I first put them on, as a sign of
solidarity with the Ukrainian people, in the first week of the conflict, and
have worn them ever since. Almost inevitably, when people see them for the
first time they do one of three things: women tend to say they 'like my clogs';
men ask why I’m wearing them; others simply look away, don’t say anything and
don’t make eye contact. I was at an NHS Alliance Leaders event in London, when
I was asked the question, this time, about my clogs.
Now it might have just been me,
but for the most part, there didn’t seem to be much energy in the room. To be
fair, there didn’t seem to be as many people in the room compared to other
similar leaders' events I’ve attended. I could only imagine that, with all the organisational
turmoil across the NHS at present, and an ever-increasing demand for care
having to be met with ever diminishing resources, many leaders and managers might
have difficulty in giving up a day to attend this type of event.
As the day started, the first
speaker noted that, as he was speaking, Yvette Cooper (Secretary of State for
Health and Social Care) was on her feet speaking at the Labour Party Conference
in Liverpool. It’s beginning to become clear, as to what she is focussing on,
and what her priorities might be. Interestingly, it seems the 10 Year Health Plan is
becoming more of a reference point, with her focus very firmly on population
groups. In an approach reminiscent of the original NHS ‘cradle to grave’
ethos, her focus is on maternity care, children and young people, the frail
elderly, people with cancer, and people with mental illness.
In many ways, addressing these groups
is also congruent with the new Prime Minister's commitment to creating a
National Care Service. I was part of a breakout groups asked to discuss this ambition. The group was made up
of three Mental Health Chairs, and just one Acute Chair. There were two outcomes we
all agreed on: the first was a desire to see a modern-day equivalent of the
successful ‘Sure Start’ initiative; and to stop thinking about 'frail elderly
people' as being somehow a homogenous group.
The elderly are (he says with no
tongue-in-cheek intended) an important group in society. Their contribution to the
wider society has gone before them, and in so many different ways. As they
reach their twilight years, their needs are clearly also going to be different. Some
will be frail, but others at the same age, won’t be. Despite not being eligible
for a Covid vaccination when I got this year’s flu jab, due to my age, I’m now
officially in the elderly age group. Whilst some things now feel more difficult
(climbing into a tree to trim the branches with my chainsaw, for example) for
most aspects of my life the only difference is I might be a little slower. In
some situations, that can be a good thing.
For me, 2026 does feel as if it
is rapidly coming to a close. However, there are plenty more things that I want
to do before the year ends. Things that will hopefully make me feel good. And that
is the thing. I hope that, the National Care Service, when
it comes, is underpinned by an unchangeable principle of helping everyone to
live their best life, and live well. It is a principal that should apply to us all, whatever our age.
As for me personally, as the year moves to
its close, I’m beginning to think about my future. Maybe my working life is
also moving closer to an end point – who knows, but watch this space folks.
I enjoyed both of your recent posts and found myself thinking about the connection between them.
ReplyDeleteIn last week’s post, you made the important point that an individual’s experience of distress remains real even where their presentation does not fit neatly into a diagnostic category. That seemed particularly relevant to the DHSC interim review, which repeatedly raises the distinction between diagnosis, functional impairment, support needs and lived experience.
A diagnosis can be clinically useful, but it is not the person. Nor should diagnostic uncertainty make it easier to overlook the individual, their functioning or their wider context. The danger is that the category eventually becomes more important than the person it was intended to describe.
I was struck by how closely this echoes themes running through your work with Sue McAndrew. Passive Patient or Engaged Expert? explored how patient experience can become lost in the business of professional practice; Splitting the Difference examined the consequences of dividing mental-health problems into neat categories; and Mirror, Mirror on the Wall considered the gap between the rhetoric and reality of clinical governance.
Taken together, those ideas seem to pose a remarkably enduring question: how do we ensure that the person, their lived experience and their complexity do not disappear behind professional, organisational or diagnostic categories?
Perhaps that is also a fitting thought as you approach the end of your working life. I would rather see it as a transition than an ending: the point at which someone who has spent decades at the front of the field begins to step aside and allow others to see further.
There is something rather Hegelian about that, and perhaps slightly Lacanian too: the master eventually has to leave enough space for the pupil to become something other than a pupil.
The image of the giant upon whose shoulders others stand therefore seems particularly apt. Your achievement is not simply what you have accomplished yourself, but the height from which others can now see further.
Seneca’s docendo discimus — “by teaching, we learn” — perhaps captures that beautifully. The finest teacher is ultimately the one whose pupils become capable of going beyond them.
So it would be a great shame to lose you from the field, but perhaps there is something rather fitting about no longer needing to remain at its centre. After a lifetime spent helping others to see further, I hope you now have the opportunity simply to enjoy the view.
Great reflection, I share many of your sentiments. I do worry by how nonchalant many people have become towards Ukraine, and others suffering tremendous loss in this unstable world, however, I support aid, I pray and I hope, for now I will continue to do so whilst counting my blessings for the life I am fortunate enough to live.
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