nature, you care about who’s steering the ship.

That’s politics.

Structural decisions — from funding cuts to workforce planning — directly affect clinical outcomes. Most of us on the ground already know: clinical care and political policy are inseparable.

The cold pedestal of the Clinician

When doctors are perceived as neutral and scientific these traits are weaponized by both campaigners and institutions. The “apolitical” doctor becomes a symbolic tool , a paragon, asupposedly unbiased figure whose silence or support can shape public health narratives in political campaigns. It's a sort of very elabourate damnation by fine praise that winds me up frankly.

I’ve known doctors who protest.

I’ve known doctors who advocate for causes beyond their remit.

I’ve know doctors who’ve run for office.

I’ve also known many more who’ve checked out completely — burnt out, bitter, exhausted.

Even that is a political position, in its own way. NHS activism has often drawn on shared professional anger and bitterness, forging “solidarity” networks among burnt-out clinicians who’ve turned disillusionment into action.

The Back-benches of Medicine

It’s worth remembering that the NHS doesn’t operate in a vacuum. Every policy, funding cut, workforce shortage — it’s all downstream from decisions made by politicians. And a lot of those decisions aren’t made by clinicians, or even people with a healthcare background.

They’re made by managers, strategists, career politicians who’ve never written a prescription or stood in resus at 3 a.m covered in all manner of interesting fluids.

Cards on table - since you didn’t ask.

Personally, I’ve voted Labour for most of my adult life.

I vote SNP where I live, mostly to block the Tories — despite being sceptical of nationalism. My politics have shifted as I’ve aged and seen more of the system.

But the central belief I have has stayed the same:

The NHS is — and must remain by definition — a socialist project.

Because here’s the thing: you can’t run shared, life-saving resource like a business. That's like trying to ration and sell a parachute mid-fall — you can’t slice it into marketable chunks and still expect it to function.

A right-wing healthcare system is what you get in America: insurance-based, profit-driven, inequitable. If you can’t pay, you suffer and die. That’s not care. That’s capitalism with a stethoscope wrapped around your neck.

This risk was already apparent decades ago, when John Meadowcroft warned that increasing NHS marketization was not just inefficient, but fundamentally distorted by “government failure” and policy decisions made outside clinical expertise.

That was in 2008. Obama. Global Financial Crisis. F*****g Twilight movies for God's sake.

TL:DR

To work in the NHS and pretend politics don’t matter is naive at best, dangerous at worst.We’re not just passive participants. We are the system. And if we don’t speak up when it’s breaking, who will?

Now — should our politics influence how we treat patients? Absolutely not. You don’t get to withhold care based on someone’s political views - compassion must be universal. However that doesn’t mean we should silence ourselves outside the consultation room.

As List argues, medical neutrality has limits—particularly when silence can reinforce structural injustice. He makes the case that political activism and ethical care are not mutually exclusive, especially when the health of populations is directly influenced by social policy.

We need a broad church in medicine. We need dialogue, challenge, reform. We need people from all sides who agree on one thing: the NHS is worth protecting. That doesn’t require party loyalty. It requires principle.

I’m not running for Parliament - I'm too honest for that job. But I’m not going to pretend I’m neutral either. I care about this service. I care about the people in it.

So yes, I’m political. And so are you — whether you like it or not.

Stay Political, comrade

—DW