Where the service gone in Health and Care?

Over many years of working within Local Authorities, some of the departments I worked for have always had the word ‘service’ attached to its name. Since leaving the local government and now living with disabilities and health conditions, I often use my experience and knowledge to assist in training and recruiting new university students into these areas of employment. 

At every meeting, open day or interview, when the applicant is asked why they have chosen such a career path - the answer is often quite predictable. It is always along the lines of wanting to help someone and make a difference. When I have delved further into why this is the case, the response is often that they have faced a difficult time in their lives and such occupational personnel have made a huge impact and assisted them through some challenging periods. 

I have been lucky to subsequently meet some of these people later in their carers and I am often saddened to see and hear that they have lost there soul to the organisations. The initial motivation of starting in this career path has been lost. The main reasoning behind doing the worthwhile jobs has all but disappeared. People say that they want to make a difference and not just push paper or be so tied up in policy and procedures from management but it is evidently easy to slip into. 

From an outside perspective and being a user of the National Health Service and Social Services , this becomes very evident to me. There are too many good people being over managed to meet some new management philosophy or procedure. 

In the political and financial landscape we face, managers are more and more focused on process than people. Prioritising costs over doing what is right for people. The staff and patients being left to the mercy of bean counting. Even when you do have some great ideas these often get lost in paperwork rather than being put in place.

From my experience, most of it is not needed. In the giving of opportunities for local decisions each CCG, trust or social care service is developing and producing reams of policies. Most of these actually relate to stopping front end staff from using a straight forward customer service approach. But instead they are tying staff down to fill out forms and to justify pennies they have spent. This process is timely and costly. 

In doing this, perhaps due to being afraid of the litigation there is a fever that runs across the pond. We must remember that not everything is better across the water. We as a country have always been about the service to crown, country and each other. At one time it was a real honour to be a nurse or social worker. You did not need clapping, the respect you got was real. 

Here is a story that a friend once told me who was a trainee nurse in the mid 80’s: ‘I was in a road near the London Hospital in Whitechapel not in the Brick Lane area. Way back then any female wearing a navy gabardine coat and brown lace up shoes were easily recognised as a “London Hospital” nurse. Most people we passed would give us a nod or a good morning/evening. One late night, I was returning to my car, which I had parked up on the streets near the hospital. On turning a corner I noticed ahead of me a gang of men with machetes in the road and pavements all fighting and shouting. When I approached they all stopped, parted and said Miss. They let me through before starting again on each other.’

Why is it that we have lost that level of respect? However, that respect was not just one way it was returned with a lot of Health and Care staff feeling it was a real duty to serve the community and do the job they were paid to do. As opposed to pampering the needs of Councillors, Board Members and MPs with political agendas.

There was a time when the people of this country would not stand for this type of behaviour from the people in charge. The people made it what it was, not the politicians or money makers. I do not know why we have seemed to lost this. Is it perhaps in the search for personal growth and wealth that we have forgotten what is best for the community and the country?