Dr Neil Shastri-Hurst is a former British Army Officer, surgeon, barrister, and senior member of the Voluntary Conservative Party in the West Midlands.
There was a moral duty to return. Faced with the risk of the National Health Service being overwhelmed by Covid-19, I, like thousands of former clinicians, volunteered to head back to the coalface. There was never any doubt that we would return to help out, where we could, with this dreadful pandemic.
Those working on the Covid frontline are not heroes. There are no capes or special powers. It is something far more human. A group of dedicated and skilled individuals pulling together for the greater good. While the weekly round of applause is, of course, a deeply humbling and moving scene, I must admit that I have found it slightly embarrassing.
I suspect, among key workers, I am not unusual. It is not that I wish to appear churlish towards the public’s appreciation however, it is the concept of elevating us to the status of “heroes” that causes me awkwardness.
It is a term that gets bandied about very easily. Our skills and knowledge have not been bestowed upon us like some Marvel Comic character. Rather, they have been perfected through long hours of study and toil.
I returned to the NHS after almost two years. My surgical career had been somewhat derailed having been diagnosed with a peripheral neuropathy. It led to me changing tack and pursuing a career in medical law.
After such a period of time it was inevitable that things would have changed. With Covid-19, things had changed rather dramatically! Everyone was coming to terms with a new way of working; virtual clinics, the postponement of elective and non-urgent treatment, and a complete overhaul of rotas. Individuals were also being asked to operate outside their usual scope of practice.
However, despite all of these stressors and challenges one thing has shone through; the resilience and determination of all NHS staff to pull together as a team. It has been truly humbling to see everyone roll up their sleeves and muck in.
This is our “war”. As we move towards the next battle, my mind has turned to how we, as a society, have a more level-headed discussion about the future of the NHS.
“Don’t let the perfect be the enemy of the good”. This is a phrase often used in surgery. There is much truth to it. Tinkering around the edges in the hope of making that fracture reduction ever so slightly better can have the unintentional consequences of making it so much worse. The same can be said for healthcare reforms.
That said, while we quite rightly acknowledge and praise the endeavours of all our key workers, we must not put the NHS on such a pedestal that it becomes a sacred cow. There is a risk that there becomes – if it does not already exist – such a religious fervour around the institution of the NHS that its growth and development is stifled.
For many years, having a grown up conversation about the NHS has been nigh on impossible. Proposing reforms is met with accusations of privatisation through the back door. I fear that the additional adulation that has resulted from coronavirus will only further suffocate that debate.
“[T]he beating heart of this country” was how the Prime Minister described the NHS following his hospitalisation. The rhetoric was powerful. In this moment of crisis, the collective efforts of our NHS workers symbolise the beating heart of the nation. However, it would be unwise and a mistake to construe those same workers and the institution as one and the same.
In doing so, one cannot criticise any aspect of the latter without casting that same criticism on the former. It is perfectly logical to suggest that a system designed more than 70 years ago is no longer entirely fit for use today, while at the same time praising the sterling work of it employees.
I am, by no means, suggesting the NHS is unfit for purpose – the manner in which is has risen to Covid-19 has proven that not to be the case. But let us not kid ourselves; capacity and resources were created by pausing elective and semi-elective work.
As a result, waiting lists for cancer operations and treatments have regrettably been elongated, with the inevitable consequences in terms of prognosis. It is the workforce that has risen up to the challenge of the Coronavirus rather than the organisational structure itself.
Although in many areas NHS care is excellent, in others the same cannot be said to be true. In terms of breast, colon, and cervical cancer survivals rates the UK’s statistics fall behind those of healthcare systems in many other developed nations. We should be striving to achieve even better patient outcomes in these fields.
When debating the future of the NHS, the United States, a country without a universal healthcare programme, is often used as a comparator. In comparison to a combination of Medicare, Medicaid, and private health insurance, the NHS is infinitely better.
However, the US model is not the only model. We must not allow our view of healthcare workers to influence our ability to analyse failures in the organisation. We must be open to exploring what can be replicated from other healthcare systems that will lead to a more efficient and co-ordinated service. And, dare I say it; we must think how we fund health and social care in this country.
The principle that our health service should care for everyone regardless of their personal wealth is profoundly important. To undermine that would be to disrupt the foundations upon which it is built. However, we would be doing the NHS a disservice if we failed to have an honest debate on how we can improve it.
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