Have we been saying "Thank you" when we really mean "Sorry"?

As the NHS turns 72 this month I think we need to talk about where it is heading, what our expectations are and how we will become increasingly disappointed as service users if we don’t wake up to painful home truths about the way we are cared.

What the Covid19 pandemic has shown us is how grateful we, the British public, are for ‘our NHS heroes’. We clapped for them every Thursday evening, we displayed thankful posters in our living room windows, and popstars promised free concerts for NHS staff when it was all over. As we unified in our support we donated over £92 million to NHS charities since the beginning of the Covid outbreak.

We clearly do value the NHS which is why it’s so puzzling that not even 4 months prior to the pandemic as a nation we choose the political party that since coming to power 10 years ago has been responsible for the under funding that has contributed to the chronic shortage of staff.

Are the British public saying ‘Thank You’ when they really mean ‘Sorry’?

The language the media has used in referring to HCP and NHS is prideful, courageous, brave and heroic. Our expectation of the NHS is that of a Hollywood action film character. In return for our gratitude we expect selfless heroism. It’s a big ask isn’t it?

The ‘hero’ narrative that we have assigned HCP is deeply problematic for a number of reasons and we all need to become more inclined to call it out as dangerous when we see in used in the media.

Why?

HCP aren’t heroes, they are humans. When we say they are heroes it implies an expectation of selflessness which is very unrealistic for HCPs working under, at best stressful conditions, at worst traumatic ones. We don’t expect heroes to make mistakes or errors in judgement and when they do we lack the empathy or understanding to learn from them because heroes don’t make mistakes.

We don’t expect heroes to develop PTSD, anxiety, depression or addictions in order to cope with the stressful working conditions that were challenging before Covid19 and became traumatic during the pandemic because of lack of PPE. It’s really hard to care for others when we are struggling with emotional health issues. From a service users perspective this can be disappointing. If we were expecting a hero and what we got was a faceless, burnt out shell unable to connect or care then it feels unsafe. The reality that the last 4 months has been incredibly traumatic for many HCP and for those using the service too.

The biggest issue with the ‘hero’ allegory is that we don’t have to pay heroes. We expect that they will just carry on through underfunding, understaffing, compassion fatigue, trauma and burnout. ‘Thank yous’ in this context are a sticking plaster over some very deep wounds that HCP were carrying before Covid and that will worsen if we don’t address the real problems.

The real problem is that we need to recognise that good quality care has a price tag.

If we want good care, then we need to pay for it. Either through higher taxation or better public spending, or privately outside of the NHS.

Surprisingly, given my left leaning tendencies, I actually don’t think a two tiered healthcare system is a bad thing. We have steadily been increasing our investment in private healthcare options for decades now partly to speed up access but partly to gain access to services that aren’t available on the NHS.

In the UK our spend on private healthcare doubled from £20.1 million in 2008 to £34.5 million in 2018.

It’s not only the Great British public that need to wake up to value of good care as a commodity but HCP providers do too. Their skills, services, experience and expertise all have tremendous value and deserved to be valued. Good quality care isn’t free it has value. Please midwives, doctors and nurses reject the ‘hero’ label. You are a human and a professional.

Please call out the ‘hero’ narrative when you hear it. It’s toxic for all of us. Join the quiet revolution in perinatal mental health. www.traumaticbirthrecovery.com