Who, or even what, we might ask, lies at the heart of the NHS?
The short Ester Rantzen answer is of course the patient.
But this is the glib answer. It ignores, for example ‘why’ questions: why, for example, is the patient in the NHS at all?
The answer of course is to avail him or herself of what we now call ‘healthcare’, which is in fact medical care, and medical care is provided by medics – doctors. The doctor is as central to the NHS as the patient. Like a ship and her captain at sail on a sea of sickness, patient and doctor sit together at the heart of the NHS; for a ship without a captain is apt to founder; and nothing is bleaker than a captain on the beach.
We might say, then, that the true heart of the NHS is not so much an isolated patient sitting on pedestal, as an interaction between two people, each of which is vital to the other. Remove but one, and the whole ceases to have meaning.
Yet this is exactly what is happening. We have, over the last few years, seen a wanton, ideologically driven destruction of UK medical training. And now, we see the inevitable result. Junior doctors are leaving in droves; and – to add insult to injury – others who have dared to persist are being turned away. Of the last 6000 or so doctors to complete Foundation Training, some 23% have boycotted further UK training for now, maybe for ever. Of the 5,906 applicants for specialist training, 244 of those who were appointed ‘saw the light’ and decided to bail out. Another 1,295 applicants were told, as the phrase was in Dr No’s junior days, to ‘come back when the leaves are green’.
Putting aside the predictable raft of claims and counterclaims about what the figures mean, it does seem (Dr No has not been able to track down the exact source figures, and those that have been reported – here, here and here, for example, don’t always quite add up), that between one in five and one in four doctors completing Foundation Training are jumping ship.
We ignore our junior doctors at our peril, for not only are they today’s ward doctors, they are also tomorrow’s consultants. Whatever the reasons – there has been ample speculation – even if Dr No believes some of it to be off the mark – these are losses on a scale that would leave even Lady Bracknell speechless. The heart of the NHS is bleeding – and bleeding hearts have a habit of dying.
Note: Dr No appreciates that nursing faces a similar broken heart. Were he a nurse, he would have written this post using nursing words. But Dr No is a doctor – so he writes as a doctor.