The NHS – A very personal view

Writing this blog is providing me with the platform to share my views and experiencing of the NHS from both sides.

Except for a short period of my working age life, when training for becoming a primary school teacher appeared an attractive proposition, I have always worked for the NHS. At 16 I plucked up the courage to apply to do volunteer work at my local Victorian mental health asylum, Fairfield Hospital I would go in regularly to spend time with the patients, feeding, washing and dressing or simply talking and listening to their stories.Many of the patients back then, had been in hospital many years and some merely admitted for getting pregnant out of wedlock, stealing from a neighbours apple tree or simply having a learning difficulty. Of course there were those who had committed horrendous crimes whilst suffering from mental ill health, so there were locked cells and padded rooms. Medications and treatments were often prehistoric with severe side effects but we have come a long way since then, and my first hospital is now a prestigious housing estate. My memories of the place were mostly, of a happy secure environment that provided these patients with an escape from the real madness of the outside world. For behind the walls were once a farm, station, church, bank, shops, cricket grounds, orchards, bingo, dance nights and believe or not sanity. Patients were given a sense of pride by being able to work for monetary rewards to be spent at the local WVRS canteen usually on fags or chocolate. Now it’s care in the community. Just look around your community for the care, does your neighbour stop you for a chat, do you check up on that the perhaps dishevelled looking gentleman living next door who may appreciate a moment of your precious time. I am not suggesting that moving from the old style of hospital care to today’s mental health care systems has been entirely a bad move, it is a very different world now especially with he advancement of medication and treatments, but I do feel that perhaps something’s has been lost.

So training as a registered mental health nurse, for me was the way forward and I have never really looked back. I have had jobs on psychiatric wards, worked as a community psychiatric nurse, taught audit and research skills on the general side, worked as a specialist nurse for looked after children and as a mental health advisor within the trust I currently work for. I now have the grand title of Clinical Lead and Service Manager for a pretty unique early intervention child and adolescent mental health service. We are a small team (11 in all) of dedicated staff covering a large county of Hertfordshire. The task we have is enormous as the emotional and mental health needs of today’s children are rising as quickly as those needs of the adults around them, and our success and reputation is our downfall, as we struggle to see our patients in a timely manner as waiting lists grow and resources reduce in the financial climate we all find ourselves in. Still I am confident in saying that every one of my team come to work wanting to do their very best, often working way beyond their paid hours and with an enormous amount of passionate for making a difference to today’s young people, our future!

Every year, a week before Christmas, (and my poor sister will bare witness to this) I bemoan the fact I get my yearly subscription bill of £100. (a professional fee required to ensure registration with the Nursing Midwifery Council) Without paying this I will not be allowed to practice. Ok so it’s not a great deal of money in the big scheme of things but when the papers are full of the proposed yearly fat cheques handed out to the city bankers and alike,
(who I am not sure are currently contributing that much to society in general, or am I being a little unfair?) it is a bit galling. Still I only need to look around me in the NHS and feel the sense of pride for working for such a large caring organisation. And not for one second would I swap a glass of the finest champagne, a fast car, a large mansion, holiday of a lifetime or Gucci bag for the national awards I hold with pride or most importantly the words in the card on my wall “Thank you Deborah for the difference you have made to our lives” that is something money just can’t buy so for the cost of a £100 pounds I guess I am pretty lucky.

Now I do appreciate we don’t get it always right and at times it goes completly pear shaped as many of you will have read I am sure, in the scandalous columns of the daily papers. And for every period of poor practice, and the resulting suffering caused to patients and families I am truly sorry. The shame and disappointment I feel is personal and as deep as a nail driven into my own skin. But I can honestly say for every bad egg or moment of substandard care their are millions of examples of the highest possible commitment, care, courage , communication, competency and compassion.

The NHS is currently going through the biggest changes it has ever seen and we are expected at every corner, or so it would seem, to do more for less money. Private companies are biting at our ankles keen to jump in to provide a cheaper, faster more efficient service. But we are strong and somehow we will survive. The spirit, desire and passion for the majority of most of the NHS workforce cannot be broken that easily, but this time YOU ( I am not really sure who YOU exactly are or blaming any one particular political party, but you will know it in your hearts) are certainly giving it a good go! We will become better and stronger and there are, lots of changes, that do in my humble opinion need to be addressed so here are just few:
1) The postcode lottery and I do think it still exists I’m afraid
2) The bureaucracy and time. nurses etc, have to spend on the duplication of forms to be filled and data to be collected. All very necessary I’m a sure to prove our cost effectiveness and ensure another years funding but ask a patient what they would rather us be doing!
3) At every opportunity when we just think we are getting somewhere another there appears to be another change, transformation, restructure or whatever name you care to give it next, lets hope the big one we are going through currently will be given the chance to bed in.
4) And very close to my heart is a plea for increased funding for mental health services(especially children’s mental health). We have had a little, but did you know that mental illness accounts for a massive share of the total burden of disease. Yet, despite the existence of cost-effective treatments, it receives only 13% of NHS health expenditure. The under-treatment of people with crippling mental illnesses is the most glaring case of health inequality in our country and for children the investment is even less!

The NHS employs more than 1.7m people, only the Chinese People’s Liberation Army, the Wal-Mart supermarket chain and the Indian Railways directly employ more people. Around 3 million people are treated in the NHS in England alone, every week. No matter what colour, age, creed or salary band, treatment is free to all at point of contact. I appreciate we all pay our taxes but I still think it’s pretty remarkable and something we should all feel very privileged to be able to access .

The population is growing and we are seeing massive changes in demographics. Alongside that we are researching and finding new medicines, and treatments that save lives every day, and that means so much to me in my current situation, but it doesn’t come cheaply. Advancement in cancer treatments and possible cures are happening at a terrific rate and I just hope my own body will hang around long enough to take advantage of them. An example of this needing more funding is please take a moment to have a read.

The care I am currently receiving at the University College Hospital London Macmillan Cancer Centre is exemplary. From the phone call reminding me of today’s appointment, down to the lovely research assistant, who checks on my progress, the nursing assistant that expertly locates the right vein each time to insert the cannula with little fuss and pain, to the nurses who then administer my beetle juice with such compassion and care. And, not forgetting the doctors and allied professionals working hard behind the scenes to come up with that elusive cure.