Archive for March 14th, 2008

Better do Better

epa0966l.jpgI’ve got myself all worked up now into an angry irate blog against the NHS. Well maybe not against the NHS, more of a passionate defence of what we hold dear.

Since arriving back (I’m thinking of dividing my life into BNZ – Before New Zealand and ANZ – After New Zealand) I have become increasingly frustrated with my beloved hospital. Though I suspect none of this is peculiar to me alone.

To be perfectly frank I think all the poor dying, sick people we’re meant to care for are getting a pretty raw deal. I think all the poor kids pulled from car wrecks are getting a raw deal, all the wee grannies dumped to our care get a rough time of it. Even the kiddies, the babies, and the mums are getting a raw deal. Health service has a kind of hollow ring to it.

Now this is of course not universal, lots of people get a great deal from the NHS and will tell of wonderful experiences. But then that’s the whole point – we’re not succeeding on a universal level, we’reĀ  not even succeeding on a passable level.

Basic principles of medicine (these are more mine than Hippocrates, thought up while waiting for the pizza on a Friday night) could go as follows:

1) relieve suffering – because we’re generally crap at actually fixing things. People die, we’re crap at stopping that. We can make the process of human existence slightly more palatable. This is a long way from euthanasia.

2) we occasionally fix people – see note above.

3) deal with people with grace and dignity and kindness

4) understand something of what it means to be in their shoes.

5) ensure patient safety – in other words that it should be the disease that kills the patient, not us.

And we’re not doing great, we’re working in a system, that’s akin to a recently departed horse getting the beating of it’s life.

The NHS is full of people who hate their jobs, at least that’s how they talk. At tea breaks, all people do is complain about how busy their department, how they’re pushed to breaking point, how they’re frustrated with their jobs, their wards and their patients. Everyone sounds like they’re one crisis away from quitting.

I feel sorry for the students, the guys coming through in every discipline. They’re exposed to nothing but stress, pressure and frustration with a system that seems to have no answer.

The depressing tea break conversation is coming from smart, committed, dedicated people. With a desire to do the job right, but seeing no way to do it in the system they’re in.

I love my job, I believe I’m the luckiest guy in the world to have it. I feel it’s nothing but an honour and a privilege to be a part of people’s lives at some of their most significant moments. It kills me to see those around me struggling to feel anything positive about the place. It pisses me off to see patients getting treated like shit all the time.

They get sorted eventually, but they get neither the time, respect nor treatment they deserve.

The NHS will continue to survive on people busting their ass for their patients. But simply surviving doesn’t really count for much.

The dear, brilliant, hard working people (though not everyone in the NHS is up for a sainthood, there’s lazy gits here too) I work with will continue to work in a system that is being continually squeezed in successive efficiency drives to meet targets to fulfill a politicians mandate. No one ever stopped to think whether an efficient NHS is good for the patient. Maybe a hospital works better (for the patient) at 80% capacity (though clearly less efficient)

But anyway, I’m not going anywhere (what else would I do), I continue to love the job, we’ll all keep trucking along to a mediocre standard till a few more people die unneccessairily, and a few thousand more get sub-standard treatment and maybe we’ll start thinking about properly funding the place…


March 2008
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