There has been loads of talk about the junior doctors contract here in the UK. I’ve been posting my support on Facebook and signing various petitions to make sure my friends who are doctors know they are supported, but I feel like I need take a bit of time to talk about the NHS. About why it’s important, why we need the NHS, and why we need our junior doctors to stay with us.
Why do I need the NHS?
Because the NHS has saved my life. Because the NHS is saving the lives of people I love.
For some, in big ways. Like my partner who needs regular surgery to correct an unusual defect in his body. If the NHS wasn’t there and like our American friends we needed to pay for these operations ourselves, we would send ourselves into a spiral of intense debt and his condition would be a ticking time bomb. The unique substance that needs to be pumped into his veins in order to correct the problem is worth hundreds of pounds. We joke that his leg is worth a fortune. But it is. And without the NHS and without a fortune, we might run into serious problems.
I think of the times we have waited in hospital; me tired and achy, he drugged up to the eyeballs, and remember that often the reason we have waited to be seen or discharged is because somewhere a junior doctor has been trying to get to us. Pushing against their enormous workload as if dragging a stone around behind them they have battled on, and en route to talking us through the post-op recovery they have been catching people’s lives in their hands. We have seen with our own eyes their harried faces as they sweep the curtains around a person’s bed – another individual on the cardiovascular ward fighting for their life. We have heard their calming, friendly voices flowing from behind these curtains as they do what they can, reassure the individual, and push on to the next. We’ve watched them read charts, take blood pressure, and gently check in with us before they leave for the evening, even if their shift is over. I think of those times and I worry for these junior doctors; that these extra hours proposed by the government will be the stone that finally breaks their back.
That slowly this nation is moving towards a private healthcare that many of us won’t be able to afford. That the journey to get us there will be overflowing with harassed doctors who can’t manage effective care in these working conditions.
And then I worry for my partner who still needs several operations on the NHS. Expensive, complicated operations for a condition that makes the radiologist sit up and take notice. I worry that a doctor might be get too tired one night from endless shifts to notice a spike in his blood pressure.
I worry for my grandmother who receives all her medication free from the NHS and who is afraid to turn on the heating in case she over-spends. I worry that no one will be there if she falls.
I worry for my parents as they struggle with their own medical problems whilst trying to hold together my 97 year old grandfather with Alzheimers.He now needs expensive secure housing in order to be cared for effectively and has received emergency care twice in the last two years. I worry that since he is elderly and not in his right mind, he will become a patient that is easy to overlook in a bloated, under-staffed system.
I worry that the NHS won’t be around to save all of these lives again, in the way that they have been doing. I worry that the doctors won’t be fit enough to keep working effectively, in the way they continue to do so wonderfully at the moment.
And for others the NHS saved their life in little ways. Like me.
I didn’t come into A&E struggling to breathe, I didn’t need a life-changing operation to survive. What I needed was someone to help me keep going.
I walked into a doctors office when I was 21 years old knowing I needed something to help with the crushing depression that was permeating every area of my life. I was on break from university staying with my parents and overwhelmed with the knowledge that I couldn’t, wouldn’t be able to go back to Scotland, I surrendered to my fears and went to the doctors. I broke down on a nice lady doctor who gave me some tissues, and suggested it might be time to try anti-depressants.
The NHS provided me with medication and an excellent doctor to walk through it with me. Since I was in Scotland and a student, the NHS paid for my medication at a time when I would not have been able to regularly afford it. The NHS provided me with a psychiatrist to work through some of my issues. My doctor was a GP trainee, also known as a Junior doctor. She listened to me, she arranged to see me regularly, she worked out my medication delicately and sensitively, and she engaged with my mental health progress in a way that suggested to me that she really cared. At the time when I was most likely to fall off the map of the universe, the NHS was there to save my life a little bit. Other people were doing it too – my therapist, my parents, my boyfriend, the friend who met me after every counselling session I had for a cup of coffee – but so was she, the junior doctor I saw at the local community hospital once a month. She was saving my life in small ways.
But this is often the story for people who are struggling with mental health. They don’t need to be brought back to life with the shock-pads like you see in movies, they don’t need to be resuscitated or given a heart transplant. What they need is an accurate diagnosis and medication they can afford. They need a doctor who listens to them and has the time to care for them. They need support groups and programs that have the funding to invest in being there for their long-term development.
These are exactly the things we could be losing in this gradual disintegration of the NHS.
Junior doctors are fighting for an NHS where patient care is the first priority, and if the cuts to mental health services have taught us anything in the last couple of years it’s that patient care has become less of a priority. Statistics already show that mental health services have overwhelmingly suffered from budget cuts, with the amount of referrals for mental health issues rising but the amount of services dwindling. 80 million pounds has been cut from the mental health budget for children and adolescents in the past four years. And 55% of young people aged 12-25 years old are not receiving the mental health services they need.
It’s fine though, because it’s not like that time of life is particularly vulnerable or mentally strenuous. (!)
Apart from the statistical evidence that says half of all mental health problems have been established by the age of 14 and rising to 75% by the age of 24 , anecdotally I can tell you that almost every person I know who also struggles with mental health issues has struggled since childhood or adolescence.
I have friends who went through several counselling services in their teenage years. Friends who have been admitted to hospital due to brutal eating disorders in their late teenage years. Friends who have tried to take their own lives at university, and received the necessary medical attention. And from my own story, my struggle with eating began aged 10 and my battle with depression was established by the time I was 13 years old.
Even though I know from my friends with these stories, that we have all benefited to some extent from some mental health services (whether through medication, hospitalisation, or a well-timed ambulance) I know I speak for them when I say that more services are needed, not less. So often we slipped through the cracks; connections between mental health programmes and public schools often failing to catch those of us who needed to be caught. Over-stretched emergency services struggled to connect us to the right after-care after mental health incidents.
The NHS saved some of our lives in little ways, some in big ways. But for some of us, especially in our teenage years, it didn’t do enough.
Then why would you still support it? You might ask.
Why would you not agree that budgets should be cut and changes should be made?
Because the “changes” I see coming to us are not changes that improve things. So far, cutting the NHS has only added to the problems. When the mental health services are being asked to do more with less, when their qualified practitioners and doctors are leaving the NHS for jobs overseas, public access to mental health becomes brutally untenable for those who are most at risk.
It’s not just a case of making sure a Junior doctor gets paid right. It’s not even about individuals having enough personal wealth to afford an operation or services.
It’s about the local anxiety support group on a Friday morning that suddenly disappears.
Why? No funding.
It’s the person who ends up in A&E in the middle of the night after an unsuccessful overdose, but there is no 24-7 liaison for mental health in their hospital.
Why? It got cut.
It’s the current 32 week wait for psychological therapy that will only get longer.
Why? Too many patients and not enough doctors.
It’s the rising suicide rate, after years and years of it falling.
It’s the Junior doctor, over-worked and desperate for sleep, who cannot, absolutely cannot do this any more. It’s their mental health patient, who desperately needs them to be able to.
This has been a long post, but I have good reason this week. I’m supporting the Junior doctors because they, and others like them, have saved me and those I love regardless of our financial or social status multiple times. They have done it over-worked and under-paid as it is, they have done it exhausted, but they have still done it.
It is not too much for them to ask me to help them save their NHS.
Sources and important websites for more information:
Young minds – for information about changes recommended to current CAMHS (Child and Adolescent Mental Health Services)
‘Mental health services cut by 8%’ Michael Buchanan, BBC article about cuts to mental health services
‘Cuts to UK mental health are destroying young lives and families’ Mark Austin, The Guardian
‘Juniors Doctor’s row: the dispute explained’ BBC article explaining some of the details, Nick Triggle.
‘Improved mental health care “Needed” for 70,000 children and young people.’ Laura Silver, Buzzfeed.