Here are six ways to save the NHS, Mr Hunt. Trust me I’m a doctor
May 16, 2018
Illustration: Leon Edler
Adam Kay, comedian and author of This is Going to Hurt: Secret Diaries of a Junior Doctor has some rather special words of wisdom for Jeremy
First of all, congratulations on still being in the job! At this rate, you should probably consider measuring up for curtains at No 10. Maybe you could reuse a few pairs from some of the A&E departments you’re closing down?
But I’m writing because I need a word. You know the sick, wheezing patient who has been under your care for the past five years – the NHS? You recently claimed there wasn’t a crisis despite thundering evidence to the contrary and you have pretended that cancelling a month of operations and outpatient clinics is a perfectly normal thing to do.
But just ask anyone who works in a hospital, or has been to one recently (and I don’t mean a ministerial grand tour of freshly painted corridors and a quick peek at the one MRI scanner that isn’t knackered). Your patient is currently critically ill, bordering on terminal, and you are pursuing a dangerous course.
I’m here to offer you a second opinion and, since I know you relish the brevity of Twitter, I’ve summarised my treatment plan in six easy-to-follow steps.
Stop blaming the patient The NHS is fit for purpose and it’s time to give up stoking the malicious rumour there is something ineluctably unsustainable about it. Of course it’s a different service from when it was established in the 1940s, but it was actually working perfectly well until … umm … about five years ago. It’s easy to blame an ageing population, but life expectancy has increased by only about the length of a Corrie omnibus since you took the reins. The much-blamed “expensive new drugs” were already in use then too. If you honestly don’t want to dismantle the service, kill off this lie.
Invest in doctors and nurses The NHS is all about the people who work there, beleaguered and exhausted as they may be. Having worked as an obstetrician in the NHS for seven years, I realise that it truly is a calling – nobody’s there to get rich – but that doesn’t mean staff should be expected to take a vow of poverty. In real terms, pay has fallen by more than 10% since 2010, when your mob took over. Thanks to the number of GPs decreasing year on year, we now boast one of the highest numbers of patients per doctor in the western world. Doctor Legg single-handedly patching up the entire borough of Walford in EastEnders has now become the reality of primary care. Those who remain behind are stressed and burned out, whizzing through patient appointments like they’re fast-forwarding through a disappointing drama. In these tiny snatches of patient-doctor contact, what’s going unseen or unsaid? It’s unreasonable, unsustainable and unsafe for patients. And for doctors too – there are record levels of stress-related leave, and the suicide rate among young medics is tragically increasing. In our hospitals, with morale 6ft deep and gaps in the rota turning every day into a nightmare, it’s no wonder half of junior doctors are parachuting out of the profession. Encourage new blood to join and existing talent to stay, and all-out crisis may be averted. Wait any longer and the damage will be irreversible.
Don’t be afraid to have grown-up discussions British people love the NHS. It’s not like any other publicly owned entity. We don’t love the Bank of England or Cardiff airport, but we love the NHS. It delivered us when we were born, fixed our broken arm on sports day, gave our nan chemo, treated the chlamydia we brought back from Kavos, and one day will zip us up in a bag. I promise you we’ll do whatever it takes to keep the NHS going. I think you will be surprised how much we are prepared to pay for it. Whether that’s in the form of income tax, death tax or some special NHS levy, we’ll do it. Just have the discussion.
Share the pain We get it, nobody wants to raise taxes and find themselves speeding towards a drubbing at the ballot box, so how about you establish a cross-party parliamentary body with responsibility for long-term NHS strategy and budgeting? You know, like an away day with people you never normally talk to at work but you might well bond with over a love of … well, life. That way the burden of “unpopular” decisions like raising taxes can be shared, rather than overturned or sidelined by flighty politicians who only care about being in power, or have half an eye on their lucrative non-executive role in a private healthcare firm. Not you, of course. I wouldn’t suggest that for a second.
Spend wisely You’re a big fan of pointing at so-called health tourism as a huge drain on the NHS. Tasty headline-grabber it may be, but it’s manifestly not a major problem – costing just 0.3% of the NHS budget. It’s dwarfed by colossal expenditure on criminally high PFI interest payments. Isn’t it time hospitals got out of their chokeholds and these debts were renegotiated – maybe do something clever or legal, or use your charm … oh never mind – so we can redirect these wasted billions towards actually saving lives? And saving lives doesn’t just mean spending money on hospitals and GP surgeries. Now that the shiny new plaque on your door also says “social care” maybe you could fling a few coins in that direction too. Hospitals are at or beyond full capacity because there is nowhere to discharge a huge proportion of our inpatients, following years of cuts. Huge cuts are also slated for public health spending – could you reconsider that? Prevention is better than cure, and if we educate people on the best ways to keep healthy and alive – not hoovering up polyunsaturated fats like they were oxygen, maybe – perhaps we could future-proof the NHS a bit better.
A private word We know you love a jumble sale, but try not to flog off too much more of the NHS to the nearest snake-tongued bidder with fistfuls of notes. Private entities should not be taking public cash to provide public services. Every penny that becomes profit for shareholders is a penny that should have been spent on the NHS. Easy, right? Listen to my advice and I predict a long and healthy life. I’ll see you for follow-up in six weeks.