Urgent! A morale boost for the NHS
I AM a consultant plastic surgeon who has worked in the NHS for 45 years. Politicians from all parties fail to understand how most of the NHS’s success is due to the goodwill of the people working within it. Successive governments have eroded that goodwill. Politicians felt that what was needed was control, especially of consultants. If you go to any hospital in Europe, in the entrance you will see lists of the doctors who work there and their speciality. In Britain, you will see lists of managers, usually with large colour photographs. Politicians have compounded this lack of understanding by following Aneurin Bevan’s mantra that all that was needed was to ‘stuff [the workers’] mouths with gold’. This was never the case — working as a health professional in the NHS has always been about job satisfaction. The blind obeisance to the European Working Time Directive (EWTD) has been a major factor in the lack of training of junior staff and the early retirement of senior staff. A past president of the Royal College of Surgeons told me that the UK was the only country in the EU that abided by the directive — other countries realised it was not workable and ignored it. We should not assume that the NHS is the envy of the world, but instead consider why the morale is so low, particularly among junior doctors. They feel disenfranchised from the historical firm structure that supported them throughout their training. Specialist training is essentially an apprenticeship, and no specialist can learn without hours spent perfecting their skills. Restricting junior doctors to working 48 hours per week under the EWTD, which essentially prioritises treating patients rather than training, does not allow this. If a hospital is under pressure, then processing and dealing with patients takes precedence. All the Royal Colleges, particularly the surgical college, are understandably concerned about this. We need to take stock and review how other health economies across the world are dealing with this issue, and address what is becoming a significant problem across all specialist training in the UK.
OLIVER FENTON, Dewsbury, W. Yorks.