Friday, February 12, 2016

Sizzle and Burn

The whole world has gone bonkers. Absolutely. And totally. If the fiasco over the junior doctor contract unfolding over social media wasn't enough, it stepped into a complete zone of surreal idiocy beyond comparison as of yesterday. People were so angry that they even forgot who was on whose side..cross fire, lateral fire, friendly fire...it would have been hilarious if it wasn't for the future of so many bright folks at stake.

Lets get one thing off the bat first and foremost. There is a heck of a lot of twaddle that this isn't about patient safety but about just pay. Well, even if one leaves the safety argument aside for a moment, then let me tell you why this is about patient safety...IF THERE ARE NO DOCTORS IN THE JOB, THERE ISN'T THE PERSON NEEDED TO SEE THE PATIENT. Sorry- I will stop shouting but when I hear that line of "it isn't about patients", I want them to come with me and see the vacant slots on the rota we are having to fill, failing and then praying all will be well. Its a bit like saying that the tube drivers strike was all about pay, nothing to do with the public. Umm...yes it was- as without them, the tubes wouldn't run- causing inconvenience to the public. A lack of doctors doesn't cause "inconvenience"- it causes harm- stop dancing around that, stop trying to say others can do their job- no doctors = harm. And yes, same as nurses- less nurses = harm.

Then we come to Dalton. Now I must confess I had no idea who he was- till he did the Dalton report. He is known to be a system leader- it is reasonably easy to spot them in the NHS- they are white and male-and many I respect tells me he is a man of integrity. I haven't met him so won't and neither should I pass judgement- but I read his Dalton report. It said all the right things- things I liked hearing but perhaps something anyone working on the coalface could have told you over a pint of beer.

Anyhow, he tried, negotiated with BMA, then got fed up and said Impose it. He said he had support of 20 Chief executives- of which by time of writing this blog, 14 had said..Not me bruv.
Well, that went well then- episodes of the Thick Of It came rushing back to my mind. Buoyed by this mystical support, Mr Hunt went and did it and unleashed the hordes of fury, anger, disappointment.

So now where to? Not about patient care? Well- tell me that when I don't have a junior doctor to cover areas or stretched to their limits and beyond as the umpteenth locum hasn't turned up. The suggestions are all becoming even more ridiculous by the moment- train more, some shout...with what? Monopoly money? Then there is the small issue of the junior doctor issue being mixed up with those who simply don't like the government. Now this is also very confusing...I supported the junior docs and I was called a leftie..I can assure you that any Tories digging into my past would be very surprised then. Then I got called a champagne socialist- that did make me chuckle as I had tweeted many moons ago about my dislike for them- and managed to offend a fair few good people. Then...hold on to your flipping horses, I supported a cross party commission and I was called a neoliberal. My apologies but I don't even know what that flipping means. I do know that you cant be a neoliberal, leftie,champagne swigging socialist at the same time. I think. I would like to add that the majority of people supporting junior doctors don't actually fit into any pre-ordained boxes.

So I will tell you what I am. I want care to be delivered free at point of care- irrespective of the patients ability to pay. I change my vote depending on policies but I want to improve care- and what Dalton and co have done will not do that. I am and will continue to try to improve care- but I need my junior doctors- happy and ready to give that extra 5/10% when asked. Because the NHS needs that extra to function well- and deliver good care. I don't want them to be bitter and angry- I don't want to give them a hug and see someone struggling to hold back a tear because one man's ego was too big. I don't want them to think managers are against doctors- as they are not- they are hard working staff without whom clinical care are impossible- and NHS Providers may ask for imposition- but they do NOT reflect every single manager or Trusts view in this country. They do not.

We recognised where we work that 7 day services were needed for diabetes patients. Data told us...most importantly patients told us- so we negotiated, we cajoled, we worked on it- and delivered it  with extra resources. The result has been a drop in errors and happier patients.

To all those who genuinely want improved patient care, take time to reflect and think how in the 21st century -imposition is fundamentally wrong. Think what you will say when you use that powerpoint slide on staff engagement....believe in it genuinely. Otherwise, in the times of history, you let us all down. 

1 comment:

  1. Imposition, sounds more like the words coming out of a despot rather than negotiator. We need the juniors to be happy, nobody seems to realise the amount of work that is done in the NHS , purely out of goodwill and not for pay by all involved - doctors ,nurses,porters and the numerous HCP's running the hospitals and in primary care

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