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| Countess of Chester Hospital at the heart of the latest NHS scandal (Image: Deeside.com) |
As a collective, the UK has an unhealthy obsession towards its National Health Service. Whether campaigners feel it should be protected it with all one's might by giving it unlimited resources to cover every gap, or critics strongly suggest the private sector should take over because the NHS in its current form is damaged beyond repair, our views are wide ranging. And as everyone in Britain can use the health service at the point of delivery, there is a sense of entitlement, in that we need to loudly express our appreciation and disdain over our treatment or the treatment of loved ones. The noise, however, no matter how positive or negative, combined with the government's erratic approach to the NHS, is bringing a proud sector to its knees.
How the NHS is run and its future is under scrutiny practically every second of the day, regardless of which UK nation you live in (for those who don't know, the public health sector is a devolved matter so the NHS in England runs differently to Wales, Scotland and Northern Ireland). The volume of this turns up various notches depending on the big story at the time. This summer alone we've seen separate strike actions by junior doctors and consultants which have created intense debates. But their angst over pay and work conditions have taken a backseat in recent weeks due to the scandal brought on by a neonatal unit at the Countess of Chester Hospital where at least seven babies died under the care of one nurse, Lucy Letby. The malpractice, reportedly ignored by hospital bosses, tore the lives of these families. The disgraced nurse, now spending the rest of her life behind bars, is being called the 'most prolific baby killer in modern British history'.
I don't want to delve too much into the case itself because it's been analysed enough. I personally can't get my head around how someone who supposedly wanted to get into nursing to look after children can get into nursing and do completely the opposite. The level of deceit is beyond comprehension. Where I want to explore further is the repercussions for the NHS. For some, it's the final straw - the NHS is rotten to the core and is beyond help. Others argue that cases like this are exactly a result of what happens when the health service is overstretched and underfunded. Having been an NHS patient all my life and also having worked for an NHS Trust for more than two-and-a-half years, I feel influential commentators and on-air 'experts' are completely missing the point and their views are building a narrative which is needlessly damaging the health service's image.
Let's start with the core problem with the NHS - it tries to be everything to everyone. It wants to treat every person in hospitals, homes or virtually, while also train thousands of nurses, take part in countless researches and lead charges against global pandemics and epidemics. You also get the impression that it therefore needs to set a benchmark in recruitment, culture and performance for other sectors and organisations to follow. And NHS Trusts do all this as populations continue to rise, move and get older, and health conditions become more complex (which nurses at all levels need to be on top of while working 12+ hour shifts). It's an expectation that's driving healthcare professionals to the edge. And because of that, the demand for treatment has become a postcode lottery, depending on the time of day. I know people who needed urgent treatment and waited 36 hours to be seen to, while the same department being able to treat another with a similar condition the following day in next to no time.
The other problem is people's lack of understanding of the NHS structures. We often see it as a collective and generalise it, "Oh the NHS is great," for example, or "The NHS is awful". We allow ourselves to think that because Letby was responsible for the death of at least seven babies, all NHS managers are incapable of spotting incompetent members of staff in fear of being seen as having a failed team. But, honestly, there are vital processes in place where accountability is at its heart. For every unlikely death or incident, it gets looked into in great depth and responsible members of staff get a talking to, and firing someone is a solution. Some NHS Trusts will be better at this than others, and it's shown by looking at individual Care Quality Commission (CQC) reports (if in England), or by the Healthcare Inspectorate in Wales, Healthcare Improvement in Scotland, and Regulation and Quality Improvement Authority in Northern Ireland. Those organisations who don't perform well on this are under strict instruction to seek ways in improving these processes. From experience, NHS England - who provide leadership above these Trusts - does a decent job of promoting examples of good practice, and it'll be up to those Trusts to act accordingly and appropriately.
In the case of Lucy Letby, it was clear the Countess of Chester NHS Foundation Trust had historic processes issues, with the CQC in September 2022 rating Inadequate for its maternity service and overall leadership. These decisions aren't made lightly, and even when in 2021, patients had significant confidence and trust in the hospital's nurses, in line with similar Trusts, it's only a tiny consolation to what had been happening there over a number of years. That Trust will feel aggrieved and horrified by what has happened, and when commentators are sceptical when it says 'lessons will be learnt', trust me, lessons will within that Trust. The same applies to Shrewsbury and Telford after its baby scandal, and Norfolk and Suffolk when more than 8,000 people 'unexpectedly' died over a three-year period after receiving mental health treatment at that Trust. New and current staff in these areas will be constantly reminded of how damaging these dark periods were and that history must never repeat itself. The CQC and NHS England will be breathing down their necks for years to come, and no doubt will want to do more to ensure that other Trusts don't fall towards similar traps.
The other issue is political. The number of Health Secretary changes the NHS in England has had to endure is a sincere concern - six in almost as many years; big personalities with bold statements, offering a fresh pitch saying it'll reform a health service that's overstretched and in need of help. By the time they start thinking about putting words to action, a scandal (either of their own doing or Downing Street's) forces personnel change and a new set of visions. A stable Department of Health and Social Care can lead to a calmer and better-run NHS, and that can in turn lead to improvements in Wales, Scotland and Northern Ireland. At the moment, we're not seeing that. Instead, Steve Barclay (current Health Secretary) is spending his days being hostile towards striking nurses and showing lack of willingness to advocate two-way communications between his Health department and NHS Trusts. Like its damaging approach to the BBC and relationship with the European Union - which I've written about on here enough times - the UK government know how to turn voters against institutions are responsible for positively and constructively serving communities.
The only 'reform' that Barclay has offered is to form a 'plan' to train more nurses and doctors in England, as if NHS Trusts up-and-down the country never thought of that. It is true to say that at present, the number of new recruits won't cover the increase in demand for treatment for years to come. But simply upping staff numbers alone will not solve the healthcare crisis without an explicit regional focus. What is the staff shortfall of each department by Trust, and do these departments have the budget to balance the workforce increase and bring in new equipment so the NHS is fit for the 2020s and beyond?
A big block to tackling these issues is that we seem to have forgotten why the NHS was formed in the first place - to deliver free healthcare for patients at the point of delivery. While the UK in 1948 is much different to the UK in 2023, the basic and guiding principles must stay the same. At the moment, it is being treated like a multinational business rather than being allowed to focus on serving communities. If the UK government sufficiently allows and invests in charities to develop ground-breaking health research, and schools and universities to lead the training and development of nurses, it'd allow the NHS to do what it's best at doing. Sure, Trusts can help charities and education institutions, but not by distracting themselves from the NHS's basic principles.
The British public can also play a big part in the NHS reform, by relying on it less. We can't think about calling the GP for every cold, or hounding a doctor for not taking action on a referral after five minutes. We need to learn to be more self-sufficient and not blame the health service by default. You may not believe it, but healthcare staff are human beings, and like everyone else, will make mistakes. They won't be at their A-game at every second of every shift (are any of us ever?) and they aren't Gods to be our saviours for our every health need. But they will do their job well, we can be assured of that.
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