John Launer: When good things happen in bad times

I’ve had a very inspiring week. Firstly, I taught a group of second year medical students who are doing a special study module on the future of general practice. Many of them already intend to become GPs and are excited by what specialist generalism can offer.

The following day I took part in an away day for 50 young people on a GP training scheme in another part of London. I spoke to them about narratives in primary care, how being a GP is often more like being an anthropologist or an investigative journalist than a technician or functionary.

I’ve also carried out two appraisals of younger GP colleagues. By coincidence, both of them spontaneously said, “I still love my job.” The only blip of the week was a minor medical scare that meant I had to pay a visit to our local emergency department. Despite the dilapidated premises, a waiting room that could barely accommodate the 50 patients there, and a failed heating system, the staff treated me and everyone else with kindness and courtesy. I wrote to them to say thank you and entered a positive review on the Care Opinion website.[1]

Such experiences happen all the time, and they create a sense of cognitive dissonance in me. My perception of the wider political scene is that the NHS is being intentionally undermined and run down. As well as writing about this I also spend some of my private time having gloomy thoughts about the fragmented, understaffed, under-resourced, inequitable, and profit seeking service my students may one day work in and my children will be obliged to use.

It isn’t easy to make sense of the mismatch between the enthusiasm and commitment I’ve witnessed this week and the dismal realities reflected in reports of medical and nursing vacancies, eye watering waiting times and waiting lists, and worsening health statistics. I guess it’s possible that all the good things I see and hear disprove the awful news I read in the medical press and on social media. Alternatively, I might conclude that the people I come across just happen to be working on rare islands of care where it’s still possible to hold onto hope—and that they’re doing so in a state of self-deception while the tide of catastrophe rises at their feet.

But I take another view. Altruism and dedication are pretty indestructible, especially in young people, and are probably present to an exceptional degree in those who decide to work in caring professions. These qualities still fortify individuals and teams right across the NHS, even when under dire threat.

We need to make sure that we’re not so disheartened by the bigger picture that we fail to see how many of our colleagues are determined to thrive as much as they can against all odds. They deserve to see better times, when their values are recognised once again as the foundations of a civilised society.