Dear Professor Baker,
It seems like only yesterday that another Professor – Stephen Hawking – felt compelled to raise concerns in the press about the current state of the NHS. If you recall, Hawking’s critique of Jeremy Hunt’s predilection for statistical cherry-picking prompted an extraordinary barrage of tweets from the Health Secretary, admonishing one of the world’s greatest scientists for his cluelessness on the matter of, well, scientific methodology.
Professor Baker, your interestingly-timed intervention today has prompted quite the barrage of headlines itself, hasn’t it? An NHS ‘unfit for the 21st century’, indeed? And that picture you paint of A&E departments’ disgraceful ‘unsafe practices’ – our ‘wholly unsatisfactory’ arrangements that ‘endanger patients, as well as denying them basic privacy and dignity’. It’s almost as if you think we’re somehow choosing to ‘keep piling patients into corridors where staff cannot even see them’ or to force patients to queue, hour upon hour, in ambulances outside log-jammed hospitals. Actually, you go further, don’t you? You directly blame us for the hellish conditions that patients and staff alike endured last winter, condemning our culture of ‘learned helplessness’ that leaves our patients abandoned, unmonitored, without even essentials like oxygen.
There’s just so much blame in your interview, isn’t there? Previous NHS staff, current NHS staff, ‘archaic’ NHS systems, bad managers, bad previous governments. Blimey. No-one, it seems, is immune from your blame. Except, that is, the one glaring exception. The one cherry you chose not to pick, so to speak.
Nowhere in your remarkable blame riff is there any mention of the funding climate in which frontline staff and managers alike are struggling – fighting tooth and nail, frankly – to keep on delivering a halfway decent standard of care for our patients. We are trying so unbelievably hard, Professor Baker. But we already have one of the lowest numbers of beds per capita of any country in Europe, as well as being one of the most under-doctored. And, of course, we have a government, currently, who has chosen to subject the NHS to the most draconian and sustained funding squeeze in NHS history. Right now, the NHS in my region is having to cut even more beds, hundreds of them. It simply cannot afford to do otherwise – like every acute Trust in the country. That’s not really going to help the patients stranded, bedless, in corridors about which you care so deeply, is it?
Of course NHS reform is needed. Of course we need greater community capacity and better integration between hospitals and primary care. But in omitting to mention the political context to your argument – the political choice to provide the NHS with inadequate resources safely to manage not only winter, but all-year-round rising demand – you come across, I’m afraid, as an oddly partisan chief inspector of hospitals. Why the omission, Professor Baker? Why blame the NHS and its dog, yet fall so shy and silent when it comes to acknowledging the political choices to underfund and understaff the NHS into a skeleton service in place of excellence?
Do you really think your admonishing letter to Trust CEOs, telling them to jolly well stop leaving patients in corridors, is going to do anything other than incense us all? Where else would you suggest we put them? Toilets? Broom cupboards? I believe Jeremy Hunt’s new toilet is rather lavish – perhaps we could squeeze one or two in there?
Anyone would think you were giving the Department of Health comms team a helping hand in the pre-emptive deflection of blame for the looming winter crisis away from the government and onto anyone else but Theresa and Jeremy. I thought nothing could surpass for sheer stupidity last week’s news that NHS staff were forced by NHS bosses to chant “we can do it” as an approach to managing ED winter pressures. But you, Professor Baker, have managed to out-Brent even that David Brent of a spectacle: instead of empty exhortation, you have apparently plumped for his more bullying style of management, through the medium of tetchy, head-masterly letters saying ‘you can and will pull your socks up – or else’. In all those years you’ve worked in the NHS since 1972, have you never noticed that nothing good ever comes from a caning?
Let me remind you what blame culture achieves, Professor Baker. First, it demoralises and undermines frontline staff. Then, it makes us feel hopeless and impotent. We stop trying to speak out, we become cowed and silent. And now, all that bullying and blame has managed to make the NHS less safe, not more, by allowing a culture to flourish in which no-one feels they can change anything, let alone risk speaking out for the sake of our patients.
In your interview, you’ve just achieved all of the above. I’m a hard-working NHS hospital doctor, and you’ve made me feel angry, demoralised, hopeless and incredulous – all in the same moment. That is not leadership, Professor Baker, and it is certainly not conducive to high standards of patient care. It serves only to present you to the public and NHS staff alike as a hospital chief inspector who seems to care more about playing a political game than the vital matter of patient safety.
How incredibly, bitterly disappointing.
Incidentally, please consider this letter my raising of safety concerns on behalf of NHS patients nationwide, as my duty of candour demands me to do.
Dr Rachel Clarke