‘If we want a better health service, we need to look after the people working in it.’ That’s what I said, in 1992, as a general election candidate for the Struck Off and Die Junior Doctors’ Alliance (SODJDA), standing against the then Health Secretary William Waldegrave. Mr Waldegrave beat me by a margin that is too embarrassing to recall, but the heart of my campaign—that we need to put humanity and compassion into healthcare, starting with how we treat the staff—remains a core belief of mine. Happy doctors and nurses make happy patients.
Fast forward 20 years, and I’m sitting in a roomful of GPs debating the Health and Social Care Bill. Everyone looks knackered, even the few brave souls determined to defend it. The eyes may just about sparkle with a manic fervour for commissioning, but the bags under them tell a different story. The bread and butter of general practice is demanding enough without the confusion of massive reform, the complexities of competition law, and the extra responsibilities of holding the purse strings.
I’m bored with the arguments now. We all know this legislation isn’t necessary. We could have put clinicians in charge of slimmed down PCTs and SHAs to get us involved in designing services and commissioning. The legislation is a stubborn vanity project of a health secretary who wants to leave his mark of the NHS with a Bill. But it’s so turgid, incomprehensible, and full of potential vested interests and conflicts that it’s taking our eyes off the importance of a safe, high-quality service for less money—something the NHS has never previously achieved.
The NHS is a people service, and you gauge its health by looking into the eyes of those around you. They reveal the emotions of the moment, and for my money I see too many ‘dead’ eyes. Staff struggling to do a job and a half, to cover for those who have been axed or simply not replaced. I’m losing my job at the end of March (all offers considered), and I know plenty of salaried GPs and non-consultant grade specialists in the same boat. I’m used to job insecurity—most of my career has been in comedy, journalism, and broadcasting—but those still clinging on to the idea of medicine as a job for life are in for a surprise.
For those left behind, it’s going to be a tough few years. Some LMCs are reporting a sharp increase in GPs seeking help for stress, depression, and addiction problems.1 We need to be on guard for colleagues who may be sinking. Everyone needs an arm around them and a chance to offload. Put the humanity back into healthcare and the fun will return. Have a ‘stuff-it’ party once a week where you shred any reform document or directive you don’t understand. Never mind the Health Bill (version 87), have you tried reading Design of the NHS Commissioning Board? It consists of 63 pages of wonk including such gems as: ‘The NHS CB will deliver improved outcomes through matrix working, by hard-wiring into the ways of working,’ and, ‘The NHS CB will have a consistent approach to leading change and transformation running through the matrix working approach. The change model will have two components: a massive improvement approach; and having clear principles for the application of that approach.’ All that disruption for this?
These reforms are like a very bad dream that we can’t escape from. We must stick together and never lose sight of our patients. In the face of imposed ideological dogma that has no evidence base, we have three defences—anger, apathy, and satire. Or, for the politically inclined, ‘constructive engagement’. Whichever you choose, try not to take it out on your staff, friends, family, or patients. Hug a receptionist now. Take the practice manager a coffee (with Hobnobs), and when the going gets tough, remember the three Ps: pace yourself, pamper yourself, and pee yourself laughing. Good luck.
- GP online website. LMCs swamped by GPs suffering depression. www.gponline.com/bulletin/daily_news/article/1115348/exclusive-lmcs-swamped-gps-suffering-depression/?DCMP=EMC-ED-News,jobsandCPD-1115348 (accessed 8 February 2012).
- NHS Commissioning Board. Design of the commissioning board. 2012. Available at: www.medmosaic.co.uk/news/nhs-commissioning-board-reveals-plans-for-dhid.htmlG
Please login to rate this article, view others comments or make your own.