Wednesday, July 17, 2013

Kate and Leopold

I really like Kate Middleton. I do actually. Forgetting the debate about republicans and royalists, she always comes across as a nice pleasant girl who conducts herself admirably..especially in the light of the unpleasant intrusion of the media in her mother-in-law's life and its horrible conclusion. And love or hate the royals, William and Kate do look like a nice couple, relaxed, enjoying themselves and more importantly not making a fool of themselves in the public arena. So you wonder why in a health related blog I am talking about her?

Well…it’s simple…the NHS has never needed her more than it needs her now. The coruscation of the NHS via the media is now well and truly on, figures and facts are being bandied about, denials, cross-denials, accusations, petty party politics, a playground spat as to "who loves the teacher the most" (substitute teacher with NHS)..and in the midst of it all, a long needed, much awaited debate about the improving of patient lives grinds to a halt. And the media does what it does best…a cynical taking down of the morale of the majority of hard working folks- who keep getting more disengaged..at a time when there is so much need for folks to be more involved, not less.

So we need to give something to the media…something to take the Eye of Sauron away..so we can get to the business of sitting down and seeing what can be done to improve patient care. Look at the areas beyond the debate about HSMR and ask why the basic core of compassion is becoming short supply. Have a grown up debate as to how we address staffing issues when the squeeze is on financially- and the biggest area, nay only area left to cut costs is by reducing staffing..how does one deliver quality care in such an environment.
So we need Kate, the NHS needs Kate, the nation who sometimes forget what they have in this country as regards healthcare, needs her. The royal baby needs to arrive soon, we need to bask again in the feel good factor, we need the media eyes away from the NHS so that constructive debates can happen.

What then about Leopold? You thought I was just fitting in the title to make it sound catchy.. a play on the Meg Ryan/.Hugh Jackman film? Nope. The word Leopold comes from a mixture of Latin and German..and it means something close to “as brave as a lion”.

And in the context of that, it must be Bruce Keogh. If you have to read a report which is concise, to the point and makes you understand why a clinician should be leading the changes in the NHS, read it. And I have a huge amount of respect for him. He tells you a story of how much he values the NHS and realets how he felt that when he had an accident in South Africa. I was there in that city at that time- and 24 hours after that, when I had the opportunity to chat with him, all that burnt through was a genuine need to make things better. And he is taking some brave steps..investigating hospitals for areas where they are failing in, highlighting staffing issues….all of which will sound like music to the thousands of staff working at the coalface. How many times have we moaned about the staffing issues, raised concerns about patients…and finally we have someone at the top agreeing with us all. Bravo I say!!Leopold is the only way to describe this effort, in an environment where the debate is more of schoolground politics rather than all concerned sitting down and agreeing the way ahead.

The story is as simple as it gets. The money in the system, as things stand, isn’t enough and to make ends meet, you have to drop wages or simply put, cut staff and shut hospitals. Cut wages- you risk losing the workforce or their morale. Cutting staff causes harm in patient care (read Sir Leopold’s review) while shutting hospitals isn’t politically expedient. Only other way is to raise taxes, stop doing something else in the public sector (how are those nuclear submarines looking), consider things like the Tobin Tax….but if none of those are in play, the system is jammed. We talk a lot about telehealth in meetings but no one knows how to explain to the staff that this will result in reduction of staff numbers- and we wonder why adaptation is low.

But at least, the first sincere salvos at having a constructive debate have been fired by Sir Leopold. Now we need Lady Kate to deliver (excuse the pun) and then we will hopefully find some time to have a sensible debate about what can and cannot be delivered to the highest quality- away from the rhetoric, away from the hyperboles. One lives in hope..or to put it simply, we must. Because once the storm passes, we owe it to all those who may have suffered needlessly and who didn't care what colour the politics was. They deserved better care and just maybe, Kate and Leopold can help us along the way.

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