Being a member of parliament is an important job, being a Secretary of State more so. I’ve asked Mr Hunt before if he knew what it was actually like to hold a person’s life in his hands. Perhaps, were he to reply, he might answer yes, that he has spent his career making ‘difficult decisions’ and that of course it is his job to champion a safe and patient centred NHS.
He would be wrong.
The truth is that our Secretary of State for Health has absolutely no real experience of what it means to hold a life in his hands. Sure, he make decisions that have the potential to impact broad swathes of people. Sure, unlike me he has the power that comes with his office. Sure, his job is immensely important, but unlike me he has absolutely no responsibility for individual patients in real time. Contained in that statement is everything that is wrong with the modern NHS.
To the MPs of Westminister, as an individual, I am inconsequential. Indeed, you might say that the row over junior contract has taught us that even as part of a voice that is fifty thousand people strong, I am part of something unimportant to policy making. While I might be invisible to our government however, to the patient on front of me I am often everything.
When I stand on front of a patient and tell them not to worry, that I will give them the care they need, it this promise that is the most important thing in the world to that person, and it comes from me….and from every single member of the healthcare team. Promises from the ground up; that is what actually makes a difference to the individual patient.
Everyday, millions of NHS staff make millions of promises to patients. We promise Mrs Smith that we will get her treatment started and do our best to get her home in time for her grandson’s graduation. We tell Mr Clarke not to worry about his upcoming surgery, that he is in safe hands. We tell Mrs Brown that the lump in her breast isn’t cancer…or we tell her that it is, unfortunately, and that we will be by her side through her journey.
It doesn’t matter whether that is a promise to help a patient die where they wish to die or to push on somebody’s mother’s chest and do everything you can do to drag their soul back into a room. It doesn’t even matter if it is merely a promise to save somebody the ice cream that they like while they’re off the ward for a scan, they are all important. It is through these promises that the NHS delivers care to individual patients, every second of every day of the year and each one of these promises is one that the health secretary or even the Primeminister himself cannot make.
I am in the business of individual patients. Our government is in the business of policy.
And what happens when things go wrong? When you look at a patient or their loved ones and recognise that outcomes were not what you or the patient wanted them to be. Sure, the Department of Health may talk of ”learning lessons”, they might pat themselves on the back for the lessons they learned and solemnly promise to carry this forward into policy making. But of what real value is that? What our modern NHS leadership seems to have forgotten is that without me, their promises are useless. Patient care is experienced from the ground-up and Mr Green probably doesn’t care if it is government policy to listen to patients because he is unlikely to every sit on front of the government. When he comes in to hospital what is important to Mr Green there in that moment is just if I actually listen to him.
I am of course not suggesting that the Department of Health is without consequence, but somewhere along the line, it seems to have been forgotten that they are there to support us in our care for patients.
Nurses, doctors, health care support workers, pathologists, radiologists, physiotherapists, porters……the Department of Health forgets that we are the NHS; we are the good, we are the bad, we are the agents for change.
The NHS will only ever be as good as it’s frontline staff and our Department of Health would do well to remember they are just passing by.
In an ideal world, it would be the corporate heads of services and government ministers who would be flat out trying to prove to us that listening to them is worthwhile; that their ideas are sound and their motives are honourable. It should never be the opposite way around and that is everything that is wrong with our NHS and everything that has pushed junior doctors into this mess.