How To Destroy The NHS In Five Easy Steps!

Mr Hunt makes yet another appearance on my blog! :p

So, I could spend my time ranting at/about Mr Hunt.  There are plenty of reasons to do so.  Yesterday he announced that he will be making doctors work for at least four years in the NHS after they graduate.  Obviously, this is a really lame idea – impose a contract, then make doctors work that contract and keep on making conditions worse and worse so that NHS staff lose all morale and don’t even care anymore if the NHS collapses or not….So I could  spend my time ranting about that.

But I won’t.

I want to direct people’s attention to all the other reasons doctors are leaving the NHS.  Because there are a lot (and surprise, surprise money isn’t one of them!).

I feel as though there are five major reasons as to why there is such a large exodus of doctors out of the NHS.  So here it is!  The five easy steps to destroy the NHS!

Step 1 – Hire Horrible People

The number of times I have seen other junior doctors break down due to rudeness from other staff members is ludicrous.  I don’t want to make it sound like doctors are the only victims here, but they are the ones who are in massive scarcity at the moment and are required to run the services patients need!

So literally, as a junior doctor you are treated with utter disdain from individuals from all other groups of healthcare providers – consultants, nurses, porters, physios, pharmacists, radiographers….any other healthcare professional you name, I can think of a few people who I have absolutely hated working with!  There are a lot of people in the NHS whose life’s purpose seems to be to make your life hard for no reason!

Simon Sinek often talks about how you know an organisation has lost its way when they start hiring horrible people who you yourself wouldn’t want to spend time with.  As soon as you make the argument “she’s got these skills, so we can let her continue to be a bully and generally be horrible.”, you know that that organisation is toxic.

Step 2 – Treat Doctors Like They Are Not Human Beings

There have been so many occasions in my personal experience where it seems that the NHS has quite simply broken the law and abused my human rights:

  • Not allowing us to eat and drink and allocating a time for this (as happens in Australia) makes us want to leave
  • Nurses and consultants who complain when registrars sleep during their nights shift (as recommended by the royal colleges) makes us uncared for and makes us want to leave
  • Asking us to “work a few more hours” after a gruelling 12 hour night shift (thereby also breaking the law) makes us want to leave
  • Ringing us up post night shift, while sleeping to bring us back to work makes us want to leave
  • Saying that you can’t go to your exam/course/teaching session because there aren’t enough doctors on the floor makes us want to leave

Step 3 – Top Down Management

I really believe that the people doing the work are the people who have the best insights into how to make things efficient and better for patients.

As patients may have also noticed when making a complaint, getting any feedback through and having some form of input over conditions and how things should be ran in the NHS is near impossible.  The NHS management system feels like it is designed to stonewall themselves away from any form of feedback.

Essentially not giving us any autonomy over how we work makes us want to leave.

Step 4 – Turn Patients Into A Product On A Conveyor Belt

Most doctors I have met are good people who genuinely care about their patients.

Most patients I have encountered also are awesome people who I really want to help!

Unfortunately, the way things are now, patients are reduced to a diagnosis or a description.  “He’s the gallbladder in bed 4”, “She’s the one waiting for that blood test.”.  As a result patients feel uncared for and unheard.  Also as a result of how things are ran right now, doctors don’t feel that they are giving the best care that they can give for their patient.  When a patient comes in to see us, as we are so busy and overwhelmed that there are so many jobs and patients to be seen we often just do a barrage of investigations, give some treatment and move on to the next patient.

This isn’t what we want to do!  I want to really understand where a patient is coming from, what their concerns are and how I can give them a bespoke solution.  I became a doctor to help people at their most vulnerable time, not to stick you on the “headache protocol” and treat you as if you are some kind of product on a conveyor belt.

Step 5 – Make Us All Scared

All doctors in the NHS currently work in a climate of fear.

We’re scared about the future.  Scared for the future of the NHS, our working conditions and also our patients.

We’re scared of getting sued.  So much of what we do nowadays is “defensive medicine”.  We end up caring more about how to not lose our licence instead of giving the patient the best care they need.  For example if you come in with some tummy pain and after carrying out our tests and examination it turns out that it’s “nothing serious”, then likelihood is that you’ll get kicked out the door pretty quick with some paracetamol and very little else.  This is one of the reasons so many women are out there suffering with endometriosis – it’s because doctors are practicing defensive medicine rather than actually listening to you and thinking about how to sort you out!

We’re also scared of not keeping up to date with our professional commitments.  Our Personal development plans, professional exams, basic/advanced life support, clinical examination assessments, patient satisfaction questionnaires, multi source feedback, teaching sessions, audits, clinical governance, personal reflections, meetings with our educational & clinical supervisors, research etc etc – all just so we have the privilege of continuing to work!

Look, I’m not saying doctors have it the worst, but generally speaking we’re a bright bunch, our skills are in demand worldwide and we have plenty of options.  Want to keep us working for your/our NHS?  Then maybe we need to alter the culture and environment rather than imposing more and more policies onto the people doing the work that really matters.


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