Gold anonymous senior sources in the NHS. You can always trust them to tell you the truth, the whole truth and nothing but the truth, right? In their latest act of radical candor on behalf of patients and frontline staff, these secretive freelancers informed the BBC about their growing discomfort over Wes Streeting’s claim that the NHS is broken.
Speaking to the company ahead of the Health Secretary’s speech at the Labour party conference, sources worried that Streeting’s unvarnished descriptions of the NHS’s current failings could “scare patients” and “make it very difficult to boost staff morale”. One brave but unnamed hospital leader muttered darkly: “If the government is not careful, it will cause lasting damage.”
Now, I’m no apologist for Streeting, but honestly? This is exactly the kind of superficial doublespeak that is rotting the NHS from within. There are two ways of facing a bleak reality. One – and we’ve had 14 years of this approach – is to pretend it doesn’t exist. At best, this is a form of benign paternalism, like when patrician doctors used to choose to hide the C-word from their patients in case being honest about a cancer diagnosis would do more harm than good. At worst, it’s nothing more than political snake oil.
Even as waiting lists ballooned to almost 8 million cases – with one in seven people in England now waiting for NHS treatment – successive Conservative spokespeople continued to fob off journalists with inane quotes about how the NHS was thriving. For every member of the public who suffered pain and humiliation, for every staff member forced to treat dying patients on stretchers in corridors, these glib denials were soul-destroying. For how can you ever hope to fix something you refuse to even name? How can staff or patients be optimistic when voices infinitely louder than theirs are trying to erase what they are actually experiencing?
Streeting has a different approach – and he is not holding back in the slightest. The fundamental promise of the NHS, he told the conference today – that it will be there for us when we need it – has been well and truly broken. He cited the 100,000 toddlers and babies left waiting spent six hours in the emergency room last year and the fact that cancer is a more serious death rate in the UK than in other comparable countries.
This last sentence drew the ire of anonymous sources, with one objecting that it strikes “all the wrong tone”—as if tone is the only thing that matters in cancer. Maybe it’s just me, but when I, as a palliative care physician in a hospital, meet a young, previously flourishing patient for the first time and have to tell him that his new, and delayed, cancer diagnosis is also terminal, these facts seem to matter more than tone. They matter even more when it’s the third time I’ve had that conversation that week.
The truth – and we all know it – is that the NHS is failure. This is not the fault of the staff, who inhabit a service that has been deliberately destroyed by 14 years of neglect and underinvestment. In that time, staff morale has plummeted. Burnout and early retirement are rife. I have lost count of the number of gimmicks that NHS apparatchiks have deployed to tackle this. Free Zumba classes that you never have time for, a pandemic-era George Cross handed out to 1.3 million people and once – in a truly revealing moment – gifting it to staff at a trust owned by a single NHS brand tea bag.
Meanwhile, the sincerity of NHS England’s commitment to staff morale was revealed earlier this year when it broke the news late on a Friday afternoon that it was cutting funding to the NHS Practitioner Health Service. This little-known but valuable resource supports doctors with mental health problems. More than 17,000 NHS staff signed a public letter expressing their disgust at the cost-cutting measure. Formerly suicidal doctors shared heartbreaking details on social media about how the service had saved their lives. Eventually, when the public outcry became too loud, NHS England made a hasty U-turn.
The fact is that the NHS has a long and shameful record of prioritising reputation management over protecting patients and (genuinely) supporting staff wellbeing. The culture of secrecy and cover-ups is endemic. We have seen it with the Mid Staffs scandal, the contaminated blood scandal and the many recent pregnancy scandals that Streeting has rightly called a “national disgrace”. But it is never acceptable to hide the truth from the public, whether you are a health secretary, a senior NHS manager or an ordinary nurse or doctor.
I felt nothing but relief when Streeting decided to explain – in all its ugly detail – the crisis conditions in the NHS. There was a real flicker of hope. What was missing from his speech, of course, was any mention of how, without a huge injection of new resources, he might possibly move the NHS from “the worst crisis in its history to an NHS fit for the future”. Staff have long been bored by health ministers who dabble in magical realism. This has to be the real thing – or the NHS could die on Labour’s watch.