So, as GP, and with the NHS all over the news right now, I wanted to throw some thoughts into the ring.
You can read all about the proposed changes that Andrew Lansley is suggesting and why he thinks they are a good idea. You can read all about why Clare Gerada, chair of the RCGP, the RCN, Physios and numerous other health bodies are now vehemently opposing the changes he suggests (or rather the ideological objective behind how these changes might be implemented). You can read Andy Burnham MP’s tweets. You can listen to podcasts, you can watch question time or tune in to radio debates. All very interesting and some huge issues to tackle. In the main it boils down to: misuse of the service, overspending, affordability in the future and the role of private companies in providing ‘services’.
For me, all of this is slightly missing the point. I’m tired of all the political point scoring that is going on, and that one idea or another is going to solve the enormous issues in front of us (though I do agree that the proposed changes – the result of a non-listening, listening exercise would be detrimental to the nhs). I think we need to reimagine together what the NHS is about and what it needs to look like in the future. The NHS is an organisation which exists to serve the health needs of the people, not the other way round. Having worked in the NHS in lots of differing environments over the last 12 years, as a student, then a hospital doc and now a GP, I genuinely don’t believe that structural organisation will make any difference at all unless we start with a change of culture.
I would love to see a culture of: service and humility, honour and affirmation, dignity and integrity, going the extra mile, kindness and
gentleness, excellence and learning, integration and partnership,
people not paperwork, respect and love! I’m not just talking about how
we treat patients, but how we treat each other as workers! I have too often encountered people being treated like dogs, burnt out staff, staff who’ve got burnt out and stopped being able to care like they used to. Lying to prove unrealistic targets are met and other crazy performance driven behaviours. I don’t know anyone who didn’t go into the caring professions because at some level they love people or want to make a difference in other people’s lives. We need to recover this. The foundations need restoring.
With the right culture, a caring community of people together caring for the community, we could have something that brings an enormous amount of life and excellent care. To me it looks like treating people like royalty, having an attitude that no job is beneath me (so no more crazy stories of people being left in their own faeces for hours or not being fed their dinner – not sure there is much more important stuff than nutrition in helping a person on the road to recovery)……It looks like every member of a team from consultants to cleaners knowing that they matter and being thanked for what they do. It looks like community and hospital teams working in partnership, with seamless transitions. It looks like joined up thinking between allied professionals (with better partnership and respect with therapists of all descriptions and the social services). It looks like communities being able to participate in budget decisions, so that the services make sense for the communities they are serving (this might also lead to less abuse of available services and things being taken less for granted). It means sharing patient records across various settings with patients having access to these records so they can understand about the conditions they have and good communication with them about what their options are in treatment and management. It looks like those in positions of power, not lording the power over other people, but emptying themselves out in order to serve and build up those who work for and with them.
It means more than just a culture change within the NHS. Most of the health needs in our country cannot be solved my a nurse or doctor. Most of our problems are to do with how we live, the things we eat, drink and smoke, the ways our communities function – or don’t; the advertising we allow, the cost of healthy things in the super markets, the amount of exercise we’ve lost in our schools, the way we handle relationships, the way we parent our kids, the way we pollute the environment, the crazy working patterns we have that leave us little time to rest and recuperate. The NHS is breaking because we are breaking……the answer doesn’t lie in privatising the NHS so it can all be done more cheaply (because poor people with chronic ill-health, don’t make good business sense)……..we need to change the way we are thinking and living. A change of culture in us and in the NHS will lead to a sustainable future. Please stop all the talk about which political options will save the day. The answer is none of them.
Jesus said something very interesting. He said that if we seek first the ways of God – that is caring for the poor and marginalised, making sure the children, elderly and most vulnerable are looked after, loving on people – no matter who they are or what they are like – without judging them, working together for what is good and brings joy and peace, then everything else we need will be given us. Whether you have faith or no faith, that’s a pretty incredible statement. If we take care with how we live and what we do, to make sure that everyone who needs it most is looked after, then everything else needed will fall into place……pie in the sky thinking? I don’t think so, but I think it’s worth a go! So, what can we change in how we think and live that will enable a change in culture? A new culture of love and kindness that will breathe life into our communities in a way that looks after our holistic health needs and helps us to have an NHS that is sustainable, life-giving, dignified and excellent? What can we reimagine together?