HCSA

What I’ll tell Cameron when invited to dinner

I have not (yet) been invited to No 10 for dinner. But if I could afford it I would welcome the opportunity to talk about the NHS as I see it. I would do so as one who for the past 12 years has not only had the privilege of representing senior hospital doctors over a wide variety of disputes, investigations and disciplinary  hearings, but also as one who has served the HCSA under five presidents, numerous council and executive members, and led a team which, frankly, is second to none. It has been an extraordinary and at times humbling experience.

So, in this imaginary dinner the first course would be dominated by a discussion around the need to value our senior hospital doctors; and indeed all those work in the NHS. I would urge an end to the nonsense arising from job plans being merely a timetable factored down to the fourth decimal point in a 40-hour week. I would hope also to remind my audience that maintaining High Professional Standards applies equally to consultants as it does to their managers, that patient care is provided by practitioners who need to be supported in that task and not prevented from doing so.

I would say that whilst it is acknowledged that those earning more may well have to carry a heavier burden during such times of austerity there is a limit beyond which such burdens turn into unfairness. That limit is now reached – indeed has been overstretched. Recruitment and retention will suffer until or unless practitioners are valued.

Reaching for the burgundy before the arrival of the main course I would talk through the wider relationship between the medical profession and government. Today’s trainees are tomorrow’s consultants; at least that is the plan even though the role may be ill-defined. Does the government really expect today’s trainees to anticipate doing the same job in the same trust until reaching the age of 68? Their posts must be attractive, challenging, rewarding, stimulating and offer them the opportunity to contribute to the development of standards, training, teaching and the myriad other activities that their own expertise brings to the table. Or is it the government’s plan that consultants will simply be technicians, employed solely to ensure that the singular needs of their employers are met? If the latter, they should be told – and should not be surprised if the applications to work in South Africa, Australia and other exotic places increase.

After a digestive break before pudding I would launch into my final hypothesis – and hopefully have consumed sufficient burgundy to make my final plea. And that plea would be along the lines of “if it ain’t broke don’t fix it.” I wonder whether No 10 could convince me that any of the numerous re-organisations over the past 20 years have ever actually benefited the public, patients or indeed the NHS. Given there have been so many it would be difficult to argue the case that reorganisations have been well thought through and effective. A moratorium for the next 10 years would at least signal the arrival of stability, the lack of which has done so much harm to the NHS.

By now it may be that with all the burgundy, brandy and black coffee I would feel like Sir Les Patterson, erstwhile Australian cultural attaché, who bears an uncanny likeness to Dame Edna Everage. So I would stagger out of No 10, and having paid my money had a good dinner. The NHS would be considerably the better for it.

In retirement, I hope to have the time to prepare a bit better for my next dinner at No 10. But until then I wish all readers (and the editor of course) best wishes for the future.

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5 Responses to “What I’ll tell Cameron when invited to dinner”

  1. JS says:

    Thanks for representing us. Enjoy your retirement Stephen – you deserve it.

  2. PS says:

    I would like to second that.

  3. Tom Goodfellow says:

    Well said, Stephen

    But I suspect you have already blown any chances of a gong!

    Thanks for all your help in the past. Your knowledge, expertise and experience will be hard to replace.

    I understand you will shortly be going on a “retirement course”. I hope you do not find this too much of a handicap!

  4. Andrew Jackson says:

    Thanks for all your hard work over the years Stephen. It was great seeing you again last week. Enjoy a well deserved retirement.

  5. Malcolm Morrison says:

    Stephen, I don’t think you have understood the workings of the ‘corridors of power’ properly. For you to get to dinner at No. 10, the HCSA would have to donate about £250,000 to the Tory Party – in order to get into the “Premier League”! And I am sure that, even if the PM were polite enough to tell you “I hear what you say” (translates into “I’m not listening”!), he would no doubt accuse you of having a ‘vested interest’ so you ‘would say that, wouldn’t you’, and of bringing your own ‘sour grapes’ to the table for the cheese course!

    The problem with politicians is that they will not accpet the profession’s diagnosis that they suffer from ‘selective’ deafness, paranoia, and delusions of grandeur!

    May you have more pleasant dreams in your retirement!

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