I tweeted yesterday something about the UK’s workforce problems facing health and social care.
There you go.
You could read this two-ways.
The first; the NHS isn’t working – look at Switzerland, Germany, France – if you want to see a doctor or nurse, you call a number and voila, if necessary, they will have a hospital bed ready and waiting.
No 111, call waiting, triage or online questionnaires for our European allies.
The corollary – let’s privatise the NHS, introduce health insurance, Americanise.
The second, there is money galore sloshing around all the wrong places. I haven’t heard much about the 1% recently – has anyone ready Danny Dorling’s book? (you can check him out online) – the reality that within our capitalist system most of the wealth is controlled by the top one percent of earners/rich cowboys.
The economic inequality in our society is stark and it is increasing at a faster rate than at any time.
The point of this deviation into Socialist ideology? Well, it is that neither the country nor the NHS are cash-strapped, at the point of collapse, it is just that for whatever reason – tradition, control, hierarchy, things keep going in one direction, and, the outcome – 70,000-odd nurse vacancies, the majority of which are filled by bank and agency nurses who are paid more than their peers; the same goes for doctors, whether you think junior, senior, trainee or consultant.
The mix is wrong. The folk at the top, jiggling the educational models have screwed-up; those of us at the other-end are trying to fix things, but it is not easy.
The bottom-line? There are adequate numbers of doctors, nurses, pharmacists and therapists in the UK, it is just that the system we are using is wrong.
Yes – it isn’t person-centred. The person is missing.
We need to flip the way recruitment is run/organised – certainly taking-out stupid IT failures, we need to turn the model upside down – you don’t arrive at an interview, you invite the prospective employers to sit down and you get to listen to what they have to say; the doctor – patient inversion that is taking hold in some parts of the kingdom of health.
We, the employer will do what we can to ensure that your work is meaningful, fun, sustainable and contributes to your health and wellbeing, for without this, what sort of care can you provide?
We want you to care, therefore, we will care.
And, if our care is not adequate, sure, you can leave, move-on to another job/place/country – you can also move us on, conduct inverse interviews to determine whether your boss is making the best decisions for you, your colleagues and patients, and, if not, off with them.
I remember discussing this a couple of years ago via my blog with a teacher friend – let the students decide who should teach what – gasp; this is an inversion of the model.
Who knows most about what interests, fascinates children? Teachers… Mmmm, equally, who knows most about the disease that is eating-away at your insides? The radiologist, psychologist, physician? Or you, facilitated in your treatment and recovery by someone who has particular technical or pedagogical skills?
Imagine the scene…
Tomorrow – I turn-up at work; the code to my office is changed, the doctor and nurses turn away, don’t acknowledge my existence and I am left floundering; I hope this will not happen – there is no way to predict; I don’t see this as how the situation will play-out.
Person-centredness works two ways. To me and to you, as the Chuckles would say.
The screw-up that has sent-out job offers to the ‘wrong people’ is wrong, it is appalling. I can imagine myself in that situation (or, at least last night amidst dreams of scarecrows and mosquitos, the anxiety of final exams and pre-interview assessment was bubbling-under the surface) – it was the system that created this wrong. The system needs to change, modify, welcome-in some critique and design by those people who understand what is happening.
Here is an idea… Instead of the award of professor* (aka he/she who knows most about the least) (often the people behind these screw-ups) being a title endowed for life by universities, how about we have the title awarded for the duration of your useful contribution to a scheme or system, with your position determined by those you serve?
Appreciate that might be tricky in certain disciplines, but within medicine, health and social care, is likely straightforward.
*Sorry any professors reading this, I don’t aim to upset/offend.