The NHS is a wonderful thing, and no one knows just how lucky we are to have it than I. For as long as I can remember the pathway for doctors has been through the Junior phase in our Hospitals where they learn the hard way putting into practice all they have learnt, and also learn a whole lot more. It has ever been the way that the huge burden of responsibility has fallen on their shoulders and they have had to work long hours. Whilst this practice has undoubtedly produced fine doctors who then find their forte and specialise into the various branches of medicine, is it really the right way to go?
I can't help it when I'm driving along the motorway and see the overhead signs beseeching drivers to take a break, tiredness kill. This really couldn't be more true for the junior doctors who staff our hospitals where peoples very lives hang on their ability to make good clinical judgements. They work long hard hours that would not be tolerated for bus and lorry drivers. They are forced to rest for the safety of themselves and other road users, so why is it acceptable to expect nay require junior doctors to work such long hours? I'm afraid the Senior doctors argument of "I did it, so should they" doesn't hold water any more. If you want the best from people you need to let them recuperate. Tired people don't learn they just make mistakes.
It is a laudable policy that the Conservative Party had in their manifesto, to have a seven day health service. After all illnesses and diseases have no concept of weekends or evenings anymore than life, excluding us, has. The NHS really should be a service that works round the clock. Some parts of it do of course, the emergency side kicks in regardless, but the majority of the service clocks off at 5pm. With the number of our population needing the services of the NHS outside the standard working day, it seems wrong to me that so much of the equipment and services are idle for two-thirds of the day. The action being taken by the junior doctors currently is as nothing as to the action that will happen when the focus changes to the support services of the NHS. The junior doctors are just the tip of the iceberg.
Humans do need their sleep, and a true 24hr NHS where the entire thing works on a three shift rota system once so common in industry is probably not necessary, but I don't see why we can't have a 12 or even 16 hour full NHS. Ah but there are a couple of sticking points. One of course is money. To do what I suggest would nearly double the staff wage bill at a stroke. In these cash strapped times, we can't afford it. Sorry but what is really the case is that we won't afford it. We want a first class health system, for a second class fee. No government wants to be labeled as the one that raised taxes, but sometimes it simply has to be done. It takes courage, real courage, to do this but if it is for the right reason then it is acceptable. Trouble is that the tax raised isn't ringfenced, it just goes into the big pot. Money is a problem, but it can be addressed.
The other, and perhaps most significant, problem is the time we call the weekend. These are sacred, a time when the working person can stop and rest from their toil. To go and enjoy themselves for a couple of days and be ready for the five day stretch the following week. If you were required to work when others were at their leisure, then a premium is paid to compensate you for working during fun time. Sure you get time off when others are working, but you miss out on parties and other social things. It is a drag. This is why I think the weekend is the most significant problem as it is a matter of our culture. Changing our culture of two days of rest is going to be a real sticking point, and the one that will break the Conservatives pledge for a seven day NHS.
This is extremely well reasoned Simone. I wonder at the idea of ring fencing a portion of our taxes, if we knew that, say, 10p out of every £1 (though I suspect it would require significantly more than that)went directly to fund the NHS I think the vast majority of us would be perfectly happy with that. We are all going to need the NHS to a greater or lesser degree at some time in our lives and to have the security of knowing your taxes are going directly to the NHS would largely offset the frustration of paying tax in the first place.
ReplyDeleteI am not sure if the weekend is really that big a sticking point and I don't see why a stricter rota system wouldn't work. Wouldn't 3 weekends off and 1 on work?