Solutions Focused Thinking for the NHS

One of the main headlines in the news this morning is that without extra funding, the NHS is in dire straits and patients are beginning to suffer as a result of less financial provision than is needed.

 

http://www.bbc.co.uk/news/health-38019771

 

One of the things I have trained in, during my career is Solutions Focused Therapy. It’s a fantastic way of helping someone to open their mind to new possibilities once they become stuck in a rut. So, for example, when someone is struggling with depression, there can be a downward spiral of thoughts that prevents the person being able to see much hope for the future. What SFT does, is to awaken the imagination to some other possibilities. The more colour and variety that can be painted the better. So, if you’re imgresfeeling low/down/hopeless/sad/apathetic/bored/exhausted, I might invite you to imagine what life might be like if you weren’t feeling that way. You might tell me that you’d feel happy and then I would ask you to tell me what ‘happiness’ might be like for you. I’d ask you to describe in as much detail as possible how you would know that you were happy – what would be different? I’d get you to put as much colour on that as possible. And once I understood how you would know you were happy, I would ask how others around you would know – what your partner/children/friends/pets would notice about you…….suddenly your mind is alive with an alternative reality to where you are currently and although things won’t be suddenly better, your mind has been awakened to another way of being!  And that brings a beautiful thing – it brings possible solutions to the problem.

 

imgresThere is no doubting that the problems in the NHS are vast. One of the things I have found is that if you try and enable someone to think about the solutions without allowing them to tel you what the problems are, you won’t get very far. A certain amount of catharsis and expression of the issues is important. So here goes: here is a picture of the problems the NHS faces (and these have already been stated many times over, but let’s just be clear):

 

imgresThe NHS is under-funded. Cuts to other services, like social care have also had a massive impact on the NHS as a system being able to work and targets are being missed as a result. People are living longer and this means more complex health problems and a rise in dementia. There is more obesity and diabetes and this has a huge impact in the cost of healthcare. The way the NHS is funded is ludicrous and puts parts of the system that should be working collaboratively in direct competition with each other. Teams across the NHS are clumsy and clunky with little ability to work smartly due to constraints of historic ways things were set up. Demand and expectation are extremely high and yet there are multiple missed appointments. And I could go on!

 

BUT we CANNOT stay on the merry-go-round of problems. We cannot continue to simply imgreseat moany pie together and complain about the issues. Throwing mud and finger pointing, blaming everybody else but ourselves will solve nothing. The awful tribalism and over politicization of the NHS is preventing us from finding a way forward. What might health and social care in this country be like if open our mind to new possibilities? What if we stopped focusing on all the problems and dreamed of how things might be in 5, 10, 50, 100 years time? We’ve been doing this in Morecambe Bay and we’re moving from not only dreaming but to doing something different!

 

imagesWe’re working with our communities to help us all live more healthy lives, thinking about health as a social movement. 97% of all health monies are spent once people are ill. We’re taking prevention seriously! We are breaking down walls between our organisations and sharing our budgets. We’re building relationships between clinicians and managers across many diving lines. We’re collaborating to share our resources and using our budgets in a way that makes sense for our communities. We’re unashamedly talking a new language of love, building trust and establishing infrastructures of positive peace. We’ve worked out where we are being inefficient and sharing our conundrums with our communities (we do actually have to be responsible about what we spend – the NHS is not carte blanche). We’re working out how to work differently and more smartly. We’re sorting out our IT. We’re redesigning care so it makes more sense for our patients. We’re working on our consultation and communication skills. We’re being more proactive in getting positive messages out there. We’re building for the next 100+ years not just the next political cycle. This is better care together!imgres

 

At this point in time, it is vital that our collaborative efforts are not allowed to fail. We are working hard at so many levels. We are doing all that is being asked of us. We are playing ball. Now we need the government to put their money where their mouth is. Holding the funding as it is will see us and many other areas trying to do the same thing fail in the process and this would be a great tragedy. The solutions, of which there are many, will be in jeopardy. But this is not the time to lose hope. This is the time for us all to make good the dreams we hold for the future.

 

 

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Solutions Focused Thinking in Population Health

My last blog focused on how we can think about solutions instead of problems in the NHS. Well the same is true in thinking about the health of our whole population. Yes there are some problems! We have growing health concerns with obesity and diabetes. We imageshave huge health inequalities. There are major issues with housing, economic policies that are not working for huge swathes of our population, with more people having to use food banks, struggling with fuel poverty, living in damp houses and unable to make ends meet. Yes, our kids are spending more time on screens and less time in activity. Yes, the sugar lobby, alcohol lobby and advertising giants have far too much power. Supermarkets are designed deliberately so that we buy things that are bad for us. And sometimes, we just make poor choices (if you can call them choices, which for some people, they aren’t always) – we do not all live as healthily as we could – we eat the wrong stuff, work highly stressful jobs, and exercise less than we are recommended to. Mental health issues are on the rise, especially for teenagers, due to crazy targets and league tables, with all the pressures they face. We are less happy and more separated than we ever used to be, despite the rise in social media…..(or maybe because of it……)…..Man, I can paint a negative picture – it’s like storm clouds and darkness everywhere……..

 

imagesBut what if it wasn’t that way? What if we got a bit angry about it, but instead of finding someone to blame and pointing the finger; instead of getting all tribal and throwing stones at others, we chose to use our energies creatively to find solutions, to work together and make positive changes?! Let’s put away our pointing fingers and our ranting tongues and let’s work together for a better future for everyone! Doesn’t that sound good?! It’s what we’re trying here in Morecambe Bay, and I’m hoping it spreads like wild fire so that we can become a place where health abounds and beauty surrounds (that’s the motto of this place!). That doesn’t mean we stop speaking truth to power, but we also let our actions (and maybe our votes) speak louder than ever before.

 

imgresWe’re talking together, taking time to dream about what it would be like if we were the healthiest area in the UK. We’re training up many people to host conversations, so that we break down walls and learn to collaborate for the sake of everyone. We’re not just dreaming about physical health, but mental, social and systemic health as well. We’re encouraging those who want to rise up and take some leadership, to be pioneers in the stuff they are passionate about. Even in my little town, we now have a mental health cafe that is literally saving people’s lives, because a lady called Jane wanted to make a difference. We have a cafe for all the people who have circulation problems because one of our nurses wanted to break people’s isolation and improve their healing rates at the same time. imagesWe’ve got a carers cafe, a dementia cafe and will soon have a breathing cafe for those who have severe COPD, sharing ideas and diminishing anxiety. We’ve got exercise classes to help with pain, a community choir, dog poo wardens to help us take more pride when we walk down the street and food banks to help those who can no longer afford to eat.

 

image[1]We have 2000 kids aged 4-11 running a mile a day at school with staggering results for our children here in terms of physical, mental and educational health. We’re hoping over time, this becomes the Morecambe Bay Mile, part of a cultural shift towards being more active. We are working with local chefs and supermarkets to enable people with pre-diabetes or weight struggles to eat more healthily.  We’re choosing to lead by example in the NHS to work well and flourish in our work places. We’ve made a commitment to see the 5 ways to wellbeing in every NHS organisation and we’re hoping many other systems and businesses will follow us in this. We’re finding radical ways to help people who are struggling with alcohol and drug addiction, get free and stay free with amazing results. We’re helping people live well with and beyond cancer.015c74b06779fe8d8496d585fb9865ea We’re changing the way consultations happen in the NHS to enable people to make more informed and better choices about their own health and conditions, so they feel empowered to make changes that work for them rather than beaten up when they go for an appointment! We’re launching the Morecambe Bay Poverty Truth challenge, learning from those who are lived NAWIFUexperts in poverty to help us work together and care better for those most struggling in our society. We’re having difficult conversations about death to help people be prepared for every eventuality.

 

All of this has started in the last year! What else might be possible? What other dreamsimages will be awakened? What other partnerships, collaborations and relationships might be formed? Being all tribal and accusatory of others saps our energy and stops us being creative. Mud slinging and blame will achieve little. We have to work from where we are. We have to build bridges and work together. We have to build a future of positive peace and that means binary thinking is over! The future doesn’t have to be full of doom and gloom. It is alive with hope! What resources might  we find? What talents might we discover? What might we see develop over the next 12 months/years/decades as we look for solutions together for a better future for everybody? Don’t you feel just a little bit excited?

 

 

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What Lies Beneath?

Do you sometimes wonder what is really going on? As the furore around the planned 5-day strikes by junior doctors unfolds, with all the clamour and the noise, the positioning, the power plays, the arguments and the counter-arguments, I wonder where is the truth amidst the madness? How have we reached a stage in which the government and an army of medics, surgeons and psychiatrists are at such loggerheads? What lies beneath all of this?

 

Theresa May, our Prime Minister tell us that “doctors have never had it so good” – I wonder when she last shadowed a Senior Registrar for Acute Medicine on a Friday night in an understaffed hospital? Jeremy Hunt tells us that he is a modern day Aneurin Bevan (I wonder what AB would think of that?!), whilst his shadow counter-part, Diane Abbott retorts that this is a ridiculous suggestion. The PM and the Secretary of State for Health both agree that the junior doctors are playing politics, something the other side refutes, but all agree that this is a disaster and patients lives may well be put at risk. The right wing press tell us it is all about pay and that the doctors are being greedy, whilst the left wing press tell us it is all about an underlying agenda to privatise the NHS. The Junior Doctors admit that some of this is about pay (who would want a significant pay cut for working long and unsociable hours?) but that it is more about resisting a policy to deliver a 24/7, 7/7 NHS, which they believe to be unaffordable and unstaffable due to shortages in funding and recruitment. Senior colleagues appear to be split down the middle in terms of support for the strikes, patient groups are understandably concerned and yet a solution does not appear to be forthcoming.

 

Shouting, anger, fighting, noise, name-calling, power-plays, hate and hollering. So, who will seek the welfare of the people and the nation? Who will make for peace? Both sides tell us this is what they are doing and this is why they stand their ground. The government apparently want to deliver the same standard of service throughout the 7 day week. The Junior Doctors say they are the ones really standing up for the people by resisting that which is unsafe and unfair.

 

So, let us learn from the peacemakers to find a way through. In apartheid South Africa, peace was not reached through hate and vitriol. It took deep courage from men and women to expose lies, to speak truth to power, but most importantly to tell their stories. It was not about the one man, Nelson Mandela, but the many together waking up to an alternative future that was fairer for everybody. In the battle for civil rights in the USA, a nation was awakened to the reality of injustice within its own borders. The story of one woman, Rosa Parks, who refused to be humiliated on a bus became a people movement as numerous as the stars, shining together for an altogether different day. In Rwanda, after the appalling genocide, those who lost everything, found a voice to communicate to their very oppressors, those who had raped and murdered their own families, not only their story, but forgiveness for the atrocities caused and found a way through to a new future. If we want peace and a better future for everybody, then we need to face up to our reality, be willing to really listen and then find that together we can embrace a new future.

 

We have an apartheid of globalisation and free market capitalism across the entire world. Every day, the gap between the rich and the poor is widened. Our entire economic system, founded on the oppression of Empire through expansion (via military violence), the creation of debt (through an errant banking system) and the rule of law (held in place by the state of the exception) is no longer fit for purpose. We see it in the plight of refugees stuck between war and barbed wire fences in a land they cannot call their own. We see it in the disproportionate imprisonment of Black American males in the USA. We see it in the vile island detention centres of Australia. We see it in the slums of New Delhi, the townships of sub-Saharan Africa and the Favelas of South America – in the eyes of children dying from such ridiculous things as diarrhoea and starvation. We encounter it in the streets of Athens and the public squares of Madrid. And yes, we find it in the midst of our NHS and social care system. Our world as we have known it is broken and no matter how much sticky tape or wrapping paper we apply, the centre simply cannot hold. The core is unstable. Everything is shaking. We must have the courage to let go of what we have known and embrace an altogether different future, a future that is fairer for everybody, where things don’t simply trickle down to the poorest, but in which the balances are re-set.

 

We have become slaves of the ‘free market’, fodder of the beast that requires ever more of us. What lies underneath the row over Junior Doctor pay and the forthcoming strikes is a great gaping hole that scares the hell out of many of us. Oh, we can sling mud until the cows come home, but it’s not going to get us anywhere. Top down, pyramidal, heroic leadership that stays its course and demands it’s own way is simply not going to cut the mustard. We must have some brave and difficult conversations about the detrimental effects of making policy from the safety of ivory towers, and learn to really listen to the stories of those affected. We have so much to learn from the Leeds Poverty Truth Challenge, the Homeless Charter in Manchester, the Community Conversations in Morecambe Bay, the Cities of Refuge initiative, the Civil Rights movements, the Mediation work done in Rwanda…..we don’t have the answers right now. The problems facing the NHS are fare more complex than trying to ensure an undeliverable manifesto promise is outworked. We need humility on all sides, collaboration and partnership.

 

It goes deeper than people right across the UK needing to manage their own health and wellbeing more effectively. It is more complex than needing to recognise where there is waste and dealing with it. It isn’t just as straight forward as needing to talk about chronic under-funding and under-recruitment. We face an existential crisis, an ontological question about the future of humanity together. Resting back onto familiar ways of operating or antiquated leadership styles will simply not work for us any more. The black hole we face is either a death or the opportunity for re-birth. A squeeze that will force us into something new. We can’t keep dancing around it forever. We must take the plunge, accept that there is no going back and see what new creation we might just co-create with Love on the other side. Don’t be afraid…….there is light at the other end of the tunnel.

 

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Reconnecting Clinicians to Healing

In the USA, doctors have the highest rate of suicide of any profession. In the UK, a similar picture unfolds. Why is it, that 69% of all physicians suffer with depression at least one time in their career? It could be because of the high workload, high stress, high demand, an increased sense of professional isolation coupled with a growing powerlessness to effect change to the systems that often work against the real healing of people.

 

I think all of those reasons are there for sure. But I also think that as doctors become increasing slaves of a system, they lose touch with themselves, the things that make them unique, and are expected instead to act like robots, or cogs in a machine that get people just well enough to return to work and be of benefit to the economy. We have managed to disconnect clinicians from their own sense of humanity. But the art of healing is so much more holistic and profound than the science of clinical medicine.

 

23ec23_61a12bbd059d4b3bbb53f656c3e7eaf7.jpg_srz_p_490_490_75_22_0.5_1.2_0_jpg_srzIf I were to design a health centre, it would not look like any of the places I work in. They are all far too clinical and are probably not very conducive to healing. For starters, there would be a whole lot more natural light, with beautiful artwork (I have some amazing pieces in my room now, by a brilliant local artist, Emma Hamilton) and sense of a continuum with the landscape. There would be places for people to talk with each other around tables where food and drink could be served, isolation broken and community restored. There would be places to encourage exercise or mindfulness through colouring. My room would have a piano in the corner and it would be filled with art, poems, quotes and there would be huge windows with magnificent views of the sea.

 

And my consultations (which could be conducted outside whenever possible!) would use not just my clinical knowledge, but would reflect more of iu-1who I am. Even now, I spend a lot of time laughing with my patients. Laughter is so good! It is healing in and of itself. There would be time for music. I would sing to my patients (they might well leave faster!)……Every doctor I know has talents, gifts, hobbies, and hidden depths that are rarely used when they encounter their patients. I wonder how much more effective we might be as healers, if we reconnected with the God-given sense of who we are and what makes our own hearts sing.

 

I love the story of the Obstetrician from Pittsburgh, who sings to every baby he delivers. What a beautiful thing. What might we all do more of as clinicians, if we thought of ourselves as healers? What spaces might we create? What might our consultations become? I wonder if we did this…..would we be less depressed and more happy in our work? And might we be more effective in gifting wellness to our communities?

 

 

 

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Better Care Together – Hope for the Future

iu-4My last post, “Time to Face The Music” was deliberately provocative. We cannot simply keep on doing what we’ve always done or nostalgically hold onto the ‘good old days’. As previously stated, it simply isn’t sustainable and we’re only deceiving ourselves if we think it is.

 

We find ourselves in a a different (post flood) landscape, a terrain that requires a new way of being together. And we are fast learning, here in Morecambe Bay, that it’s not just enough to break down the traditional barriers between Hospitals, GPs, Mental Health, Community Nursing, the Emergency Services and Social Services. No, we have to go much wider and deeper than that if we’re going to develop a radically new way of working that is sustainable. We need to develop a Wellness Service that is of high quality, able to continually improve and offer compassionate, excellent, affordable, safe and accessible health and social care to everyone in our community. In order to do so, we need every person in every community to partner with us. We need partnerships with education, business, sport, justice, housing and the voluntary sector to name just a few. Old silos must be broken down and centrally driven targets must be re-examined to give communities the ability to creatively flourish together.

 

We need big conversations across the sectors of society about what it really means for us to be well and how we can take better responsibility for ourselves and each other. It is so much more than just physical and mental health. It must include a wider understanding of social and systemic health also (see earlier posts on this).

 

And this is exactly what our team in Morecambe Bay is trying to do.images We’re not always getting it right and we’re learning some really tough lessons along the way, especially that our old habits of trying to fix things die hard! Real engagement takes time, but in the process of doing so, we are seeing 3 core principles emerging out of our focused work in Carnforth that we believe to be important keys to unlock this process in every community.

 

As we listen and engage with local people and communities, firstly we are seeing community leaders naturally rise up to make a difference and help increase the well-being of their area. We have many varied examples of amazing initiatives beginning. Secondly, we are seeing clinical leadership that is evidenced based and responsible, but empowers others to make a change. Thirdly we are seeing culture change beginning to emerge, with a more effective coaching culture and a focus on the wellness of those who deliver the care within our communities.

 

iuConversations really matter and carry within them the dynamic potential to make significant and lasting change, as we learn not only to talk differently, but to act differently as well. In the NHS, we have some expertise, but the true experts of their own lives and communities are the citizens we serve. We must change to be much more in conversation with them rather and lose the role of ‘grandma knows best’!

 

 

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Time to Face the Music

UnknownWe have yet to really face up to the crisis we are in. We keep on pretending that by making a few alterations here and some adjustments there to how we deliver health and social care, we might be able to save the NHS. But this simply isn’t true. Last weekend saw a crisis conference for GPs nationally as 38% think they will be forced to leave the profession in the next 5 years due to severe under-resourcing and increased stress (that would be a loss of 10000 GPs throughout England, with government plans to recruit only 5000 by 2020). Yet again our Emergency Departments are at breaking point, Junior Doctors are staging further strikes, Public Health Services have been decimated and although new partnerships are being forged with social services and (to some extent) the education system, deep cuts in both those areas mean there is little time or energy left to find new ways of working for the future health of our population. Throw into the mix a need to save £22 billion through “efficiencies” and couple that with the crippling debt caused through programs like PFIs in our acute hospital trusts and we really do have a problem.

 

Complicating this picture is the stark reality that 1 in every 5 pounds spent in the NHS is as a direct result of our current lifestyle choices and we have images-2believed a lie that the NHS is “free” and therefore we can treat it however we like and live however we want and it will somehow magically sort us out. On top of this we have an ageing population with increasingly complex health needs and an ongoing under funding of the entire system (only 8.9% of GDP).

 

And we cannot we forget the financial crash of a few years ago which was a major warning sign to us that we are living in a broken system and the god that is
imagesthe Nation State is beginning to crumble all around us. Let me just repeat that difficult statement in another way. The grandfather that is the Nation State is now utterly riddled with a cancer and it is dying. The cancer, like all cancers needs ever increasing growth in order to sustain it’s life and our economy is set up to feed it, but even built on the pyramid of power, control and debt, it can no longer survive. Like any dying man, it is holding on for dear life and as it does so, it puts the squeeze ever tighter on to health, education and other public services, pretending it is still powerful, controlling public services through the slashing of budgets and ever tighter and undeliverable targets whilst not actually dealing with it’s debt issue at all, but telling us all a story that it is. And the mouth of Unknownthis dying beast, the media that has become utterly complicit with it all, spouts out tale upon tale of how mighty the State remains, “punching above it’s weight” on an International scale (using violence and threat where necessary to do so), but tightening it’s belt to ensure economic sustainability. Am I being dramatic? Listen, when 85 people now have more accumulative wealth than half the world and when the 50 richest global corporations are richer than the 50 richest Nation States (and are therefore powerful enough to tell them what to do), the facades must come down. The Emperor has no clothes on.

 

images-1And so it is time to face the music. Once we realize that the centre cannot hold, we can permission ourselves to find new ways of being. There really are alternatives to what we have now. there are other ways of being. Life will go on. We can learn to dance to a different tune, we can sing a new song and begin to reimagine a different kind of future. We can learn to live differently. There are some tough conversations to be had. But, as the old systems begin to pass away, what might emerge instead? What brave or holy experiments might we try without letting go of the wisdom we have learned? What might it be like if politics and economics were just part of a collaborative and cooperative world rather than assuming the role of dominant sovereignty over every other sphere of society? What if we can’t have everything we want right now, learning some new and more effective boundaries around the ways we live? What might we prioritise? How might we move towards a more peaceful world? How are we going to live in a way that is sustainable and leaves the environment as a gift rather than a burden for the generations to come? How might we develop an economics of equilibrium (the state of a healthy body) rather than one of continual growth which requires us to feed its ever hungry belly with our own lives? What might we recover in education? How could we shape regional wellness services? How might cities and regions gift their expertise to one another? How might we choose to protect the most vulnerable in society and provide for the most deprived, keeping love at our core over self-preservation, greed, fear or hate?

 

Unknown-1Truthfully, we can no longer afford to avoid these conversations or hide away in our business. If we want things to remain exactly as they are, then so be it, but what will we leave for our children’s children? In the NHS we spend our lives trying to preserve and prolong life at all costs. But we must learn to face death, because there is life the other side of it. There is life the other side of the Nation State as we have known it. There is still ethical, free, safe, sustainable and accessible healthcare for all the other side of the NHS in its current form. It might become a National Wellbeing Service. Or it might be more regional and cooperative. It will mean some different lifestyle choices and some more effective partnerships. It will mean changing our attitude towards how and where care is provided. But I’m sorry to say that unless we make some radical choices to either pay a lot more tax or not renew trident and spend all of that money on healthcare, there are some deep cuts to be made in the mean time. It is going to be a very painful few years ahead. We must not imbibe ideologies that protect the rich and punish the poor. But we have to be brave enough to let go of the good we have known in order to embrace a future that is better for everybody together.

 

Unknown-2And that calls for a different kind of kenarchic leadership. We need leaders who will serve and collaborate with communities in open and honest conversations, so that cuts do not happen in an isolated boardroom, but witUnknown-3h and among the communities most affected. Leaders must learn to ‘hold the space open’ for the new to emerge. It will mean understanding that we must make choices about which targets we do and don’t decide to meet, prioritising some services over others and taking better care of ourselves individually and in community. But it is not a time to lose hope! There is much goodness to come, much rediscovering to take place. Much creative reimagining to enjoy. Many songs to be sung. So, let’s face the music and dance.

 

 

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Telethon for Trident!

pudsey tridentI love comedy that makes you see something so much more clearly than you have ever seen it before. The NHS in this country is on it’s knees and will require a £22 billion fund over the next 5 years on top of the £8 billion promised by the government. Trident will cost £23.4 billion to renew. Our education system and social services are also facing terrible cuts.

 

What is it that we love about trident? The fact that we would never actually use it? The fact that it is a weapon of a bygone era that would be utterly useless in our current world situation? The fact that it has deterred none of the terrorist attacks across the world in the last 15 years?

 

We have to break the power of the metanarrative that believes that this kind of bomb is what ultimately protects us. It does not. We also have to break the lie that there would be no hope or jobs for the people of Barrow-In-Furness (part of the Bay in which I live) if we stopped commissioning it. There is actually other far more needed work for skilled engineers to be doing. The risk of something going wrong in the process of building this bomb is far more deadly to the people of Barrow than the thought of reimagining the future of the town without it.

 

This bomb does not bring us peace. It is a colossal waste of money and renewing it at a time when we are making such terrible cuts to education, health, social services and other vital infrastructure is utterly absurd. If we do feel so passionately about keeping it, then I do believe a telethon is the way to go!

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We’re Treating the NHS Like A State-Sponsored Prostitute

iurIf we were to view the NHS as a person instead of a mechanical system, then we would have to conclude that she is the most used and abused person in our history. She is someone with a great heart, incredible talents for healing people and who wants to do the right things for people, but she has completely lost any sense of boundaries or the ability to say ‘no’. Therefore, she is walked over and treated as a state-sponsored prostitute for anyone to come and do with exactly as they want, as if there were no consequences. However, as a result of this behaviour, the cells which make her up have become damaged and infected, her tissues are breaking down and she is dying. It is not too late for her to be mended and revived, but she must learn that she cannot say ‘yes’ to everybody and everything that is demanded of her and as she learns more appropriate boundaries, she will help others amend their own behaviour to create a loving, sustainable and mutual relationship that can last long into the future.

 

Black Friday demonstrates just how utterly consumerist we have become as a nation and we treat the NHS as if she were a commodity to be ‘had’. There is little sense of personal responsibility with diet, alcohol, drugs, exercise, maintaining healthy relationships and managing stress and yet we have a developed a meta-narrative that we can live exactly as we please because in the end the NHS will fix it. We give little thought to developing our personal and corporate well-being and why should we, because when we fall apart the NHS will fix it?!

 

We can be utterly disorganized and forget to renew our prescriptions and then shout and scream at our GPs receptionist to ensure we get our tablets (that we might not have needed to be on, had we taken more care of ourselves) turned around in a 24 hour period, as if it was someone else’s fault that we forgot we were running out of our own medications. We can fail to iuturn up to appointments when there are already long waiting lists, because who cares if the appointments are wasted – they are ours to waste after all!  We can run to the A&E when we fall over drunk and hit our head, or get into a fight with someone we’ve never met whilst under the influence because we haven’t bothered to learn any healthy patterns of processing the anger we feel. We can go to the walk in centre with a 3 hour old sore throat, demanding treatment, instead of trusting our incredible immune systems. We can continue to eat far too much meat, over injected with antibiotics, whilst we head towards the super-bug apocalypse. We can drive too fast and cause near fatal accidents (if it wasn’t for the seat-belt and airbags) and some clever surgeon will put us back together. We can smoke our lungs into a tar filled bog or stuff our arteries full of cholesterol and sugar crystals because there is medication (that is super expensive by the way, but subsidized so we don’t care) that will fix our ill-behaviour. We can experience the love, kindness and generosity of our elderly relatives, but dump them into hospital for Christmas, when they might spoil our fun. We can stuff ourselves with food, until our joints can’t take it because then we’ll either get new ones, or a bariatric surgeon will half the size of our stomach for us.

 

OH THE GOOD OLD NHS!! She will sort out all our problems……except that we are killing her. We have believed a lie that we can live exactly how we please as if there were no consequences. If we love the NHS and she loves us, then she is going to have to learn some boundaries and we are going to have to change our behaviour……..

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Floods, Fire and Fresh Thinking in the North

imgresAs I was driving along the A6 today, between Carnforth and Morecambe, on my way to visit an elderly patient, I experienced in the space of a few moments both exhilaration and dismay. I was exhilarated by the magnificent view of the mountains of Cumbria, just across the Bay in the beautiful sunshine and felt very grateful for living in such an inspiring and spacious place. And then onto my radio, came the voice of the Prime Minister in response to Jeremy Corbyn at PMQs. He was asking David Cameron about the lack of government response to the floods in Cumbria of 2014. This direct lack of action across the North of England (despite clear warnings) contributed to the appalling flooding that thousands of people have experienced over the last month. That, coupled with de-forrestation and the clearing of land upstream was a recipe for disaster once the storms hit us. Mrimgres Cameron, however, seemed to think it more important to mock Mr Corbyn on his shadow cabinet reshuffle rather than address the very serious questions in hand. The floods have been no laughing matter for the North. They have been devastating and could have been avoided had the North been treated with equity to the South.

The North is a remarkable place, filled with people of great heart and courage, a people who have historically had the ability to unite at a level to bring about significant change. As one example, it was a petition of the people of Liverpool, Manchester and Sheffield that saw the end of the slave trade in the UK. So, when the people of the North get a fire in their bellies, you can guarantee that change will come.

imgresWell, the floods are serving as a catalyst for this fire. The floods are only another indication of the injustice the North suffers in favour of the politically lucrative South. The South is not to blame and nor is this post intended to be divisive in any way, but it is high time that the North stood up to be treated as an equal partner and not a poorer brother. In my area of passion, health and well-being, the differences between the North and South are completely unacceptable and indeed detrimental when it comes to making effective change to health outcomes.

As already stated on this blog, despite all the worst health outcomes being in the North, 94% of all health research money is currently spent south of Cambridge. We have conclusive evidence from the Academic and Health Science Network, that health outcomes are significantly better in places where research is carried out , because funding follows the research.

We also know, from Health Education England, that when a direct comparison is made head for headimgres between the North and South when it comes to recruitment and staffing levels there is a £17million deficit in the North. It’s not that we can’t attract people to work here, we’re just not given the money to pay for them in the same way.

imgresWhen it comes to council cuts, again we see the North punished in comparison to the South, even though the need is greater here – which area has the highest use of food banks? The answer is the North West! If you study the map on council cuts (deep red = heaviest cuts, blue = increase in spend) – you will see just one blue area in the North, but major areas of protection and even significant growth in budgets for the South.

 

In Lancashire alone, the county council has to cut £262 million from their budget in the next 2 years. This is going to have devastating consequences to public health provision and social services, which is in in effect a cut to the NHS also. We are already seeing severe bed blockages in our hospitals and without social workers to support our elderly citizens, the crisis will only deepen.

 

imgresMy hope is that the North harnesses the emerging fire to come to a place of equal partnership with the South, raising its voice for justice and love rather than in vindictive, competitive vitriol. I hope that the North will together decide what it is to become a “Northern Powerhouse” rather than being prescribed what it will mean via the ideas and ideals of the Chancellor in Westminster. From my perspective, the North is about a different way of doing things. The North stands for a more equitable and co-operative society. In this moment the North can stand for a forward looking culture in which:

Men and women are equal.

Children are prioritised.

The environment is stewarded well.

Hospitality is an art form, practised and adhered to, where all are welcome and all can find a home.

Inter-culturalism thrives as mutual respect for difference is a core value.

The elderly are honoured and cared for with dignity.

Justice involves much more restoration and less retribution.

The rich do not become ever richer whilst the poor become ever poorer, but cycles of poverty and deprivation are broken through hope and aspiration.

Work is done, not simply to earn money and pay debt, but to create more joy, beauty and care in the world.

Well-being is more important than economic growth which involves people being used as fodder to drive the ever hungry machine.

People take responsibility for themselves and each other leading to more sustainable systems (health/education/social services etc) for all.

Healthcare and education is free and accessible to all.

The North must rise up, not to dominate but to become a different kind of “powerhouse”. A house in which power is poured out for the sake of those who need it most in order to create a more fair, just, loving and peaceful world. This is the new politics, not the farce we are seeing in the corridors of power. People learning to live together differently, having important conversations together to create a future that is more beautiful. Come on the North – let’s use this passion for good!

 

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Christmas

In my last blog post, I talked about the concept of meta-narratives and how they effect our health and wellbeing. For me the Christmas story is the ultimate meta-narrative (the big story with which I align my life). It changes the idea forever that God is a far off hierarchical, imperial, power-hungry megalomaniac. It eradicates the notion that we must go to him where he is in some special sacred space and will only find him if we clean up our act and start behaving in certain ways. No. He comes to us. This story (as JRD Kirk says) is not one of God changing his mind about humanity, but about humanity changing its mind about who God is.

iuHe comes to be with us and changes himself in the process. He becomes utterly human, not some weird, ready-break glowing child, but deeply human and in so doing destroys the stories we have told ourselves about what he is like. He comes to us. He comes right to our very situations, our joys, or triumphs, our brokenness and our shame and says, I AM with you.  And if you run away, I’m there with you. And if you turn away, I’m there with you. And if you hide away, I’m there with you. And if you fail, I’m there with you. And if you don’t believe, I’m there with you in your unbelief.  Because contrary to the caricature of Dawkins, I am love itself. A love that will pour itself out time and again.  A love that is stronger than bitterness, hate and division. A love that is willing to be misunderstood, misinterpreted and misrepresented. This is not the story of a God who slaughters his enemies in order to protect himself and those he holds close (a narrative upon which the nation state is built and uses to predicate the violence it does to others – and if you don’t believe me, then you haven’t read enough history). No, this is a story about a love that will lay its own life down for its enemies and enables us to do the same.

As Steve Chalk says, Jesus never came to start a religion. He came to start a political, social, economic and spiritual revolution. God with us – wherever we are. The God who prioritises the poor, the refugee/marginalised/outcast, the sick, the prisoner, the woman, the child, the environment. The powers have never and will never understand Light in Darkness-02or overcome this light. The promise of the light is peace. Peace on earth. If we embrace the way of love, anything is possible. Even in the midst of all the turmoil in our world this Christmas, I find great hope in the idea of God, who is love, with us in it all. I believe that when we embrace this light and this love as our meta-narrative, as our raison d’être, we find healing for ourselves individually and corporately.

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