[Un]Tangled up in blue, the new Libertarians, Alligators and Umbrellas

Well Tuesday the 13th of July 2010 dawned bright and warm. The BBC promised blue skies. But I didn’t really believe it would happen as it was our Graduation Day. This was my third year presenting students and every year it has rained on Graduation Day, and usually rained hard. Hard Rain is the title of Bob Dylan’s album produced in 1990 which has those two great songs Maggie’s Farm and Lay Lady Lay on it. It is however, Bob Dylan song ‘A Hard Rain's A-Gonna Fall’ written in the summer of 1962 and released in 1963 for his second album ‘the Freewheeling Bob Dylan possibly resonates more with a certain generation. It was the song most associated with the Cuban Missile Crisis, which followed US President JF Kennedy’s announcement that Soviet missiles had been discovered on the island of Cuba. I was, of course only 8 years old at the time, and it wouldn’t be for another 7 years before I learnt to play the few chords that make up the melody for ‘Blowing in the Wind’, the other famous and these days a somewhat ubiquitous protest song from this album.

I don’t know if it was my state of high anxiety on Tuesday morning or just a general sense of feeling sorry for myself, but as I drove into Manchester City centre, I found myself singing over and over again the chorus line from a hard rain’s a-gonna fall. For those of you who play the guitar, it is one of those songs were you can deliver a pounding rhythm as you get to the chorus:

here black is the colour, where none is the number

And I'll tell and think it and speak it and breathe it

And reflect it from the mountain so all souls can see it

Then I'll stand on the ocean until I start sinking

But I'll know my songs well before I start singing

And it's a hard, it's a hard, it's a hard, and it's a hard

It's a hard rain's a-gonna fall.

As it turned out, this year’s Graduation ceremony was a triumph for all who participated. We had a great turn out of staff on the stage to support and celebrate the students’ successes. Irene Khan our new Chancellor proved to be highly effective in ensuring that all felt included. The students gave all my colleagues a standing ovation. My worse fear – pronouncing the students names correctly, faded, as standing in my wonderfully blue and red robes, my tongue mysteriously became untangled, and out came all the names more or less as intended – and there were lots of them. Over 500 nurses and midwives graduated between the two ceremonies. I wondered what the next few years would bring these newly qualified nurses as the NHS is to be re-organised yet again, and this proposed reorganisation will also include how nurse education and training will be organised, commissioned and managed.

This week saw the White Paper Equity and Excellence: Liberating the NHS published. The document, which outlines the most radical reforms to the NHS for more than 10 years, puts the power to commission patient services back in the hands of GPs who will take control of around two-thirds of the NHS budget. Health secretary Andrew Lansley has pledged to give frontline nurses more control over decisions about patient care. However, the role of the nurse in these reforms is only mentioned twice in the 61-page document.

Whilst I think the lack of detail is worrying, I did hear that Anne Milton, currently parliamentary under-secretary of state for health in the new Conservative-Liberal Democrat coalition government has expressed an opinion that there is no desire to change the way in which Nurse and Medical education and training is currently commissioned (this despite the fact that SHA’s, the main commissioning body, are likely to disappear come 2012). Interestingly Anne trained as a Nurse at St Bartholmews Hospital in London, and worked for the NHS for 25 years as a District Nurse. Dr Graham Henderson, whom she married in February 2000 in Surrey, also works in the NHS in the field of community medicine, and is Director of Public Health for East Surry PCT (another body also destined to disappear). As Bob would say, a hard rain’s a-gonna fall…

…and it did on Graduation Day, and again later on in the week just as I was walking across the Lowery Piazza on way to the Honorary Graduates Dinner. My hair was of course, completely ruined. And dinner wasn’t anything to write home about, but the conversation around the table more than made up for it. The topics were fascinating and very interesting. From clinical trials looking at a chemical compound developed from the blood of Alligators that apparently prevents scarring as wounds heal – clearly good for cosmetic reasons, but if the drug works, internally as well as externally, the possibilities are endless and very exciting – to the value of CBT for those people who have a diagnosis of Bi-polar Disorder, and why the oppressed and vulnerable need a champion. As I sit and write this on Sunday morning, the rain continues to pound down, although I do have a very big strong umbrella!