Sunday, January 26, 2014

Healer or more?

The role of a doctor has always one which has fascinated many for ages- and continues to do so- perhaps never more so in such uncertain times as in the NHS. There are those who firmly believe doctors should and must have a responsibility towards society..more than just attempting to provide the best care to the patient in front of you, while there are some who feel their job is the latter and leave the idealogical debate for others. And a distinction is created..the problem I personally find is the level of intolerance demonstrated in different camps...a bit like that immortal Bush-ism.." You are either with us or against us".

I keep hearing of how privatisation of the NHS is all wrong, how it will provide poor care and I fully understand the logic behind that. That is also suggesting all countries who are not blessed with the level of socialism that the UK has incredibly poor care. Having worked in other countries, it is not the case...the debate over there is different...you get high quality of care and treatment based on your wealth and circumstances...the fortunate minority have the best healthcare available. That is a different social debate rather than saying the NHS will suffer,isn't it?
You want to solve inequality..come and see what happens in a rural village in India where the only drugs available are Septrin, aspirin and paracetamol compared to the high tech hospitals a few miles away in a city where wealth brings everything medical science has created...that's where you understand the importance of social equality or lack of it. If the NHS is privatised, the same staff will still provide the same quality of care...its not the care that is at stake, its the lack of universal coverage which will be.

I also hear how its all gone down the pan since the new Act came in place...I don't know what sort of utopia most of these commentators lived in but I recall doctors and nurses still struggling when I was an SpR..same pressures, same frustrations..the different media outlets, harsh politics, social media result in amplifying the problems even further. Factor in what was always inevitable..the steady realisation that unless funding was matched,we were going to run into trouble..and all the ingredients of a perfect storm have been beautifully crafted.The sadness is that lots have allowed their dislike of ideologies blur the adult debate one has always needed about the NHS. And don't please say it was all fine, or only "minor" changes were needed...if you prefer that, suggest speak to all the whistle-blowers..the Julie Baileys, the James Titcombes or the relatives who have suffered..or even go through the Francis report.

So to the initial question...what is the role of a doctor? Play within the system...irrespective of changes or political colour helming the changes, have the chutzpah to do what's necessary for patient care...or take a stand for social equality and take on a more political role? Some clearly have gone for the second role and my tip of the hat to them but I don't necessarily believe that will improve patient care..what will improve it is genuinely giving the front-line the power and responsibility to lead the change that is needed..and that, I am afraid, no political party will do..for fear of losing control.I have heard over the last 5 years plenty talk about it, show pretty presentations how they are doing it...at the level of the wards or clinics, that still is a rarity. Till then, irrespective of whatever changes happens, I can only promise to deliver a quality service for all those who walk into my department.

On the other hand, you want to start a genuine movement to put the frontline in charge...dissociate health from party politics...I will dust down those old boots from my college days when I used to live and breathe politics..and lead from the front. Till then, this doctor stays what his dad taught him to be..a healer first, everything else..later.Never forget what Hippocrates said..." A life so short, a craft so much to learn". Amen to that indeed.

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