30 years ago……..
In 1987 130 young and hopeful doctors fledged from Nottingham University with big plans for healing patients, sharing hope and health, holding hands……a journey of discovery and relationships.
Every 10 years we have come back together to share our lives again, only a few of us are no longer here; a fond memory only, and in the summer we will toast their lives and smile as we recall the times we had together. Those of us who soldier on giving succour to the ill, reassurance and advice to the well and try to pass on the years of wisdom gleaned to our junior colleagues are now wondering if at our next reunion in 2027 (!!!!) we will still be proud to be working in our wonderful national health service. Perhaps we will no longer have an NHS.
You may ask why I say that when the public are adamant that the NHS is an institution that these days is more sacred to people in the UK than the Bible. Well here goes……
Even before austerity hit, the investment by the labour party had begun to plateau just as the percentage of GDP was approaching that of our nearby neighbours in Europe (but still way below that spent by Scandinavia and the USA). Since the combined efforts of poor government policies and poor banking practices plunged the money markets into a downward spiral, public services have all been forced to make huge cuts in spending. The NHS and social care were not exempt and at a time when our elderly are living ever longer with increasingly complex co-morbidities quite frankly we cannot cope!
My 103 year old Nana lives alone in sheltered accommodation but could not do so without a couple of regular carers who do care about her and several family members living nearby who also care. I live 2 1/2hours drive away so responding to emergencies would be tricky. Many of our elderly have no family who see them regularly and are dependant on neighbours who can be bothered or carers who look after them. Increasingly, when ill there is not enough capacity to increase care at home so into hospital they go.
And we wonder why hospital A&E departments are clogged with trolleys on many days of the year?
Call me cynical, but when the government manages to demolish junior doctors’ and senior doctors morale by putting political pride above sensible discussion and has sped up the haemorrhage of doctors to Australia, Canada, New Zealand, retirement, the private sector…..one can only assume they don’t really care that the public want our NHS to continue to be available free at the point of access to the most needy as well as those more fortunate.
In the same way as we needed honest fact sharing and discussion before the EU referendum (and look where that has led us) we also need honest fact sharing and discussion about the future of our NHS. Instead we have insidious undermining of personnel that is currently the modus operandi of our government, with most of the media complicit.
The facts at the moment:
- There is a requirement for the NHS to deliver £22 billion of productivity improvements by 2020/21.
- Across every sector of the NHS vacancies of doctors and nurses are increasing every year.
- Emergency GP cover unfilled shifts left 4 million people without access to GP advice last year.
- General Practice is coming under ever increasing pressure from extra workload (useful infographic) while GP vacancies are going unfilled long term countrywide.
- Hospitals are stopping elective surgery due to financial pressures.
- Waiting targets for hospital care are regularly breached nationwide.
- Demand for both community and hospital-based care increases year on year – The Kings Fund has analysed and commented on this.
- Interruption of health and social care could be the answer but will the latest government initiative, STPs (Sustainability and Transformation Plans) be the answer?
Only time will tell but most of us struggle to be hopeful.
I hope that my 14 hour days supporting my patients in the community will help to play a small part in maintaining our health service for the next 10 years at least. I think perhaps that if I don’t get burnt out in those years I will need to continue to work to afford private health cover in addition to the dwindling pension…….
Musings. 
Dear Julie,
I and all your friends hugely value you and the work you do in your several roles (GP/hospice/etc.) as a doctor. and I know you must actually be feeling “burnt out” much of the time. I am not sure how to fix things in the NHS, when there are so many things that are wrong in the provision of services, lack of funding and mismanagement of services.
We clearly need to mend society by loving and valuing our elderly and looking after them, as they have looked after us when we were younger. Only when we start to pay decent wages to carers can this be the case. Keeping my Mother (who has Alzheimer’s disease) in her care home costs us nearly £3000 per month, and I feel considering that she wanted to leave us a legacy that this is also iniquitous. I feel rather powerless and trapped within the system with no viable choices as to what to do. My mother deserves the best of care and I have no regrets in one sense, but we are doing the best we can and have effectively had to sell our Mother’s house to “back” to the NHS, which I find it difficult not to resent, given the fact that my Father’s factory and my Mother’s shop employed many people and paid their National Insurance for many years.
The Bates family and all your other friends greatly value who you are, what you are all about and what you do, and I do not have the resources to make the changes that need to be made. We all have to make the “the best of a bad job” and continue to be loving, kind and sensitive to the needs of the people that we come into contact with at work and at home and to gently “push” at the system when we can and if we get the chance to make the changes for the benefit of the majority that we can.
It is a privilege to have you as a friend, you are a star.
Much love from Tim, Helen, Rachel and Peter Bates
Thanks Tim, that’s appreciated. I find that my regular Holy Spirit top-ups are protective in preventing burn-out and keeping me postive towards patients and colleagues. Having said that every NHS colleague I talk to is deeply concerned about its future, hence the blog.