WENDY’S RANTS
These rants are about things that I need to get off my chest! I hope you find them interesting.
I have no intention of posting them on any Social Media as I find the platforms anything but Social and I can do without unconstructive; deliberately hateful, personal comments from anonymous people who wouldn’t say it face to face.
However, if you would like to add your comments, thoughts and ideas to a general discussion on these topics then please go to the Contact Page of the website.
The NHS today
There is no question that the NHS is in trouble – serious trouble. It needs a complete root and branch re-organisation to be able to fulfil its primary function of providing all the health services needed to keep the population as fit and healthy as possible. This means that people are generally happy - and at work, which in turn keeps the financial wheels running for the whole country!
But what went wrong? Pouring even more into the NHS “money pit” has never been the answer! We have to look how it is spent, who is spending it. Clinicians and frontline workers are not always the best people to decide where the money should be spent!
A little history
The NHS cost £248 million pounds in the first year (1948), but this was nearly £140 million over budget.
Part of the problem was that the only way to get the medical profession to support the idea was by the government offering significant amounts of money to the consultants. This apparently was the only way that they would agree to being employed by the NHS, as previously all healthcare had to be paid for by the patients.
Interestingly, GPs are still not employed by the NHS. The are technically self-employed, but under contract to the NHS. Even more interestingly, this means that GP medical records do not belong to the NHS (like hospital notes) and is one of the major problems with communication between GP and hospital!
When I began my career in the NHS in 1969 as a student physiotherapist, it very quickly became obvious that there was a definite hierarchy in the NHS. The consultants were at the top of the tree and we students were only just above the porters, cleaners and the administrative staff! In those days, the Physiotherapy Training Schools were actually in the hospital - on site. This meant that from Day 1, we were working on the wards as well as having all the lectures from the Physiotherapy teachers and the doctors.
We accepted this situation as we didn’t know any better and in the late 60s “you didn’t question authority”! Over the years, this “class system” in the NHS has developed into an extraordinarily biased system.
Everyone knows there are only doctors and nurses in the NHS!?!
In fact, there are also 14 Allied Health Professions (AHPs), that used to be known as Professions Supplementary to Medicine; Professions Allied to Medicine (PAMs), and even Paramedical Professions, which means something completely different today! (New Name/same job!)
AHPs of today:
1. Physiotherapists
2. Occupational Therapists
3. Radiographers
4. Chiropodists and Podiatrists
5. Clinical Psychologists
6. Speech and Language therapists
7. Prosthetists/orthotists
8. Art Therapists
9. Biomedical Scientists
10. Clinical scientists
11. Dietitians
12. Hearing Aid dispensers
13. Operating department practitioners
14. Paramedics
All of these professions have protected titles and misuse of the names could be breaking the law and liable to prosecution.
They have to be registered under the Health and Care Professions Council (HCPC), which is the new name for the State Registration Board, which covered all of these professions and the nursing profession.
My understanding is that the government of the day wanted all the Healthcare Professions to come under one governing body. The problem was that the doctors would not play ball and refused to be lumped in with everyone else!
When I worked at Barts Hospital in the late 1970s, there was the Medical Council and the Heads of Departments Committee. The Medical Council was a committee of the doctors and the nurses who met once a month with the intention of deciding on policy, procedures and problems within the hospital and the other units within the City and Hackney Health District.
The Heads of Departments (HOD) Committee would meet once a month to also decide on policy, procedures and problems within the hospital and the other units within the City and Hackney Health District.
The HOD committee included representatives of all the different departments in the hospital except for the doctors! I suspect that they didn’t see the need for them to be involved in problems that the cleaners might have! But what it really did emphasize was that the doctors considered themselves as being apart from the rest of all the NHS staff.
What they have always failed to understand is that their work is dependent on all the staff in the NHS!
You can have the best surgeon in the world but without nurses, radiographers, laboratory technicians, phlebotomists, physiotherapists, any number of other professions and people (depending on the surgery), and even the admin staff, then the surgery could not take place.
It was always supposed to be “team work”, but the “whole team” is considerably more than just one profession!
As a final point, the patients sit in the middle of this great Empire and without them the Empire would have no purpose and.
Nothing like stating the obvious, but everyone who works in the Empire needs to be reminded that their very existence depends on sick and ill people. 1.6 million people would be out of work!
Patients are people who have health problems. They are not health problems who happen to be people. Communication between patient and practitioner is at an all-time low.
Over the last 2 years, I have seen the NHS from the viewpoint of a very close relative of a patient. I hadn’t realised just how bad the communication with the patient has become It is all but non-existent; varies enormously between hospitals/trusts and is almost exclusively in one direction ie from hospital to patient.
The NHS app provides information in one direction. It is
The Healthcare Team includes the patient – and their family!
