Its bloody confusing. If aliens descended and started reviewing twitter, newspapers, blogs, media reports...they probably would just shake their heads and leave- simply confused by the lack of consistency in any news story about the NHS. A recent example of that was the recent Commonwealth Fund report which compared different countries and came up with the analysis that the NHS was the best in the world, maybe even the universe. Cue folks going absolutely bananas...twitter was agog with adulation, back slapping, joyous outpouring...none of which is surprising given the absolute shellacking its been taking recently.
As ever with the NHS, any sensible debate around the findings or even using it to plan for the future has been pretty impossible. We again break into silos...in general three..."Team Happy".. proclaiming that its all fine and its the fault of the government that a perfect system is being broken apart- and it absolutely was the land of milk and honey 5 years ago; "Team Angry".. who vociferously proclaim that there are evil healthcare professionals out there, uncaring, money driven, dark,dastardly souls , killing folks and must be stopped ...and finally "Team Sensible" the more rational or sane ones whose voices tend to get drowned a bit while idealogical battlegrounds are marked out, posturing is done, credit is claimed for the NHS being amazing..while a rational debate to actually debate where we go from here in a few years time...no sir..that's a tricky option, isn't it?
The Tories say we must name and shame GPs in an environment where we can't recruit them for love or money, present GPs are fed up with everything thrown at them...then countered by Labour saying they will organise for patients to be seen within 48 hours.Even the RCGP joins in saying more money to primary care will solve the puzzle...while any sensible person will tell you its not just about the money, its about the morale. Why would you pick a job, whatever be the money, if you face such incessant pressure and public flagellation- especially when some specialities offer a better work life balance, less abuse? Stuff their faces with gold...give over..those days are long gone.
So let's look at the Commonwealth Fund report...those who want to improve don't rest on their laurels..they don't just say - ah well, we are the best, so why bother improve any more ..they look at areas where they can improve. So where is the UK NOT good...look down the table..its in one category..we come 10th out of 11 countries...the section? "Keeping people healthy"...and in a nutshell thereby encapsulates the impending crisis of the NHS. We are amazing, fabulous, awesome etc etc in looking after people who are sick - and lets make no bones about it- but we are rubbish at stopping people GETTING sick. Cue increased pressure, cue need for more resources...and when that doesn't happen? The bubble..for want of a better expression...bursts. So if you are genuinely trying to learn from the report, where exactly are the initiatives to keep people healthy...do remind me who are the sponsors for the World Cup or even the Olympics again? The penny drops.
So to Team Happy, I say, rejoice but also be humble enough to see that there's only way from number 1..that's down. Rather than blame it on specific governments, maybe we need to address the issues which will make us slip from that enviable pedestal- as a profession we need to challenge ALL politicians. To Team Angry, yes mistakes do happen but by god, we are trying our best every day with cramped resources to learn and move forward. Don't denigrate this amazing institution- work with Team Happy or even better let the folks from Team Sensible have a say.
The NHS..Simply the Best? Possibly yes..will it stay there? Not if we as a profession fight siloed corners and idealogical battles...the capacity or its strength to cope will wholly depend on the agenda of prevention. If we can't tackle that..then we are dead in the water...whether that health system is a private sector led one or a public sector one. And THAT is the bottom line..cos the Common wealth Fund report said so.