My wife came home from work last night ‘too tired to chew’. She’s a nurse, and she’d just completed a ‘double’ shift – leaving home at 6am and getting home at 9.15pm after a solid shift of almost 14 hours on a ward full of ‘dependent’ patients.
She came in, and I asked if she wanted me to warm something up for her to eat. ‘No, I’m too tired to chew‘, she said – and it wasn’t humour. She then warmed up some instant porridge that she could eat with minimal effort before having a quick bath and then going straight to bed. She’s on another ‘double’ today, so she couldn’t do anything else before sleeping in order to be ready.
It hadn’t even been an unusually busy shift – just ‘par for the course’ on a ward that has about 8 patients for every qualified nurse, and almost all of them with conditions that make them ‘high-dependency’, needing help with even the most basic functions.
Earlier today, in a speech to the Nuffield Trust, Health Secretary Jeremy Hunt criticised NHS hospitals for ‘coasting’. In his considered opinion,
too much of the NHS is focused on doing just that [‘not coming last’]. Not on achieving world class levels of excellence – the gold medals of healthcare – but meeting minimum standards, the equivalent of ‘not coming last.
The weeds of failure grow more quickly in a garden of mediocrity.
Hunt was comparing the NHS to Olympic athletes. Since it was unthinkable, he was saying, that an Olympic athlete would train with the aim of ‘not to win, but to not come last’, we should also expect NHS hospitals to aim for not only excellence but constant improvement.
The thing that strikes me most about the whole, fatuous speech – and it really shouldn’t, because it’s entirely normal in the way this government treats the targets of its measures – is the blatant skewing of any semblance of truth or sense, but stated as if it’s the most unarguable, self-evident thing in the world.
Elite Olympic athletes are singled out, given support, funded – everything is set up to give them the best possible chance to shine for personal and national glory. The best training facilities are provided. And when the government wants a greater chance of success, funding is increased – often massively.
How far would Olympic athletes get in pursuit of excellence if they were underfunded? If their fellow team-members progressively disappeared and their coaches were removed? If they were forced to compete not just in their chosen specialism, but to stretch themselves to cover 2, or 3, or more related events – if every sprinter, for example, was forced to become a decathlete?
The NHS is under sustained, multi-fronted attack by a party whose ideology simply cannot tolerate the existence of healthcare free to all at the point of need. Only politics prevents the Tories from immediately abolishing the NHS. As former Tory minister Michael Portillo put it:
They did not believe they could win an election if they told you what they were going to do.
So the attack has to be multi-faceted, progressive and ‘kept under the radar‘ as much as possible – and it involves a constant ‘drip, drip’ of poison in the ears of the British public to erode support and affection for the NHS, with occasional intensification to prepare the ground for a new phase of the assault.
You see, the Tories want Olympic glory – so they’re prepared to pay for it. They don’t want an NHS free to all – so they’re not.
Elite athletes work hard – but everything is set up to give them the best chance of success, and they are lauded and feted in front of the country. The NHS, by contrast, is starved of funds (no matter how the government tries to twist the figures), under-staffed – and vilified by craven government ministers whenever it’s politically convenient or possible to do so.
Hunt spoke of a need for ‘continuous improvement’ and said that it’s just not good enough to be ‘good enough’. He even dared to use Mid Staffs as an example of what happens when hospitals settle for ‘mediocrity’ – even though the real story of Mid Staffs is one of gargantuan efforts on the part of health staff preventing an increase in the death rates in spite of desperate under-staffing and cuts.
The daily reality of the NHS is one of constant, untrumpeted hard work that routinely goes ‘above and beyond the call of duty’ – in spite of being treated as a punchbag by politicians who’ve never known hardship. Or hard work, in many cases, for that matter.
Nurses and other healthworkers give their best on a daily basis – without glory, without high financial rewards and without the support that they should expect as a right from those at the top, and usually without even recognition or thanks.
Here are some examples that are known to me personally – and which deserve a wider audience, just like the millions of other such acts of dedication that I don’t know about:
- a ward manager who was asked by the the hospital’s senior matron to release a nurse from her ward to help out another ward that was struggling. The manager knew that her own ward was already overstretched – so after a 10-hour shift she went up to the other ward and worked another 4 hours to help out. Unpaid.
- a healthcare support worker who, at the end of a 13.5 hour shift, stayed another hour rather than leave a distraught, bereaved relative before her family could arrive to grieve with her.
- a nurse phoning her ward at 3.20 in the morning, in spite of only finishing a late shift the previous evening, to make sure a patient’s belongings had been brought up from Accident & Emergency.
- a nurse working on a ward where the patient to nurse ratio is regularly 12:1 – double the recommended level, but battling hard to keep things from collapsing altogether.
- a nurse (my wife) who regularly cries quietly into her late-night cup of tea over the death or fear of a patient with whom she’s ‘connected’ in order to provide some human contact and comfort, even though she knew they were terminally ill.
- and it’s not just nurses and healthcare assistants. 2 doctors – SHAs or ‘senior house officers’ who regularly stay back 3 or 4 hours after the end of their shifts, to make sure that everything is done that needs to be done.
I think you should hear from a couple of those people in their own words. First, our HCSW who phoned the ward in the middle of the night:
Something so trivial yet it worried the hell out of me, I couldn’t sleep thinking that he won’t have anything in the morning and his bag may get lost. Lol. I had actually took it up with him, DOH! but when your busy, your heads trying to think of a billion things to do. I’m a HCSW..I’ve been kicked, punched, verbally abused and bitten, yet nothing is done about it, just recorded and that’s it! I sometimes wonder why on earth I do this job, but the simple fact is I love it. I love interacting with the patients, caring for them no matter how vunrable they are. Sitting with a dying patient and comforting them through their final hours and most of all saving someone’s life. These are the most rewarding things about my job.
And our nurse who faces caring for twice as many patients as she should be:
it is virtually impossible to provide the sort of care that everyone should be able to expect. I have to prioritise on a daily basis and I very rarely go home feeling that I have done a good job. I never leave work on time, my breaks are unpaid (except for a 10 minute tea break) and as I don’t get time to take more than a sandwich on the run break, I am giving the Trust my time every day for nothing.
The reason I carry on working is that I consider myself to be a good nurse, and I try to make a difference to some-one’s life every day. However, I can’t begin to tell you how angry it makes me to see the demonisation of the NHS and nurses in particular as if we are the main reason why the NHS doesn’t always perform as well as it should. There are few jobs where people would put up with the conditions that we have to work in under a constant barrage of criticism. The danger as I see it is that people will be put off going into nursing – I know many colleagues who have left to go into other jobs where they don’t go home at night worrying about the dear old chap in bed 1 who may not be there when you go in for your next shift.
(If you want more examples of the real story of the NHS, I’ve written two ‘day in the life of an NHS nurse’ posts, which were two of the most-read posts on this blog last year – you can read them here and here.)
The weasel words and self-serving distortions of Jeremy Hunt and his ilk are on our TV screens and in our news media every day. The words of the people he denigrates and undermines are not. But there’s no doubt about which should be listened to and trusted.
Hunt and his party are seeking every way possible to kill the NHS in a ‘death by a thousand cuts’. Whether it’s downgrading Lewisham because of problems at another Trust, or propagating a death-myth and then putting Mid Staffs into administration even though the Trust has stuck to a plan agreed with Monitor and the Department of Health – or making an utterly spurious comparison between athletes and the NHS as justification for whatever he’s planning next – it’s clear that the Tories’ aim is the end of the NHS as we know it.
The NHS is not ‘coasting’. It’s sinking.
Holed beneath the water-line by by a hundred Torypedoes – as the Tories then mock, deride and impede the heroic efforts of those who are trying to bale out the water, keep our national flagship afloat, and to keep things ‘good enough‘ against all the odds.
And those efforts are heroic. Olympic athletes achieve great things – but they do it for their own glory and fulfilment.
The real heroes are the hundreds of thousands who give their time and hard work – at great emotional cost and for little reward or recognition – because they care.
We fund and fete our athletes to give them the best chance of success. If Mr Hunt wants more from the NHS, he needs to put his money where his mealy mouth is and stop trying to cut the legs out from under the heroes who really matter.
(If you want to do something to help defeat the Tories ideological and greed-based attack on the NHS, please take a look here and consider making a small donation to the fight)