A prophecy ...

... in process of fulfillment: Psychiatric services in Britain are being destroyed by an apparatchik class. (Hat tip, Dave Lull.)

... patients must see an assortment of "mental health workers", of varying levels of intelligence, education and commitment. While the changes in the service have been brought about in the name of "Person-centred services" (what, one wonders, were they before?), even in very small matters the wishes of patients are disregarded and dismissed with lordly indifference. For example, it has been established over and over again that patients would like to be known as patients rather than clients or "service-users". But the latter terms are used, because the former would imply the necessity of medical rather than bureaucratic leadership.

In 1939, W.H. Auden noted that "the picture of the State as a strata of ruled and ruling classes is ceasing to be altogether adequate; it is becoming more and more, the united professional politicians and bureaucrats versus the disunited rest."