• Dr Hugh Willbourn

CC1 When you've finished clapping ...

Updated: May 14

If the Commissioner of the Metropolitan Police Service were to announce that the Service had run out of cars, or uniforms, or handcuffs, it would be reasonable to infer that the procurement arm of the Service was at fault. If the NHS doesn’t have the Personal Protective Equipment (PPE) to do its job properly then the procurement department of the NHS, or Public Health England, or some other part of the bureaucracy of healthcare in the UK, did not do its job properly. We should not be clapping those people.

There are two parts to the NHS. The NHS has hundreds of thousands of wonderful and inspiring front line staff. It also has hundreds of thousands of overpaid and burdensome administrators. Many of those administrators used to be wonderful and inspiring front line staff, but, tired of being exploited, bullied and underpaid by overpaid and burdensome administrators, they decided “if you can’t beat ‘em, join ‘em” and swopped sides to become overpaid and burdensome administrators.

Let us be fair. It is a rational choice. If you have a mortgage to pay and children to raise, at some point, after years of battling to come to terms with endless reorganisations and pointless paperwork, it makes sense to get paid more money for less stressful work and regular hours. Here the blame really does lie with the politicians who have spend decades interfering with the NHS and with each reorganisation adding yet more bureaucrats to adminster and measure and admonish the clinical staff.

About 12 years ago, I was pitching for a qualitative research project at the Dept of Health. Our presentation started like this:

Slide 1 From the introduction to the brief by the Health Minister: “This is a once in a decade chance to reform nursing and midwifery”

Slide 2 From a practising Nurse Specialist:

“I’ve been a nurse for 27 years. I’ve been reorganised 32 times”

Slide 3 What are we going to do this time that is different?

The board commissioning the research consisted of ten senior health service officials with most of the alphabet after their names. These were the people who had co-created the mess they were claiming they would “reform.” Of course we didn’t get the job.

Perhaps this is too cynical. Let us take another perspective. Let us consider the argument that the nub of the problem is not procurement or bureaucracy but cash. Perhaps the NHS simply could not afford to stockpile PPE. What can we, the population, do to help? Clapping boosts morale but it doesn’t raise cash.

One-third of the entire budget of the NHS in England and Wales is spent on the sequelae of obesity. If you really want to help the NHS, when you have finished clapping check your BMI and maybe go for a run. If you need to lose weight, you will also be helping yourself because obesity is, unsurprisingly, a factor which increases the risk of dying from Covid-19.

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