In the BBC’s TV serialisation of Adam Kay's book, This Is Going To Hurt, we see the NHS for what it truly is: an underfunded, understaffed healthcare system held together by skeleton crews of exhausted workers.
The series starts with junior doctor Adam waking up in his car, having fallen asleep after a long shift. In reality, long hours, short breaks, and heavy workloads all contribute to the exhaustion reported by junior doctors. So much so that a quarter of doctors have reported that tiredness impairs their ability to work safely.
Sadly, however, it falls short of pointing the finger at the real culprit for these ills: Tory austerity and privatisation.
While Adam works long hours and wrestles with graphic flashbacks, his consultant Mr Lockhart drives an expensive car and rarely visits the ward. Similarly, my trust’s CEO sits on a six-figure salary, while emailing generic reminders every week to staff to work harder for our patients.
In an episode highlighting the two-tier healthcare system, Adam takes a shift in a private hospital. His workload consists of a single pregnant patient, and he is given his own deluxe suite and three-course-meal.
Yet when the patient becomes too unwell, she is rushed to the local NHS hospital. As a senior NHS midwife forlornly mutters: “It’s a shame we don’t see any of the cash those poor patients spend.”
This is true. While our healthcare system slowly collapses, parasitic private sector bosses line their pockets with our money. The safety and lives of workers and patients are sacrificed at the altar of profit.
Epidemic of racism
The show also touches on the racism and abuse experienced by NHS staff.
Last month, a survey by the British Medical Association revealed that 76% of doctors from black and ethnic minority backgrounds have experienced racism in the last year. 71% of these doctors did not report the incidents for fear of being labelled a ‘trouble-maker’, or because they have no faith in the reporting system.
While the series sadly did not touch on the racial inequalities amongst pregnant patients, we know that racism affects all, staff and patients alike. For example, maternal mortality for black patients is four times higher than for white patients in the UK.
The NHS may claim a ‘zero tolerance’ approach to racism. But the indifferent bureaucratic hierarchy does little in reality to protect workers and patients.
Mental health crisis
High workloads, racism, misogyny, bullying, and underfunding all add to the mental health crisis amongst staff. This is demonstrated in the series by the tragic story of junior doctor Shruti.
In a recent study by the University of Birmingham, 70% of junior doctor respondents reported severe anxiety and depression. Half of these stated they had even contemplated suicide.
In the series, bossy consultant Miss Houghton has no sympathy for Shruti’s mental health. “Well, it’s a difficult job. What do you want me to say?”, the callous manager bluntly states.
But the myth of resilience and a stiff upper lip crumble under the debilitating work conditions health workers face.
The solutions offered by the NHS bureaucracy include ‘finding time for self-care’ – this at a time when one-in-three junior doctors don’t have time for a lunch break!
When one of my colleagues suggested that a solution was “recruiting more doctors”, she was met with a patronising smile and evasive platitudes by our Medical Director.
We must never forget the equally appalling work conditions of nurses, midwives, healthcare assistants, and other vital staff. In one survey, 80% of midwives did not believe that their NHS Trust had enough staff to operate safely.
Meanwhile, over half of nurses are considering or actively planning to leave their job. The government's recent pathetic offer of a 1% pay rise – a massive real wage cut, given soaring inflation – will continue to drive staff out of the NHS.
The same hospital management who heap pressure on clinical staff often abandon outsourced workers to exploitation by companies like Serco. The forces that strip the wards of staff and resources, in other words, also underpay and bully our porters, cleaners, and estates crew.
Faced with the misery of work in the NHS, Adam looks into alternative careers. The cynical Miss Houghton delivers the demoralising climax of the show: “This hospital’s got about three doctors and a budget of £12.50…there is bollocks-all any of us here can do.”
But this is not true. Already, the unions are moving into action and preparing for the industrial struggle. Workers are resisting attacks on their conditions, winning major victories, and showing that there is much we can do – if we’re organised.
The capitalist decimation of the NHS must be stopped in its tracks.
We must fight for a health and social care sector run democratically by workers. The private sector, including hospitals and the pharmaceutical industry, must be nationalised without compensation. Led by the trade unions, we need a massive recruitment drive of doctors, nurses and all healthcare professionals on a fair wage.
Only through militant socialist action can we end the greed of the capitalist class and the bloated NHS bureaucracy, and save our NHS.