A Cause For Celebration.

I observed the celebrations marking the 75th anniverary of the NHS, as I took a bit of a break from writing yesterday. Its been 75 years since Britain established a free, unversal public health care system, one I worked in 20 years ago, and one I usually observe from Australia from social media feeds. Thsi week Iam in ireland, before heading over to the UK to attend a conference, joining many doctors that work in the British NHS system.

The news feeds were full of celebration, little British flags, big Royals and celebrities enjoying the moment like it was a personal milestone. The whole affair was an example of the splitting off of the ideal, the inability to tolerate any negativity or honesty about the plight for patients and more importantly to me, the doctors struggling to work in the system. Just pure celebration that the NHS still existed.

At the same time, social media feeds are awash with hashtags and accounts of NHS staff unable to comprehend what people are actually celebrating. The system, which is no longer built for purpose is still managing to operate. It’s hard to see why that should be celebrated. It’s merely a sign that it’s much easier to hold on to something and control the spin that take a good look around and work out what to do.

Over 20 years ago, I fared very well as an Aussie doctor working in lots of different mental health posts across the UK. They were called psychiatry posts back then; somethings are capable of changing. I was a psychiatry SHO and a staff grade doctor with little supervision and a lot of responsibility. I was one of many borrowed from other countries to prop up an ailing worforce. I am a doctor who has worked in the NHS.

Nowadays, for many legitimate and tangible reasons the workforce is more decimated than ever. The systematic running down of the NHS, a ideaology that many consider a right not a privilege, and the onslaught of a pandemic with more than one wave has left very few doctors standing in its wake. Doctors that have no voice or buying power when it comes to advocating for real wage rises. Doctors that are ignored even when they decide to strike en masse. Doctors that have direct workplace injuries like never before, injuries to their physical and mental health, that they have spoken about incessantly until they have given up and just left. Doctors that governments think can be replaced by people with half the formal education that they have.

I am a doctor that has chosen to walk away from the mental health system in Australia. It’s nowhere near perfect either, and I left because I decided that my physical and mental health were way too important to keep surrendering to a system that could not care less about me. On my second last day I was physically assaulted by a very unwell patient who had not been managed before I arrived into a locum role. On my last day I turned up after no sleep and did the necessry papaerwork to leave my post. It was the first time in my life that I walked out of a role. Not one person stopped me or asked after my well being. I don’t blame anybody for that, I simply recognise there was no empathy left in a ward that was staffed by clinicians more burnt out than me.

The one things that we do have as doctors is opportunity. We have decades of training and plenty of experience, so with a bit of distance and some time, we can reconfigure our careers and remember what it is like to feel valued. I’m not underestimating the effort or work that it took me to do this, exactly one year on from the assault, with the patient charged and convicted, and my conviction that I would never set foot on a psychiatric ward again. I don’t need to, I have been resourceful enough to establish myself as a medicolegal expert and now I provide assessments for those with psychological injuries from all different reasons. I recognise that we are all fallible and vulnerable, what we choose to do next is what matters.

I have also increased my work coaching and training psychiatry registrars for their exams, recognising that something I can do is help them get through to be the consultants of the future.

I’m comong to the end of a week in Dublin, a week that I organised to experience what it was like to write in one of the most inspirational cities in the world. I feel really sad that’s its over but I’m reassured that I will continue to write more as I leave here and venture on. I have the beginnings of a fiction piece that uses a lot of my understanding of people and their vulnerabilities, weaving the experience into the characters and their journeys. Up until now I haven’t had the space to let the writing happen. At that, indeed, is a cause for celebration.