I have spent much more time living with chronic long term conditions as a patient than I have spent as a Doctor on the UK medical register. I owe my life to the NHS, having been resuscitated from a cardiac and respiratory arrest on the same day and having been kept alive for a subsequent month in a coma both in a busy London teaching hospital.
My response to the notion of regular five day strikes is therefore mainly emotional, rather than cognitive, for which I apologise. As a member of the Royal College of Physicians of London, I’d like to thank NHS consultants who’ll be doing their best in exceptionally difficult times. They’ll have to do blood tests, write TTO discharge notes, do all the correct management for their complex inpatients as ever. That won’t be easy for them.
The NHS is not only in dire straits, but social care is. They act in one big system – therefore having social care in managed decline means that social care practitioners are hard pressed to enhance the wellbeing of users, but it also means that NHS patients cannot be discharged in a timely manner. Doctors are not the only ones who are demoralised. I have had personal conversations who are literally living in fear that something will go wrong on their watch. They view their shifts as a matter of survival. They know if something goes wrong the Nursing and Midwifery Council will not have any sympathy for the argument that nurses don’t even have time to go on a tea break, let alone implement the 6Cs to A* level.
Just as justice delayed is justice denied, and we know about the mental pain of grieving families from NHS scandals, treatment delayed can feel like treatment denied. I’ve never personally never bought this argument that ‘no harm is done’. Take for example, somebody writhing with colicky pain due to a ureteric stone (a stone in the tube from kidney from bladder)). Waiting and waiting for an appointment for a procedure to remove the stone, over months and months, is undeniably mental agony. But it is also physical agony – and what about those reams of reams of QUANGO guidelines about acute and chronic kidney injury?
Whatever the political posturing of the chief protagonists, such as the BMA, the GMC, the NMC, the RCN, the AMRCos, Hugh Pym or Roy Lilley, it’s clear that the cliché that there are no ‘winners’ is partly true. True up to the point that Jeremy Hunt can consider it a win that he can start the job he started, of imposing a contract against the will of some of the medical profession. A strike is now happening against some of the will of the junior doctors. We are all going for #Brexit, despite some of the will of many of us who wanted us to remain in the European Union. We’re all paying through the taxpayer route for the private finance initiative bequeathed to us from both New Labour and Conservative governments, akin to a corporate Wonga direct debit.
When you think about the NHS Outcomes, you realise that all the policies are immediately rendered null and void, and this should alarm most of us. We all have our own personal opinions about how we arrived at this mess. But for all the razzmatazz about NHS vanguards, new models of care, ‘rocking the boat’, we have the dire position that we cannot meet any of the NHS outcomes (for example on patient experience, avoidable admissions.) We don’t know how many people will die prematurely from the strikes, but we don’t know how much damage has been inflicted so far from paying off the PFI debt and paying for certain CEOs for a long period of time at the expense of running timely services either.
I have a particular personal pain, in that despite my moaning and groaning I think it’s a huge privilege and honour to be in a position to be a medical Doctor. I ‘get’ this thing about how one would be happier in New Zealand, but I feel I really have been through hell and back to get my professional registration. I was also given no support for my own substantial mental health problems from the NHS which prefers regulation to performance management. And yet, despite this, or perhaps even because of this, I feel a profound sadness of where we all are. And of course Jeremy Hunt can sleep well at night, one assumes?
