Don’t aim to work in the NHS

A little while back, Lisa and I were out for dinner at a friend’s house. The mother, ’M’ was a doctor and the husband, ‘H’, worked in finance. M ticked all the boxes for what you might wish for if you were a patient: technically competent, deeply caring, and worked way beyond her contractual hours. Nor did she park her patients in some tidy box somewhere: her job was part of who she was.

M and H had a few children under 11. As often happens, while watching the children play and interact, the question was asked what they might end up doing as a career. H spoke immediately and with conviction: ‘I just hope neither of them ever works for the NHS.’ Note, not I hope they do not become doctors, but rather I don’t want them ever working in the NHS.

I find it hard to imagine this same conversation a quarter-century ago. Things have changed.

Training is in tatters as doctors prioritise urgent care and discharges | The BMJ

“During my last job on an acute medical unit, one of the FY1s would sit in a box room separate from the doctor’s office for three days a week and write up to 15 discharge letters a day. It’s farcical to suggest that’s rounded training.”

…

“Prioritising training for juniors isn’t just about having competent and confident doctors in the NHS but actually having them at all. It’s hard to feel compelled to pursue a career in the NHS after a week in which your sole learning point was how to make the ward photocopier work,” she said.

A dog at the master’s gate predicts the ruin of the state. (William Blake)