Sunday, October 11, 2015


Somewhere down the line, we have most certainly forgot to treat our colleagues as adults.

No, I am not even being mildly sarcastic about it. It's a fact- ever since the junior doctor contract erupted, the plethora of views have been fascinating to observe- but there comes a point when we, as a community, must respect the position adults,as a group, are taking. We call them "junior" doctors but they are anything but- these are people who in any walk of life would have been respected for what they are..after all, these are people adult enough to decide to have families, people adult enough to have mortgages- yet somehow many have decided to treat this particular workforce as anything but. I will tell you how I see my "juniors"- adult colleagues who are helping me do my job. Along the way, if I can help them develop- even a fraction to the point I got from my Consultants- well, that's very good indeed.

But why? If you look at the various issues, the pay factor comes into play- and I am tired of hearing comparisons between different professionals- and I mean everyone. Stop comparing junior doctors to a cleaner- or a banker. Different jobs, responsibilities etc etc- stop that- that helps no one, and disrespects others, let alone doctors themselves. There are far bigger issues- most notably- hours and its protection. Is there a degree of hysteria around it? Perhaps- but note many who have leapt in with advice, don't do the job themselves. It's a bit like advising Rooney to take the corner properly when you wouldn't have even made the school team. Would I give advise about right payment to a journalist- no- because I have no idea how much slack they have, how honest they are or even how hard working they are.

Let's be crystal clear on this- if our junior colleagues AND nurses held to their contracted hours or asked to be paid for for every extra hour worked, that 1 billion deficit would have looked decent in comparison  The counter? It's a vocation- so you must. Let me point out a fundamental flaw in that logic. Look at the Oxford dictionary: "Vocation: A person's occupation, especially regarded as worthy and requiring dedication". Or "A  strong feeling of suitability for a particular career or occupation". Anything jump out? Let me give you a clue- its about making people feel valued- make them feel valued- the vocational aspect comes to the fore. Some seniors point out to the hours they worked- yes indeed, different circumstances, without the burdens of administrative issues, with the perks of free accommodation- with the golden pot at end of rainbow such as Consultant salary, permanent contracts and a guilt edged pension to look forward to.Sorry did I forget to mention CEA points?
We aren't offering our juniors those- or in the process of taking those away/reducing them- so where exactly does the vocation aspect come from? Not valued, less security to look forward to...vocation, strangely enough doesn't pay your mortgage.

I don't want a strike- but do admire the unity of junior doctors. Apart from a few with their own views-biased as they are, there isn't many left who feel the junior doctors ask is unfair. It isn't about pay but about safety. It isn't about money but recognizing that in 2015, a woman taking a break to have her family doesn't make her any less a "high-flyer"- and most importantly, in an environment where you need the workforce to deliver any efficiency, imposition of unilateral views is daft and unnecessary. The letter from Mr J Hunt shows a willingness to take it forward and to someone who enjoys negotiating, there appears areas to sit and discuss. BUT it does need to be accompanied by removal of any threat of imposition. Threats and negotiations aren't good bedfellows- ask the middle East

Finally, its about being treated as adults. Our junior colleagues are being treated poorly- and whatever be the belief, we should as a whole, recognise that. Not denigrate, not sneer- point out politely what could help- but treat them as adults. Be a friendly critic- as I have always said, not about the pay (wrong argument) but about safety and equality. But I don't mind if that's not listened. Do you know why? Because they are adults.

And adults must and should have a right to choose and fight for their future.

Saturday, October 3, 2015

Inspired maverick

It's been actually a lovely few weeks. No I am not really has been..on many levels. Weeks which have been laced with meeting new people, learning about new the cursory question one gets when one meets someone after some time.."How's things?" The answer, truly has been "Not bad at all".

The request to meet Simon Stevens came out of the blue and admittedly, a pleasant surprise. There's only so many times you can believe your own hype so I suppose an invite from the head honcho is always welcome. Without going into too much detail, the personal meeting was informative , enlightening, not to mention actually quite educative- away from the bubble of 140 characters opinions on Twitter, it was nice to talk to the man who runs the NHS. Clear thinking was a feature apart from the calmness - sometimes you learn about leadership much more from personal meets than any leadership course can teach you. Stevens has his share his detractors- would anyone in that role but he had encouraging words for someone much down the food chain- I liked made me think again where I could help as regards type 1 diabetes in this country.

Interspersed in those weeks was an obligatory trip to meet some CCGs, yet another tour for the Super Six diabetes model- and once again, met with many a people who had the will, but not necessarily the finance needed upfront to get things moving. A transformation fund - if monitored well- could indeed unlock many a door..austerity has brought forward a fleet of new thinkers...the system needs to support those, not deflate their energy when the NHS needs them most. What was nice was to see the belief that diabetes care needed to change, and change needed based on needs of patients, not as a money saving exercise.

A trip to Ireland brought many joys not to mention to observe some amazing work being done by Neil, Lesley and Athinyaa- what struck was not only the talk- but the actual ability to walk. I will be honest- in my travels and different roles, I meet many, many folks who are brilliant at doing the talk- but pretty ordinary when it comes to delivering- certainly not these guys. It was wonderful to watch over dinner the sparkle in the eyes- as the discussion was about how to do it, less of what wouldnt make it work. If you really want to see something special in development- based on sheer energy and infectious enthusiasm of a team- take a trip to Londonderry- many many diabetes centres could have much to learn from them.

In between clinics etc also came a trip to Hertfordshire- at the request of a friend- to talk about diabetes and the role of inspectionthe fear factor as regards CQC was palpable- and thats the feedback the CQC needs to take on board. It has the potential to be a critical friend- a power for real good- as well as being something leaders within organisations can use to improve care. A force not to be feared- but for that to happen, all parties need to change a bit. What however struck me was the 2 patients who spoke to an audience of more than 200 HCPs. The message was loud, it was clear.please stop judging us, please work together. In 2015, that cannot be that big an ask. A loud message to me what needs to change across the country!

A lovely few weeks- much seen, learnt- and much positivity around too- in spite of the virtual meltdown we face as regards finances. Austerity has clearly inspired some thinking differently- the question is whether its come about 4-5 years too late- we shall see. There is indeed a lot of chaos but within that, the question is whether it offers opportunity too. My passion is for type 1 diabetes care-a nd the energy seen over the last few weeks has indeed rubbed off a bit. To all the people who matter whether it be Simon Stevens or Samantha Jones or Martin McShane or Jonathan Valabhji, my message has been crystal clear. Sitting on my laurels is an easy option for me- but the energy and desire to do things is now. 

So thank you to many who have inspired- I hear plenty of medics shying away from leadership- I will publicly buck the trend and simply say..Here I am. I, along with many others such as Pratik, Emma, Natasha etc, want to improve type 1 diabetes care- and the time is right with all technology, patient power at a nice critical mass. 

Shake off the cobwebs- and ask away. Brave enough for some mavericks?