Abstract:
Humans are distinctive primates behaviourally, yet are also
uncannily like chimpanzees. Both evolved for survival in
places such as the forbidding African savannah and are thus
good at sustaining themselves through activities such as
resource foraging and socio-political navigating.1 Amongst
humans, this can be observed in both hunter-gatherer and
modern technological habitats. Life can be tough in each
setting. To get more resources and succeed politically,
many humans strive to move from being one of the troops
to a place of power—the classic alpha male or socially
predominant female.
This is especially noticeable amongst that most
interesting of cultural groups, the health reformers, who
by definition have climbed up the primate hierarchy to a
position of authority. These are ministers for health, heads
of health departments or private hospital chains, chief
executives of trusts, directorate leaders, and others in
senior policy and management ranks. They can be
contrasted with the staff who occupy posts with little
formal influence. We have come variously to call these
‘workers’, ‘clinicians’ and ‘the shop floor’.
It is eerily as if there are two emerging, recently
evolved, sub-species. Homo commandus controlus and Homo
extremus flexibilitus, while often co-inhabitants of the health
environment and externally similar to each other, display
contrasting cognitions and behaviours. Exposing and
understanding these two sub-species, we argue, is
important in determining whether and how the health
system works. Early identification of the sub-species in situ
will allow participants to understand events and reduce fall
out damage to themselves. Personal and sub-group survival
is, after all, the name of the game in heavily threatening
environments.
