Although blossom season isn’t as big an event in the UK as it is in East Asia, it is still enjoyed by many around the country. This bank holiday (the archaic British term for public holiday which originates from when the Bank of England closed) has been the warmest recorded which means that many families have been enjoying the blossoms and the many other delights of Spring. I don’t think I’ve ever seen so many families, young and old people, dogs enjoying early May as much as over the last few days.
British blossoms are delightful, though they do not have the symbolic meaning that they have elsewhere. In Japanese culture, cherry blossoms (Sakura) are a symbol of the transient nature of life, and are a cultural feature in art, literature and film. The way they bloom en masse, like clouds, conjures classic iconic images of Japan. There is even a hierarchy for work trips to hanami (“looking at flowers”) picnics. Its definitely on my wish list to travel to Japan for cherry blossom season, but for now I have to make do with the UK’s version, which isn’t shoddy at all (I hope you agree):
Lots of shades of colour on this street’s blossoming trees.
I like the juxtaposition of the pink blossom and the blue sky (which can be a rarity for this time of the year in the UK)
Here I am under a particularly blooming tree, taken with an old iphone camera.
£3,300,000,000 = The amount we got last year for arms exports to Saudi Arabia.
Wikileaks: Saudi Arabia’s rulers threatened to make it easier for terrorists to attack London unless corruption investigations into their arms deals were halted… told they faced “another 7/7” and the loss of “British lives on British Streets” if they pressed on with their enquiries.
Wahhabism (as part of the Salafi movement) = The ideological concept of destruction and terrorism (suicide bombings, indiscriminate attacks) which is the root of current home-grown terrorism. From Saudi Arabia. We have now sponsored it for years and years to come.
46,700 = Total number of police cut by Theresa May since she became home secretary
£3,300,000,000 = The amount we got last year for arms exports to Saudi Arabia
Saudi Arabia 2016 (Wikileaks) Saudi Arabia’s rulers threatened to make it easier for terrorists to attack London unless corruption investigations into their arms deals were halted… told they faced “another 7/7” and the loss of “British lives on British Streets” if they pressed on with their enquiries
Wahhabism (as part of the Salafi movement) = The ideological concept of destruction and terrorism (suicide bombings, indiscriminate attacks) which is the root of current home-grown terrorism. From Saudi Arabia. We have now sponsored it for another decade.
The Destruction of the NHS: A Dialogue at Breaking Point
by Nima Ghadiri
Is the NHS at breaking point?
Yes, it really is. As things stand, it will not exist in five to ten years time, and different elements of our Health Service will be apportioned as Dialysis-Plus East Coast, CrossCancer, Virgin Maternity, or whatever other word-pasticcio the “brand positioner” regorges.
With consecutive governments in seemingly total denial about the state of the NHS, the phrase “crisis point” is an understatement. We need to do something now, every month which passes brings the death sentence closer.
Ok, just…. just chill out there for a second. Are things really THAT BAD?
Chucking about numbers is often a precursor to a well-known Disraeli quote, paraphrased by Mark Twain. Nevertheless, sometimes they are needed so people can grasp what is happening.
Since 2011, there has been a 504% increase in the number of patients waiting over four hours in A&E Departments across the country, forcing Secretary of State for Health Jeremy Hunt to ditch the target. 23 hospitals were simultaneously on black alert earlier this year, which means that they “are unable to guarantee life-saving emergency care”. This included Jeremy Hunt’s own local hospital The Royal Surrey, which had 27 patients urgently needing a bed but no space.
Waiting times for surgery have been getting much longer, and 4093 urgent operations were cancelled in 2016, an increase of 27% in just two years. Knee and hip operations are now being rationed only for those who aren’t able to sleep because of agony, using bogus “pain tests” as a differentiator.
Cancer treatment targets have been missed for four consecutive years, and services are now failing. Mental health services are being rationed, so people who suffer are dying in their homes, unable to care for themselves.
These are frightening figures, it’s no wonder the Red Cross (who stepped in early in the year to help with a shortage of ambulances) has declared the NHS a humanitarian crisis, as people are dying needlessly in the world’s fifth-richest country…
Stop, I get the idea, things are looking gloomy all round. Surely, we have the MONEY to stop this?
Astonishingly, as demand has risen hugely, funding has been cut. Our spending on the NHS as a percentage of our GDP has plummeted below 10%. This is a lot less than France and Germany, and amongst the lowest in the developed world.
If our national health funding matched the average amount that Europe’s 10 leading economies spend on their healthcare, perhaps we could lose this uncoveted accolade:
Yes, we need more NURSES and DOCTORS!
And we are getting far less. Medical school applications have plummeted, the proportion of med school graduates who become first year doctors has gone down from 70% to 50%, with phrases such as “in droves” and “en masse” describing the number of junior doctors leaving the United Kingdom. Enormous rota gaps are now ubiquitous, GP vacancies have skyrocketed from 2% in 2011 to 12.2% now, and 84% of general practitioners now say that their workload is affecting patient care.
Nursing applications have fallen by 23% over the last year, and the removal of bursary funding for student nurses and midwives has sent one clear message “We don’t value you”, underlined by years of below-inflation 0% and 1% pay rises. By 2019, NHS workers will have seen their pay capped for nine consecutive years, and nurses will have seen their pay reduced by 12%.
To add salt into these raw and gaping wounds, the Secretary of State for Health massively over-estimated nurses’ average pay this month when he was asked why so many nurses are having to use food banks.
Source: British Medical Journal
So they want things to fail, is this all about PRIVATISATION?
We don’t need to speculate about this, it’s all there in numbers, contracts, even a book with Jeremy Hunt’s name on it, calling for the de-nationalisation of the NHS. There has been an increase in spending on “independent sector providers” of a third between 2014 and 2016, and an estimated 500% more contracts have gone private since 2012.
The plan for privatising the National Health Service isn’t exclusive to one party. The groundwork was done by the previous government, with poorly conceived “public service reforms” leading to unfettered introduction of private corporations into commissioning. It has accelerated over recent years, however.
So what are the POLITICIANS saying?
Absolutely the wrong things. For a National Health Service which is quite visibly starving, Jeremy Hunt said: “The NHS needs to go on a 10-year diet”.
Theresa May also didn’t like the Red Cross assessment of the NHS, calling them “irresponsible” and “overblown”.
The BMA has identified five key issues for the future of the NHS, and it would indeed be “irresponsible” if politicians did not address these:
Are you subtly telling me which way to VOTE?
No, it’s not for me to instruct you, and people don’t like being told what to do. Nevertheless, it’s currently very easy for the mainstream media and tabloid press to distract the general population and report on fake scandals rather than one which is very real, and affects all of us.
As long as you are aware of what is happening and can make up your own mind, then that’s already very important. If you can spread the word to others, even better. Over the next few months we will see an increase in grass-roots movements in social media and the streets, in support of the National Health Service. There will be a nurses’ summer of protest activity, a show of anger against pay-rise caps and maltreatment which has left 40,000 posts unfilled.
Battling a Murdoch and Dacre Press which has vested interests against the NHS will be challenging, and no doubt lies will be spun which confuse and subvert. Tabloid journalism had a pivotal role in the Junior Doctor contracts dispute, and may do so against the nurses too. It is crucial to appreciate that supporting our nurses means supporting our National Health Service.
Earlier this year, former prime minister David Cameron pledged a mental health revolution of almost a billion pounds. Whilst this proposed outlay is welcome, it must be matched by a proactive change to the stigma attached to mental health in media, the workplace, and at home.
Mental health and doctors
Professor Debbie Cohen of Cardiff surveyed almost 2000 doctors this year and found that 60% had experienced mental illness in the UK (82% in England alone). In the general population, the rate is 28%. Doctors experience the same range of problems as everyone else, but the cocktail of work, exams, academia, family and relationships lowers the threshold for illness. Many have perfectionist traits which lead to doubt and self-criticism when things go wrong, leading to a self-perpetuating cycle.
Worryingly, more young doctors are being diagnosed with mental health problems. There may not be a pre-existing illness: After 25-year old junior doctor Rose Polge tragically committed suicide in February 2016, her family described a young lady with an infectious enthusiasm for life and no previous mental health problems, but long hours and work-related anxiety contributed to her decision to end her life.
Extreme stress early on
Doctors are as susceptible to mental problems as the general population. However, particularly early on in their careers, they face a unique combination of challenges. These include the need to develop countless skills within a short period (for which university education can never fully prepare) and service burdens in a chronically under-resourced environment, only more challenging for those with family or caring roles. Early junior doctors shifts are usually incompatible with outside interests, and losing day-to-day balance can unearth mental health struggles.
Doctors face a societal and professional weight compelling them to ignore difficulties. A cultural idiosyncracy of willing martyrdom exists, in which doctors feel it their role to attend work regardless of fitness. This is less prevalent in other countries, for example Australia and New Zealand, where attitudes towards sickness are more rational.
Fewer professions stigmatise mental health disorders more prominently than medicine. In the Cardiff study, 41% of doctors with mental illness said that they would not disclose it. Doctors are not supposed to get ill, and seeking help is weakness which imperils trust in the practitioner’s ability to do his/her job. This featured in the heartbreaking suicide of GP Wendy Potts in November 2015 after a patient read her blog on living with Bipolar Disorder and complained to the surgery.
Some doctors find changing roles from helper to patient unnatural, others find treatment from a colleague embarrassing. Often the prevailing fear is of a career-threatening “black mark” on a permanent record: Doctors must labour through appraisals and assessments, and competition for jobs and training posts can be ferocious.
A culture of fear
A 2008 Department of Health report said:
“Doctors may fear that acknowledging the need for help will damage their career prospects or lead to scrutiny of their fitness to practise”
This happened in the case of Dr Dakhsha Emson, who killed herself and her baby during a relapse of bipolar disorder in 2000. A stirring tribute from her husband reflected a talented doctor and a successful medical career. However, worry of colleagues and patients finding out when she was applying for consultant posts led to a lack of treatment. The report highlighted a:
“Widespread stigma against mental illness in the NHS”
This stigma can arise as early as medical school, fostered by a triad of competitiveness, fear and uncertainty. Students sometimes receive conflicting information about mental health, and may fear disclosing illness. Pastoral care can be arbitrary, often with little demarcation between disciplinary roles and support roles. Some universities have introduced “fitness to practice” hearings to monitor student behaviour, fostering a culture of castigation.
For some doctors, this culture is epitomised by the General Medical Council (GMC), whose role is to protect the health and safety of the public. All doctors with mental health issues are required to notify regarding their problems, which are investigated under the same procedures as misconduct and poor performance. Subsequent fitness to practise processes are required to be declared on application forms for jobs. These can sometimes be beneficial, for example recommending support. However, often they are described as harrowing experiences, and the duress of investigation affects doctors personally and professionally.
The toll can sometimes be too much, between 2005 and 2013 there were 28 reported cases of suicides following investigation. One of those was GP Belinda Brewe, describing the process:
“threatening and isolating”, eroding “self-confidence and self-belief”.
The NHS needs continued active campaigns to encourage openness, tackle stigma and promote healthy working practice.
Medical schools should be proactive in support and awareness: counselling services, pastoral care positions and peer support.
The insight that doctors with mental health problems have when treating their patients should be valued.
A doctor who has a mental health disorder might put his patient at risk, but a doctor hiding or in denial because of a culture of fear will put his patient at risk.