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.
Here is some great practical advice about how to help kids with constipation. It is the advice local Paediatric Consultant, Dr Owen Galt, gives out in his clinic, here in Morecambe Bay:
Here is a great video, done by my colleague Dr Owen Galt, Consultant Paediatrician here in Morecambe Bay, talking about how to help kids with D&V – loads of great practical advice!
So a huge study from Norway tells us that being inactive at work and sitting at our desks for too long is as dangerous to our health as smoking and is a major cause of early death.
Hour’s activity ‘offsets sedentary day’
http://www.bbc.co.uk/news/health-36895789
Here is my response:
There are two different narratives that are shaping the debate around the NHS at present. They are different stories, but they are becoming dangerously intertwined. I want to highlight the two stories and make a clear distinction between the two.
The first story is that there are some ways in which the NHS needs to be more efficient, work more smartly, integrate its services more effectively, cut some unnecessary waste, be more collaborative and ensure that the service it provides is as affordable as possible in a manner that is safe, learning, compassionate and continually improving. Some of this involves working with communities to help us live in a way (individually and corporately) that helps us to be more healthy and well, taking some strain from the system. It also involves some restructuring and rearranging of services to enable them to deliver care in a more streamlined way. This is a true story.
There is another story that is told that sounds like it has some similarities, but it is not the same story. This is the story that tells us the NHS is unaffordable, that it is failing and that we need parts of it to be privatized for it to survive. This is based on an idea that we have to balance our books, cut our cloth, tighten our belts and ‘live within our means’. This story is not true. It is not true because no country has ever lived within its means. Countries are nothing like households. Households are very simple. The economies of nation states are not. Households do not have banks in their back gardens that print money when things go wrong. Households do not give special privileges to rich friends, making life easier for them, whilst treating poorer friends like servants, taking away things they need and telling them are lazy and need to work harder, whilst blaming their problems on other friends who have moved into the area aka immigrants. Cutting public services and seeing the gap between the rich and poor grow ever wider whilst taking away the welfare that helps families in genuine need, cutting the services available to help them (pretending these are efficiency savings and not cuts) is a choice being made by our politicians. We are told there is no other choice, but this is not a true story. The NHS could be better funded (it is currently one of the most under funded health care systems in the entire developed world) and we could choose to manage the money of the country in an altogether different way! The NHS is affordable and the first story is helping to make this more true, but it needs greater investment, not the removal of vital services. Do not confuse the two stories.
The NHS really is amazing. Today, I have been at the NHS confederation (confed2016), a conference which helps to set the pulse and rhythm of the health system over the following 12 months. I heard Dame Kelly Holmes speak movingly about her own experiences, help she received from across the NHS and how grateful she is to live in a country where there is such excellent healthcare available to everybody, no matter how rich or poor. As a double Olympic champion, she highly values her personal relationship with her GP, keeping care local and personal. She would not be where she is today had it not been for the superb care she was given when in the depths of depression only a year before she was able to achieve her dream. Had it not been for surgery, physiotherapy and nutritional expertise all from people working within this incredible system, she would never have accomplished what she has done in her career. And not only her, there was a moving tribute from her mother who has also had significant health problems over the last year.
In a time of austerity, although in the OECD countries, there have been 260,000 extra cases of missed cancer in the past year, not one of them has occurred in the UK!! The NHS is staffed by brilliant, caring, compassionate people, who are pursuing excellence in the care they provide. The NHS is able to provide some of the best health outcomes in the world and is still rated as the best health organisation in the world by the World Health Organisation, despite having one of the lowest government expenditures in the developed world.
We hear so much negativity in the press about failures, pressures, targets and financial strain that it is no wonder there is a low morale at times amongst the staff. But Kelly Holmes tells us that we must learn to celebrate our successes, because in our dark times (and there are many in the field of healthcare), it is
vital that we keep hope alive. There were many times, when the press was against her, out for a good story, many times when things did not go to plan, but the celebration of her successes along the way kept her hope alive. We are going to have days when we get it wrong. We are going to have increasingly more situations in which we feel squeezed, hard pressed and floundering, but there is so much we are doing every single day that literally transforms the lives of countless individuals. We look people in the eye and tell them our names, that we will be caring for them and that they matter to us. We compassionately communicate the best and worst of news. We use our skills to arrange appointments, clean, bathe, bandage, measure, test, diagnose, operate, teach, manage, cure, deliver new life, care for the dying and so much more. This is nothing short of amazing.
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I am so grateful for the teams I work with at Ash Trees Surgery in Carnforth, Lancashire North CCG and Better Care Together around Morecambe Bay. We are doing brilliant things together every day, as are countless teams across the UK. Part of the culture shift we need to see is for us to lift our heads, celebrate what is excellent and use it as fuel to propel us further forward into the love and good of the future. I thank God for the NHS, it is worth remembering what a treasure we hold in our hands and continue to be grateful for the privilege it is to serve people through it. If we don’t learn to celebrate our successes, we may not find the reslience we need for the path ahead. But with hearts full of gratitude and a sense of achievement, we can continue to go for gold.
