Social challenges are as tough and engrained as ever. With the increasing strain on health and care services, the mantra ‘more for less’ has become deafening and, on occasion, paralysing. In this intimidating context it remains just as important but altogether harder to ask the important question, how can we help change the way our society works to better service the most disadvantaged?
It is a commonplace assertion that society, the economy and public services face unprecedented challenge: from demographic pressures to a stuttering economy; to critical workforce shortages and developments in technology that outpace our ability to harness them for public good. In order to survive (let alone thrive) we must change; work differently, think differently, live differently.
But all change is not necessarily a good thing. And not all new things turn out to be that ‘new’ after all. Don’t throw the baby out with the bathwater (das Kind mit dem Bade ausschutten), has been a German catchphrase for 500 years. In seeking out productive change there might also be things to retain, adapt or even revisit from the past.
I haven’t always loved being a doctor. Too often during my training, I left work wondering how I could drum up the enthusiasm needed to return to work the next morning. Long hours on call, constantly rotating to new wards and clinics, and the sense of futility I felt was intense. There were moments when I would look at the patients on my rounds and briefly wish I could trade places, just for a chance to lie down for a second.
Looking back at those days, it’s clear to me I was struggling with symptoms of burnout. It felt incredibly lonely, and yet I know that so many of my colleagues felt the same way. Far too many still do.
By 8pm in most departments in most UK hospitals, the majority of people whose title implies a leadership or management role are on their way home, returning the following morning at, let’s say 8am plus or minus one hour.
Does this imply that for around half the average day, our great NHS hospitals are ‘un-led’ or does the mantle of leadership pass to another group who lead without access to fancy titles?
One hundred years since the vote was first extended to women in the UK and over 140 years since women were allowed to train as doctors in Britain, do we have equality of power for women in healthcare, either as professionals or as patients? What would real equality look and feel like, and what will it take to get there?
In our eagerness to be helpful, are we in fact, all part of the problem?
Entire industries rely on being needed to help people. Having people in need of help gives these industries a justification to exist. Ultimately, we can never get away from the uncomfortable fact that it pays many of our salaries. We all play our part in an expensive game of bidding, competing for and winning ‘work’.
You might hope the answer to that question is self-evident. Whatever your long-term goal, you need a plan for how you’re going to get there, particularly if you work in a complex, dynamic environment like the health service. And particularly if you’re relying upon multiple organisations to help you achieve that goal.
I am a psychiatrist. I love people. I believe in happiness and opportunity as basic human needs. As a teenager, I thought that if we could just live in a true democracy, we could have a peaceful world, where everyone could have equal opportunities to reach their potential. I was truly a product of the era of that great song “I’d like to teach the world to sing in perfect harmony”.
However, having no singing talent, to play my modest part in creating happiness and equality, I became an NHS doctor! This blog is written through the lens of my experiences with patients and communities.
Artificial Intelligence is opening up new frontiers, whether in health care, business or (only slightly alarmingly) warfare, promising a new generation of ethical conundrums. The quandaries caused by driverless cars may require grappling with sooner than most. “It is not the ferocity of automobiles that is to be feared, but the ferocity of those who drive them. Until humans intervene, they are usually harmless.” (Georgia Appeals Court, 1909)
Topic for Melting Pot Lunch 20 September 2017 ‘Geno-what’? A new technology is sweeping across the NHS, but what can it offer and what does it mean?
Genomics - the ability to test for 20,000 genes in one go - is now available in many clinical services. Whilst you may not have personally accessed such testing, someone you are biologically related to may be offered it. And the questions that they have answered may be of interest to you too.