I woke up on Tuesday morning with the realisation that a further year had been added to my age. The next form I fill in will no doubt make me say “no surely that can’t be right” as I begrudgingly supply the required details.
But as I drove to a meeting outside Northampton I had time to reflect on the ageing process and suddenly realised how lucky I am. Compared to the NHS whose age is marginally older than my own, I counted myself fortunate that I have not needed cosmetic surgery to keep going, whilst the NHS has endured countless operations under the guise of service reconfigurations, organisational restructuring, strategic re-alignment or indeed performance management.
But if human beings get wiser with age, I wondered whether that also applied to the NHS? By the time I arrived at my destination I had worked out that we, mere mortals, do get wiser because we learn from experience. I wish the same could be said of the NHS. The NHS is a modern marvel when it comes to technology and its ability to promote scientific advance. But has it matured with experience?
If anything, the NHS is becoming less experienced as it gets older. Medical training is a case in point. Trainees’ hours in the log book are considerably less than a few years ago - that is not because there is less to learn, far from it.
Consultants are spending less time working in the wider interest of the NHS because trusts are fixed on short-term targets, blind to the longer term benefits consultants can bring to the NHS by active participation with their royal colleges.
There are few chief executives who can claim to have been in post for more than five years; and when it comes to NHS monitoring and quality standards the goal posts seem to move every season.
Getting older is no bad thing if we learn from our experiences, use them to shape the future and share them with those following on behind. But, as the NHS gets older, I worry that those following on will have no-one to learn from.
Talking of training, the newly-qualified HO (now F1) has already had five years’ training but has little power in the NHS; the newly-appointed consultant has had a further 8-10 years’ training and still has precious little power in the scheme of things in today’s NHS. On the other hand, managers have had a few years’ training in ‘management’ (in ‘general’ as opposed to the NHS) and wield considerable power. But how much training does a Secretary of State have (in anything)? And how much power do they posess?
The NHS is supposed to be about treating patients; something seems to be a bit topsy-turvy here, does it not?
Retired Orthopod