GThe NHS's good old anonymous senior sources. They can always be trusted to tell you the truth. The whole truth and nothing but the truth. In their latest act of radical candor for patients and frontline staff, these secretive freelancers Report to the BBC On the growing concern over Wes Streeting's claims that the NHS is dysfunctional.
Ahead of the Health Secretary's speech to the Labour Party conference, sources expressed concern to businesses that Mr Streeting's unsparing portrayal of the NHS's current failings would “scare patients” and make it “really hard to boost staff morale”, with one brave, but unnamed, hospital chief executive tweeting darkly that “if the Government isn't careful, it will cause lasting damage”.
Now, I'm no apologist for Streeting, but honestly, this is exactly the kind of boring doublespeak that's rotting the NHS from within. There are two ways to confront the dark reality. One, and we've been doing this approach for 14 years, is to pretend it doesn't exist. At best, this is a form of benign paternalism, like the aristocratic doctor of old choosing not to say the C-word to his patients in case being honest about their cancer diagnosis might do more harm than good. At worst, it's just political quackery.
Despite waiting lists swelling to nearly eight million, with one in seven people in England waiting for NHS treatment, successive Conservative spokesmen have toyed with reporters with unfounded claims that the NHS is doing well. For all those Americans suffering the pain and humiliation, and for all the staff forced to treat dying patients on trolleys in corridors, this blithe denial has been soul-destroying. How can we expect to cure what we refuse to even name? How can we be optimistic when staff and patients, with voices much louder than our own, are trying to erase what they are actually experiencing?
Mr Streeting has taken a different approach and is not holding back one bit. He told the conference today that the NHS's fundamental promise “to be there for us when we need it” has been completely broken. He gave the example of 100,000 infants and toddlers. I was kept waiting the number of patients who spent six hours in emergency departments last year and the fact that cancer is more likely to be a cause of death in the UK than in comparable countries.
This last phrase drew particular ire from anonymous sources, one of whom countered that the phrase struck “totally the wrong tone,” as if tone really was what mattered when it came to cancer. Maybe it's just me, but as a palliative care physician in a hospital, when I have to meet a once-healthy young patient for the first time and tell them that their newly, late-diagnosed cancer is terminal, these facts seem more important than tone. And they matter even more when it's the third time I'm having that conversation that week.
The truth is, as we all know, the NHS teeth It is failing. This is not to blame the staff who work in a service that has been deliberately destroyed by 14 years of neglect and underinvestment. Meanwhile staff morale has plummeted. Burnout and early retirement are widespread. There is no count of the ploys that NHS bureaucrats have deployed to address the problem: free Zumba classes no one has time to attend, pandemic-era George Cross donations distributed to 1.3 million people and, once, a truly revelatory moment, when one trust's gift to staff was 1 NHS branded tea bag.
Meanwhile, NHS England's serious commitment to staff morale was made clear earlier this year, when it sneakily announced the news late one Friday afternoon that it would defund the NHS's GP care service – a little-known but valuable resource that supports doctors living with mental illness. More than 17,000 NHS staff signed an open letter expressing their disgust at the cost-cutting measure. Doctors who had once had suicidal thoughts described in heartbreaking detail on social media how the service had saved their lives. Eventually, public anger became too great and NHS England withdrew its support. I made a quick U-turn.
The truth is that the NHS has a long and disgraceful record of prioritizing reputation management over protecting patients and (genuinely) supporting staff wellbeing. The culture of secrecy and cover-up is pervasive. We have seen it in the Mid Staffs Hospital scandal, the blood infection scandal and the many recent maternity scandals that Streeting rightly called “a national embarrassment”. But no one, whether they are the Health Secretary, senior NHS managers or ordinary nurses and doctors, can ever hide the truth from the public.
When Streeting laid out the NHS crisis in all its ugly detail, I felt nothing but relief. A real glimmer of hope. Of course, the only thing missing from his speech was whether we could get the NHS out of the “worst crisis in our history” and build an NHS fit for the future without a massive injection of new resources. Staff have long been tired of Health Ministers selling us magical reality. This has to be real, or the NHS may disappear under a Labour government.
