Saturday, August 27, 2016


It rarely fails to fascinate me. And in my opinion- is a key issue to a whole lot of disputes which ranges within the NHS. Its probably applicable to life too- but lets keep this to within the NHS.
Do you know what I am talking about? Ok- its the sheer inability to treat adults as…well..adults. Have a look at the junior doctor issue- my views is well known- it hardly matters whether I work for NHS England or the Ming Dynasty (No- there is NO parallel there- don't be naughty)- my view is what it is- its been handled appallingly. And it stems from the inability to treat a group of qualified professionals as..adults.

Lets check this theory out. Lets take the example of a junior doctor I supervise- she is 32 year old, she has a mortgage, she is married- along with the fact that she is a fantastic professional. Society has trusted her enough to have a mortgage, have a family, treat her as an adult when she goes on holidays, watches a movie- yet we, somehow, have been incapable of doing that. When this group of folks started off by trying to say in a decent manner- guys, this won't work, its tough as it is, we have gaps, we are struggling, we have training issues…the response from a significant part was what? Well- it was a bit of 'There, There"..a bit of "Well in my days"…a bit of " its a holistic profession"..and a whole lot of "well you are all kids so what do you know"…let me tell you what happens when you treat adults like that…its annoying, its disrespectful, its patronising and it creates friction. Funny that we have such an angry bunch of people around, isn't it?

Let me give you another recent example- a trainee comes to see me- has had an incident flagged about her- there has been a meeting where some folks around a table have decided what rating the fault was. She, has had no opportunity to answer the question raised, she has had no right of reply but hey, there's report to her educational supervisor. On which godforsaken planet is that even remotely right? Its awful, a lack of respect but stems from treating, once again, groups of adults as…well..not quite adults. Times are different, ladies and gentlemen, the take it and lump it era is quite rightly over.

Then came the issue of 7 day services and the risks being evident from leaked reports- and the response was simply astonishing fro many quarters. A lot of tut-tutting, a bit of "Meh, its just a risk register"…folks -UNDERSTAND the angst here..its being proven right after being fobbed off..respect that- again, adults talking to adults. Maybe the misnomer,as pointed out by many, sits in the term, "junior" doctor. A risk register existing is no good for patients unless there are mitigating processes put in place to put a red into green over course of time. If thats our attitude to any patient safety issues (hey, we have it n the risk register) then lets not bother with this lark of improving patient care. Its not the register that matters- its the effort to make sure the register has no cause to exist that matters.

So it continues- the NHS and its inherent way of being paternalistic- for ages, it has done so with patients- the "its ok, I know more than you", the "There, There"- and that has now seeped into bringing that attitude to our own generation next. What chances do patients have of moving past lip service to "patient engagement", "patient centred care" or whatever the latest buzzword bingo is -if we cant even treat our own colleagues with a degree of respect adults deserve. Its not all about politics- when such a group of hard working folks, raise an issue- listening to their concerns isn't that tough.

So I don't know how we move on- but I would like to appeal to many within the NHS- whatever be your position or grade- to respect adults for what they are. You don't need to be fit a certain "prototype" to be seen to be experienced and knowledgable. Experience is of course important- but lets not ignore the youth either. Treat them as adults- they could turn out to be amazing allies to ensure risk registers don't have a reason to exist.

As the saying goes…"Give Respect…then you will get some back"


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