So, Apparently, we don’t know what causes the high mortality in NHS hospitals! Why else would national mortality groups make three-day visits from 8 am to 11 pm to the top 14 offenders or bottom 14 good guys (depending on the way you look at your cup’s contents)? Many of us feel that we know the answers, but oh no, you don’t have any evidence do you? You just feel it in your gut, your heart and other body parts but that is merely your organs talking. We need proof. We need hard evidence. What do you mean? You think that merely saying that the lack of nurses, lack of doctors, the EWTD introduction while sending 10,000 doctors back to their foreign countries in a fell swoop in 2007, recruitment difficulties due to geographically stranded hospitals, lack of funding for speciality posts, poor quality doctors since dumbing down of the undergraduate curriculum are all to blame, would wash? Have you got any proof that this is the case anywhere in UK hospitals? For starters, the people who matter, (definitely not you), namely the department of health, the immigration office, the royal colleges, the GMC and the Deaneries, are unlikely to agree with your scurrilous accusations above. You, the clinicians and nurses in your hospitals, your trade union organisation the BMA or such are all trying to shirk responsibility for your hospital’s high mortality by blaming it on the system. I can feel a “Your country needs You”….to take the fall, coming on. It is more than Abe’s finger that is pointing at me I feel.
Those wiser amongst us (read “Managers” and “clinical managers”) know how to parry these kind of sweeping accusations of conspiracy and cock ups at the national level. They have been paid for this. They have been trained for this. They have been sent to courses for this, while you poor thing was bleating on the wards. They have seen the wider picture, but you? They have a more holistic approach to the problems, but you? You merely winch don’t you, that is all what you are good at. And you are fast becoming one of the best in that business. I can hear the parrying question delivered on a chilled plate; “OK, Heard all those problems you mention. Let us assume they are true in the fictitious world that you live in, What is the solution then?” Uh oh, Solutions. You are not good at it are you?. Neither are they, but they got the question in first. That means you have to answer it. Suddenly you have become the defendant. “But those are system problems. It is not within my gift to change any of those” you croak. Right answer to the wrong person. (Story of my life). You get stares from all around the table.( Yes, we are still on my story). “Can you identify any problems that YOU can solve?” Not a rasp, just a hiss from one of the “wiser than thou” across the table. You decide to rise to the challenge. Not your first mistake, but we won’t go there for now. “I think we should try to improve our recruitment chances in this region” you passionately whimper. “And how exactly do you suggest we do that?”. Uh Oh, still your problem, not theirs. “I think we should try to make it more attractive to the trainees. Subsidise accommodation, provide free Wifi, sky TV connections, non-smelly rooms, doctors mess with a swimming pool”. You meant pool table, but changed your mind at the last minute for good effect. Nobody is accusing you of paranoia, but this time the stares seem very real. You look behind to see if there is someone else who deserves this more. No, it is you alright. Maybe they are impressed? You wait with bated breath for the reaction. A sweet lady at the end of the table chirps, “very good suggestions, any other practical ones you have considered?”. You kick yourself for having thought of so many impractical ideas. No wonder you only made it till here. You make a mental note to forget Massachusetts. You rack your slushy brain. “We should consider separating the recruitment for the North and South. That way, you won’t have consultants going to interviews and recruiting trainees, every one of whom chooses to go south where the night life is.” You are suddenly not sure where stare ends and exophthalmos begins. This is grave. This is a room full of graves’ disease. You would rather be in your grave. “We will talk to the deanery about that, but you have still not told us how we can make our area more attractive to new doctors”. Your sins never end. You commit more. “maybe we should provide cabaret and night life here?” you think but you don’t talk aloud. If only you would do that more, you wouldn’t be here in the first place. Your long silence, fallen countenance, contagious depression and palpable suicidal ideation all evoke one response from the Manager in the biggest chair “Why don’t we all go ahead and think about this and meet up next month with an action plan?” you run out of the room in search of a barf bag and fail to reach in time. Welcome to my world.