The NHS, our crowning glory!?!

Currently, across the globe, there are just 43 countries where there is a monarch as head of state. That is 43 countries out of 195 countries recognised by the United Nations. The Vatican (or Holy See), Taiwan (currently seen by the UN as being part of China), and the State of Palestine are all included, but not officially recognised as being sovereign states. I suspect that many of these nation states will have received invitations to the forthcoming King’s coronation. I haven’t received mine yet, and strangely I don’t mind. Day by day, as we grow closer to May 6th, I know I should be interested, perhaps even vaguely engaged, but if truth be told, I’m simply not. I know I probably should be, but somehow, the importance and significance of the event is not gripping me.

I can already hear the cries of outrage and anguish. It’s not that I’m anti-royalist; completely the opposite actually. I admired greatly what our Queen did for the country over her entire lifetime and like many others, mourned her passing. I simply think that there are too many other competing concerns going on both in the world and my life that are particularly distracting at present.

In the joy and happiness of sharing family time over the long Easter weekend, it is easy to park the growing concerns of trying to help and support my parents. I’m fortunate to be the eldest of a large group of brothers and sisters, who whilst spread out across the globe, all do their bit to help. But like many others who have one or both parents living with dementia, providing the right kind of support grows more difficult each day.

And whilst I try and avoid politics in this blog, I’m immensely proud of J who is standing in the upcoming local elections. I pledged to help her in any which way I can, but this sometimes means we have days where we pass like ships in the night. It looks like there is some determined competition too, which adds to the sense of turbulence.

However, whilst these two examples require a great deal of emotional labour, it is the ongoing industrial action that captures most of my attention and focus. I watched in awe as my colleagues made sure we continued to provide safe, high-quality health care over each day of the four days of industrial action. I used the bed management meetings (held three times during the day) as my barometer. I didn’t see panic, just a calmly delivered action plan; I didn’t see frustration or blame, just folk reaching out to help others when needed and throughout it all, I saw positive and effective communication being used to ensure brilliant team working.

I also saw a very different health care service being provided. Whilst we did see doctors in training (the correct collective term for so called junior doctors) working on the wards, it was the consultant body that stepped up, stepped down and stepped across in leading and providing the assessment, treatment and care for our patients. They didn’t do this on their own, but worked with nurses, allied health professionals, admin staff, porters and all the many other folk who keep a big acute hospital running smoothly. The same was true in our community services too.

We did have to cancel some of our elective work, but overall, our productivity was up. Patients were seen, assessed, treated, admitted or discharged much more promptly than perhaps we have experienced in the recent past. Clearly consultants have the experience, skill, knowledge and confidence to make decisions in a way that most doctors in training simply cannot yet do. As a country we invest a great deal of time, resources and money into developing sufficient numbers of consultants able to work across all types of health care.

Thinking about the last four days might lead you to think that a consultant-run NHS would be truly excellent, albeit rather expensive way of providing health care. But if we went down that route, in a few years, we would start to run out of consultants. One of the many things that they do well is to train future doctors. One of the other reasons that patients were seen and treated quicker during the industrial action, was that there was no training going on at all. All of which leads us to an interesting place. Are our patients paying the price for medical education? They are not of course. Every patient will have a consultant who ultimately will have responsibility for their care, and who will want to see that care provided expediently and effectively. So, a more complex situation maybe?

And the future for the NHS appears equally complex. We heard yesterday that the RCN had rejected the government’s pay offer. They announced further industrial action to be taken on and around the King’s coronation. With this decision comes the apocalyptic possibility of both nurses and the doctors in training going on strike at the same time, and to do so with no derogations being granted. If this were to occur, many folk would die unnecessarily. The industrial action undertaken so far has resulted in nearly 400,000 missed appointments and procedures. The already very long waiting lists will have grown longer and made the task of reducing them, that much more difficult.

Bold action is required to resolve this situation. A 35% increase is not going to happen, but a staged pay deal response, staggered over time is possible, particularly if it were to be coupled with some imaginative short-term thinking*. Most doctors today end their university education owing a six figure sum, perhaps we should forgive this student debt? There is an example. After all the angst our future King’s young son has wrought, yesterday Charles stated he was proud of both his sons, and wants the best for both of them. And yes maybe, just maybe, I will be tempted to watch the coronation too.

 

 *I was reminded last week that when I qualified as a nurse in 1978, I was paid £3,020 a year. I had just bought my first house in Swansea, which cost me £6,000. At the time I was able to get a 95% mortgage, and the £300, 5% deposit was relatively easy to find. Today, a newly qualified nurse earns £27,055 and that same house I bought in Wales will now cost £210,000. A £10,500, 5% deposit wouldn’t be so easy to save up (and that is if you wanted to live in Swansea, it gets worse if you move closer to London or Manchester).