Right Man Wrong Job Case Study Obstetrics

IT IS one of the world's great cities—with problems to match. London is Britain's economic engine, generating more than one-fifth of its wealth. Yet its greatest industry, finance, is perpetually under attack. London's immigrants, who give the capital its energy, also put huge pressure on hospitals and transport. The city's schools are bursting. It is an obvious terrorist target. Sadly few of London's difficulties, or its greatness, are evoked by the race to become the city's next mayor.

The election, which takes place on May 3rd, pits Boris Johnson, the Conservative incumbent (pictured right), against Ken Livingstone, a left-winger who ran London between 2000 and 2008. The battle between the two main challengers has been dominated by niggling personal issues and trivial disputes. Is Mr Livingstone's use of a (legal) tax-avoidance vehicle inconsistent with his socialism? Did Mr Johnson spend too much money on some retro-chic double-decker buses? Were Mr Livingstone's tears at a campaign broadcast genuine? Is Mr Johnson sexist? The incumbent has a slight lead in polls. But his party has grown toxic in London. The vote should be close.


Mr Johnson has been a good mayor rather than a great one. His image of tousle-haired disorganisation is not merely a pose. He has a habit of fastening on social problems, setting up an advisory group, then losing interest. Under great pressure—following last summer's riots, for example—he can wilt. Mr Livingstone ran London as a machine; Mr Johnson occasionally appears to forget where the levers are.

Yet he has two great things to recommend him. The first is that, on the big issues, his instincts are right. The mayor defended bankers and called for a cut in the top rate of income tax when both positions were deeply unfashionable. He is socially liberal. For years he has been enthusiastic about immigration, and has even called for an amnesty for illegal immigrants, although he has bowed to a harder, more conventional line in the past few days. He has also done a good job of getting cash for infrastructure from central government.

His second advantage is that he is not Ken Livingstone. London's first elected mayor began boldly. Belying his left-wing instincts, he introduced a congestion charge inspired by Milton Friedman and cosied up to the City. This newspaper backed him for a second term. Disappointingly, though, Mr Livingstone has gradually conformed to the “Red Ken” stereotype. He claims he can cut public-transport fares and even the rents Londoners pay private landlords. Over time, an ugly side to Mr Livingstone's personality has emerged. He has shown startling insensitivity towards Jewish people. This would be unattractive in any politician. In the mayor of a diverse and occasionally tense city, it is intolerable.

Give him something important to do

This newspaper would like Mr Johnson to serve another term—and pull his finger out. We do not imagine, though, that he will abruptly be transformed into an English-accented Michael Bloomberg. For that to happen, the mayoralty itself would have to be radically changed.

A big reason the mayoral race has degenerated into squabbles over personal taxes and the shape of buses is that the candidates do not have much more to talk about. London's mayor has great power over transport, as well as rather less power over housing and planning. He has almost no sway over education and health. The legislatures of Scotland and Wales, with a combined population roughly equal to London's, are much more powerful. Most emasculating of all, less than 10% of the money London's mayor spends comes from local property taxes. The rest comes from central government, which often tells the mayor how to spend the cash.

If the mayoralty is to become a serious job, attracting serious candidates, this must change. One thing Mr Johnson has demonstrated is that London's police chief cannot hold on to his job if the mayor wants him gone. That power should be made formal. There is a case, too, for giving the mayor more sway over education: power is rightly being devolved by local authorities to individual schools, but Westminster still keeps too much to itself. As America shows, mayors are often the boldest education reformers: Mr Bloomberg is not the only mayor who has transformed local schools. Most of all, London's mayor should be allowed to raise more money locally.

London's mayor has the biggest personal mandate in British politics. He, or she, is a model to other cities that are toying with the idea of elected mayors. Mr Johnson has carried his responsibilities rather lightly. Time to increase his burden.

This article appeared in the Leaders section of the print edition

Actually you probably have a good case to sue for discrimination. The BFOQ requirements are pretty limited, in medical cases where the patient base is mixed they hardly ever hold for discriminating. The cases where it has held has been in L&D where the patients are all female. I really doubt they could make the case for discriminating when there is a near even mix of patients. I really hope someday one of you files a suit and forces the issue, its the only way it will change.

I had to have a scrotal ultrasound and specifically requested a male, the facility I went to had 2 males, 2 females. Our local hospital does not, when one of the providers found I went to a facility outside our community for it they asked why I didn't support the local. I told them I asked, they didn't have a male, so I went where they did. They told me they had tried to hire a male but could not find one....I really hope you will challenge the facilities, the only way any discrimination is changed whether that be racial, gender, or religious is by someone having the guts to challenge the status quo...if you want to see how many men are looking for options google patient modesty a more significant issue, a thread by Dr. Maurice Bernstien, or Medical Modesty by Dr. Joel Sherman...it should be interesting reading for you all and may be encouraging...don't give up guys, there are a lot of men who feel more comfortable with a male tech for these and are looking for facilities that have them....

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