What do you think needs to change in the NHS?
I think the work we do is really important, for the simple reason that the World is highly populated. The NHS born in the 1940’s was built as a small entity for a smaller population and suddenly it’s become this monstrous machine that delivers a service to so many people nationwide. On the backside of that a lot of people from overseas come to use the NHS, whether they pay for it or not. So, it’s a recognised service. One of the key things for us, is to spend taxpayers money wisely and more efficiently and part of that reason is people want to be at home. They are more comfortable at home if they are sick. And to aid admission avoidance, it costs more to keep people in hospital. Some people need to go to hospital, but the beds then get clogged up. It’s about everything moving all the time, so patients being comfortable at home. Patient’s family as a support structure, so you don’t need the people to come in and provide the service if we can use the natural support structures around us, in line with the integrated care services which we have available. To have specialists come in on occasions, or scheduled sessions to see those patients. That in turn is more cost effective, than putting somebody into a hospital, far more expensive, away from their family and you’ve suddenly clogged up a bed for somebody that may need the bed more urgently.
What other challenges are facing your industry right now?
There are a number of challenges facing the healthcare industry right now, one challenge is the availability of the work force, the numbers are extremely low, there are thousands of GP shortages, we have more people leaving the industry than entering. This is both nurses, doctors, and healthcare professionals overall. You’ve a healthcare system that is lowly paid, but the demand is extremely high, so it doesn’t get the recognition. I try not to be politically minded, but I think one of the best things the government thought of is the national insurance contribution increase going into the NHS, I believe it should go in to provide for additional workforce on the ground level/ the front line so we can achieve what we are trying to achieve.
If you look at what happened during covid, you’d go to the hospital for an appointment and wait for hours, covid happened and all of a sudden we have this structure of an appointment system, that you went on your own, you were seen in 15 mins and you left. But I don’t feel we’ve learnt from that. I feel we are already slipping back into this chaotic world rather than taking what we had, what we learnt and applying it to move forward. So, I think there is a lot to be done and a lot of structure that we’ve learnt from the past, being implemented, rather than just being used for a period. We just slip back into a calamity. So unfortunately, it will repeat itself until we do learn.
If you were the health secretary for the day what would you do?
I take my hat off to these people if I’m honest, it’s a hard job! I sit on the outside and I see it from my own world, they see it from their world. I just think ‘can one person really make all the decisions’? Yes we give them a team to enable them to do the job they do, but they don’t go out to people like us, go into trusts and listen to what they need, look at supply chain to see what we can supply. It’s great we have an idea that we are going to do ‘xyz’, but actually is there the ability to do that? It’s really, that we have great ideas in theory but can they work in practice. If they can work in practice what’s the implementation period and it’s having that structure laid out.
Look at NHS direct, a really good product, not marketed or branded correctly and not utilised and unfortunately it was closed and reinvented as the pathway 111. Overall, a different system but very similar. Which seems to have worked because they have stuck with it and have the structure. You will always have emergency and non-emergency working side by side and this is the way it’s going, but it’s sticking with it and seeing it all the way through. The thing is governments change and they want to make an impact and they break something that is probably working just fine, but may need a little more tweaking. It has to be about the big picture not the personal/ political gain.
It’s continuity as you say. If you throw the baby out with the bath water, every time there is a change of government. It’s the nation’s largest employer so it’s not an easy task.
Yes it’s the nation’s largest employer and the reality is we could put another 100K people into the NHS it wouldn’t be enough. If we look at everything that has happened in society everything is becoming so big. I’m not saying things should be fragmented off, but do each region / trust work collaboratively? What works in the South may not work in the North.
For me there are also so many workforce opportunities in the NHS, we have affluent areas, deprived areas but opportunities should be available for all. We need more bursary’s, ways to encourage more people to think about the healthcare service as a career option. Why are we not promoting that? I was at school a long time ago and I had a careers officer speak to us, people from public services, police, nurses, doctors, bakers, and kids got it. All we get now is bad press about working in the public sector, but look at all the good it does, this narrative never plays out. Think about the pension, infrastructure, the investment in people, a vision of where you’re going, teamwork, total diversity, it’s absolutely awesome, but we don’t promote that. We speak about the bad things, and for me if we started early enough, sowing the seeds in schools to tell them all the great things, instead of listening to the media, then we would have a larger, diverse, capable and motivated workforce.
Do you think there is a perception then about a career in healthcare being an option for some and not all? If there was more awareness earlier, do you think there would be a levelling? So that people begin to see this as a long-term opportunity.
Yeah, I do because we have a lot of ethnic minority families who work together as families and support each other. Some give up their dreams of a career, as they must contribute to the family. Why are we stopping good academic people having a career and adding something to the value of the country? We could be investing in them to do that, and supporting them. So, we have a double-edged sword. Not only supporting them to have a career but supporting the family, allowing them to integrate and contribute to society. I think it’s really important.