Monday, 31 March 2014

Open letter to Health Secretary

Not quite 4 score and 7 years ago but I came to this country in 2001. As a Doctor trained in India I was neither an asylum seeker nor an economic migrant. In fact I was working in the Middle East before coming to the UK.

I was and am an intellectual migrant. People use and abuse the term racism and perhaps sections of society are racist here. 

But in India, we practice all the isms that you can think of - racism, sexism, ageism, nepotism we have down to a fine art. Add casteism and sectarianism and you have a system where talent and hard work counts for nothing. This is what I was fleeing.

The NHS was a breath of fresh air. My first job interview consisted of a panel of Drs comprising an Irish consultant, and Egyptian and a Brit with an British Asian medical staffing representative. Amongst several candidates including home grown ones I was selected. During the 6 month post I was not only encouraged to develop myself further but given leave and paid to go on courses which I could only dream of affording/attending in India or the Middle East. 

This nurturing of talent and knowledge continued and within 3 years of coming here, I was Associate Tutor of the Royal College of Physicians whilst doing a medical rotation and today I am a GP appraiser and a GP principal. When CCGs came into existence I was elected onto the board and again my training needs were met and encouraged. 

I spoke of being an intellectual migrant. The idea I was attracted to is simple enough in concept but hard to achieve in practice. It is simply this- everyone should have access to health care that is free at point of care and more over is the same high standard for everyone regardless of their paying capacity. 

The NHS does this better than anyone else in the world I feel. Any fee based system whether paid for by patient or insurance cannot match it. Here, in the UK I have been able to practice medicine that is 'evidence based' or 'best practice' and never had to think about the paying capacity of the individual I was treating. 

And over the last 13 years I've bought and sold several cars, houses and staycationed all over the UK and have visited most places from John O' Groats to Land's End. I have used no public funds and have broken no laws apart from a couple of traffic offences. Under the new scheme I would retire at 67. In the next 25 years I calculate I would contribute at least a million pounds to the exchequer.

And yet...
Having reached the pinnacle of my profession- a principal GP, working for the CCG and as an Appraiser one would have thought I would now be settling down and enjoying my success.

But, I'm now in the process of emigrating to Australia.

Why? If I were a hot shot Banker or a young Turk working in the city that had failed to hold me back the reasons behind my decision would be debated on TV, perhaps even in parliament. 

Is it the lack of another runway at Heathrow, our corporate tax laws, banking bonuses, house prices etc etc. But it's an NHS employee leaving and nobody bats an eyelid. The NHS has over a million employees and counts amongst it members some of the most highly regarded professionals ranging from paramedics to nurses to GPs. These professionals routinely trounce MPs, Councillors and other professionals in the public eye for trust.

Yet, not a single day goes by when the NHS is not denigrated by the press in an attack which often seems to be orchestrated by your office. Staff morale is at an all time low. There is a looming workforce crisis in District Nursing, A&E Drs, social workers, GPs etc.  these issues are routinely glossed over and anybody fighting for better working conditions is painted as a money grabbing no gooder. 

Mr Minister let me tell you something- the NHS, like our armed forces is staffed by people you could never pay enough. People working 12-14 hrs a day in highly stressful situations like A&E; often without adequate breaks or support and to the detriment of their own health is not an exception but the norm across the NHS. These people don't want more money; they demand some respect. They want to work in an environment that's supportive and appreciative. They want an end to the constant top down restructuring and endless clinically irrelevant targets. They don't want to go to work everyday feeling like they are getting ready to do battle and they want you to tell the public the truth. You promise the population a world class health service yet you steadily cut services and front line staff face the criticism.

There is an old saying- do a job you love and you never have to work a day for the rest of your life. The people I alluded to earlier do this job because they love it. The changes ushered by your department since the White Paper are making more and more NHS staff less and less in love with their jobs. People like me who seemingly have it all. There are 5 GPs, all fairly young leaving for Australia from my town. On Facebook there is a group made specially of UK GPs in Australia and it has more than 200 members. The GP in Birmingham who did the medical for my visa is retiring from the NHS aged 49. He is going into private practice. This is a terrible brain drain and the loss of talent is stupendous and unprecedented. Almost all of the psychiatry consultants have emigrated to Canada from the local Trust and many GPs are on the verge of retiring. 

In the end, I'd like you to ask yourself one question. It is this- why are you letting a million pound asset like me leave? Do you have what it takes to do a bit of soul searching required to answer that question?

And I'd like to end by asking you one question. Can you reassure the end users of the NHS which is pretty much everyone in the country that the NHS is in a fit state to tackle the looming problems that a Country with an ageing population needs and that despite all the cutbacks the needs of the populace are safeguarded?

I may not be around to see how or indeed if you respond. But, I'm an ardent admirer and supporter of the NHS and for the sake of the millions of people who work in it and just about everyone else who relies on it I sincerely hope you do.

Dr Gaurav Tewary
GP


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