I have been forced today by circumstances to do a serious post about the state of the NHS in this country. Quite recently I turned to the dark side, leaving frontline medicine for medical management.
My motivations for doing this were many but chief amongst them was the desire to make a difference to the service which I considered was being mismanaged.
I am becoming disillusioned. It has become increasingly clear to me that this government has no desire for a better, more efficient service. They want rid of the service, period. Various initiatives which I, to my shame, have been involved in implementing, are destroying the psychological contract between doctors and their employers at the Department of Health.
Today on the radio I was listening to the comments made by General Mike Jackson with regard to the army, see here. Now I am no fan of the army, or of General Jackson in particular, but some of his comments regarding the ethos of soldiering and the trust between a population and its armed forces struck home. It would be easy to replace the word army with the word medicine.
In my younger days I worked 140 hour weeks for a service I believed was doing good. For the most part health professionals were left to make decisions regarding the resources they required to do the job properly. They had the respect of the government and the public. In return they worked long hours and had a real pride in what they were doing. This is no longer the case. Resourcing decisions are in the hands of management consultants, frontline clinicians are given targets and protocols without the means to deliver them. Respect from the public is decreasing and their confidence in the service is at an all time low.
It is my belief that the government's unspoken agenda is to bring down the NHS and contract health services from competing multi-national health providers. They will do this by continuing to undermine the service by setting business-style peformance targets without consultation with those delivering those targets. Clinicians are leaving the service, medical education is a mess and getting worse. I am afraid that when I am old and vulnerable there will be no NHS to look after me. I have tried to influence this process from the inside but I have failed to make any impact. Where this leaves me personally is my concern but the rest of you should be very afraid, very afraid.