We are still all about the medical here. It is like being on Casualty, but in the boring, back office, where nobody shouts CRASH! CHARLIE! and runs around in crocs, throwing blood up the walls.
Now I’ve just read that back to myself, I’m quite pleased. I’d be terrible at blood. Let us not even think about what vomit does to me.
Mine, or other people’s.
One of the things that makes me cross about this situation is how many bureaucrats are worried about this. That might sound counter intuitive. After all, I should want them to be worried, right?
Yes, but I want them to be worried about the right things. What I want them to worry about is people with long term, chronic conditions being able to manage their lives with the help of GP’s they trust and who they can choose to see more than once in a blue moon. Not like the lady I spoke to today who has seen a different GP every week since she has been forced to move to one of the government friendly, large practices. What I want them to worry about is supporting GPs that are good at their job and not putting them in a position where they feel they have to resign. What I want them to do, is to focus on helping from the bottom up, not the top down. What I want them to worry about is patient care.
Not self care.
What worries the bureaucrats, from all the evidence I’m seeing at the moment, is being shouted at by people like me. What worries the bureaucrats is what the media think of them. What the bureaucrats worry about is whether they will lose their bonuses, and their comfortable jobs. What worries some of them, is being found out.
It worries me that this is the mentality I’m discovering in the middle levels of the NHS. God knows what the upper echelons are like. I am not talking for one moment about those who are on the front line services by the way. All my sympathies go to them. They are doing a hard job in trying circumstances, and much like us patients, they re being made the scapegoats of all this.
It worries me that for the management committees, and the groups and the bureaucrats it is all about what’s on the surface, not what’s underneath. It’s all about platitudes, and patronising phrases that ooze with false sympathy and mean nothing. It’s all management speak and obfuscation.
Is that what we want from health care?
Guess what? Birth is grisly, living is a messy business, and dying is fucking horrendous. Health care is at the gritty end of things. That’s its job. That’s what it does. We don’t expect it to look lovely. We don’t expect it to speak nicely, and wear expensive clothes. We expect it to work.
We expect it to get down into the guts of the matter and fix things. It needs to fix people. It needs to fix lives. It needs to help us give birth, it needs to ease living, and soothe the dying. It isn’t about forms and management committees and balance sheets, not where it really matters.
At the sharp end it is about making sure my baby is delivered healthy and well. It is about holding my hand while I’m dying and giving me the dignity I deserve because the life I have lived demands it. It is about making it all better. Even the terrible things can be handled so that they’re better. We all know that. It’s not magic. It’s just care, and patience and being allowed to help people.
What absolutely frustrates me is that what I’m seeing with the middle men is the language of helping and the actions that make that a lie, that are the opposite of that. What I am seeing is them helping themselves, while we go without.
When the bureaucrats start worrying about the right things, I’ll start believing the things they say. When the evidence matches the words, I’ll start listening. When what they do matches the promises they make, I’ll start backing off. Until then, I’m carrying on.
And I’m still worried.
I think I have every right to be.