Collaboration for Academic Primary Care (APEx) Blog
Collaboration for Academic Primary Care (APEx) Blog
Posted by jchoules
3 July 2018My decision to aim for medicine
The NHS is undoubtedly a source of great pride in this country. The fact that anyone can book into any of the 7,000 GP practices (or 168 acute trusts) in this country and receive top quality care for free is surely one of our greatest achievements. There is a strong argument to spend more on the NHS, as the UK spend less as a proportion of GDP than comparable countries, but that we have been able to achieve this level of access is quite incredible.
That being said, we are a nation of complainers, and the NHS receives more than its fair share of groans, eye rolls, and tut-tut-tuts. I often find myself defending the NHS against these (often totally justified) complaints, because I feel like a real part of the system, and truly believe the NHS to be a national treasure. Perhaps this is part of what first attracted me to a career in medicine.
From my (admittedly limited) experience of working around doctors of all specialties and grades, it is evident that medicine is an arduous job, with long unsociable hours, high pressure, low levels of flexibility and literal life-and-death situations on an almost daily basis for some. This is something that everyone entering this noble career needs to understand; it isn’t all running around with defibrillator paddles shouting “Clear!” and shocking people back to life. It isn’t all chest compressions, medical mysteries, and slow-motion moments either. Medicine is a stressful, difficult, and often frustrating career, and it certainly isn’t for everyone.
For me, this was always vastly overshadowed by the positives of this career. I felt that working with people in what can be the most difficult time of their lives, opportunities for leadership, the requirement for lifelong learning, and the clear career progression (not forgetting the more-than-comfortable salary of course) were all strong enough reasons to look past the angry drunks in A&E, the nights on Geriatrics, and the screaming in Paediatrics. Thankfully I am still of this opinion now and, if anything, am even more confident that I made the right choice when I embarked on this professional journey.
What does the NHS mean to me?
The NHS is much more to me than a network of trusts, deaneries, CCGs and administration teams. It is more than an interconnected web of doctors, nurses, porters, cleaners, ODPs, HCAs, and secretaries, too. It is a symbol of a national ideal that I feel is often lost in the name of ‘strengthening the economy’, ‘encouraging competition’, and ‘streamlining services’: the notion that everyone, no matter their background or income, is entitled to care for their entire life without having to worry about finding the money to pay for it. This basic right, so often taken for granted in the UK, is absolutely fundamental as we strive for equality and justice in this country. The success of the NHS flies in the face of the laissez-faire attitudes of some people in this country, and shows that what we can achieve together is vastly greater than what we can achieve on our own. The progression towards a fair society begins, I believe, with seeing just how powerful a force the united peoples of this country can be. Establishing the premise that everyone deserves to be treated fairly, regardless of their income or background is the first step in achieving true equality, and it is this idea that, for me, the NHS embodies perfectly.
My hopes for a career in the NHS
Like many people in my cohort, I can see my career in the NHS taking a tortuous route. I currently feel that some part of acute medicine is where I want to be – be that A&E, MAU, ICU, anaesthetics etc, but I am certain that I won’t be going straight through a training pathway into a consultancy post as people often felt they had to before. I have always had an interest in medical education, which has only been reinforced by the Masters in Clinical Education I have undertaken this year, and definitely feel this will form a part of my career. I also hope to conduct research alongside my clinical work, and aim to complete a PGCert in Clinical Trials alongside my fifth-year study to further this aim. I am also currently in the latter stages of an application to become a Magistrate, and feel that volunteering and working outside the NHS is important for maintaining morale and avoiding burnout. Finally, I see no reason why I shouldn’t change careers as I progress through life. While the fast pace and more antisocial hours of acute medicine appeal to me now, I have enjoyed my time in primary care so far and would like to consider this as an option as my career and life progress.. I essentially want to have my fingers in as many pies as possible. After all, variety is the spice of life!
My concerns about working in the NHS
My main concern about entering a career in the NHS is that it may not exist by the time I retire. Even within the few years during which I have been conscious of these things, I have seen a gradual effacement of the NHS at the hands of various government and private companies. This of course did not start recently, and goes back in my opinion to the hallowed Blair years of extremely high spending but also privatisations and PFIs. Today, despite the recent announcement of a £20bn funding boost, the NHS remains chronically deplete of money. My worry is that this is part of a concerted effort to devalue and destabilise the NHS so it can be increasingly moved into the private sector – being as it is totally antithetical to the belief that the state should hold as small a role in the lives of working people. Perhaps this is why I argue so vehemently against those who moan about the NHS, as every disillusioned voter is another step towards the end of the NHS.
The NHS I would like to be looking back on
I hope that, at the end of my career, I can look back on an NHS that has not only continued to lead the world in terms of efficiency but has improved outcomes to a world leading level and that has also grown to absorb more aspects of healthcare. Why do we complain about 2 month waits for non-emergency surgery, yet tolerate 2 year waits for dentist lists? Why do we accept a £15 charge to visit an optician, while begrudgingly paying an £8 prescription charge for drugs that would otherwise cost £30?
I believe the NHS will once again be an organisation that can claim to truly support people from cradle to grave, but first we have to ensure that we see its true value, not only as a collection of buildings and workers, but as a bastion of unity, togetherness, and equality unparalleled anywhere in the world.