By Dr Veronika Wagner
This week the NHS is celebrating what it calls Values Week. Now, this may sound like the brainchild of a HR department who were on a staff awayday, but I believe it could be useful to see if the values that Values Week champions are really put into practice in reality.
According to the NHS Values Week is “designed to celebrate NHS values and encourage staff to talk about how they bring these to life on a daily basis”. The toolkit for Values Week tells us that, “the NHS belongs to the people and is founded on a common set of principles and values that bind together the communities and people it serves, and us who work for it. The values of the NHS are:
- Working together for patients
- Respect and dignity
- Improving lives
- Commitment to quality of care
- Everyone counts
- Patients, public and staff helped to develop this expression of values that inspire passion in the NHS and that should underpin everything we do.”
So, are these values really being put into practice in the present-day NHS? Well, let’s firstly take a look at the idea that the NHS “belongs to the people and is founded on a common set of principles and values that bind together the communities and people it serves, and us who work for it”.
Its hard to see how the NHS continues to belong to the people when not only are communities across England having their hospitals either downgraded or closed down, but also when the NHS has been carved up into 44 parcels by the imposition of Integrated Care Systems (ICS) which will give US health corporations such as Kaiser Permanente or United Health America a permanent foothold in the NHS. The rhetoric of community ownership may be nice, but it doesn’t match reality. The shareholders of these companies are not “the people”, but before long, it will be for these shareholders that vast swatches of services will be designed.
So, this then begs the question, is the NHS “working together for patients”? Undoubtedly hard-working NHS staff do their best. But, when we’re seeing a proliferation of “referral management centres” that are reported to be screening out referrals from GPs to hospital specialists - all in the name of “managing demand” as the government likes to call NHS cuts – it becomes hard to see how the best interests of the patient have remained front and centre of NHS practice. In fact, the continued presence of a group of private companies in the NHS who have a track record of having endangered patient safety by, for example, messing up the transport of patient files would appear to indicate that the financial interests of private companies are continuing to take precedence over the interests of the patient.
Next up on the list is “Compassion”. But can we honestly say with a straight face that a government which created a hostile environment in which vulnerable patients dared not access healthcare and where others started cancer treatment only to be told they couldn’t continue unless they paid up extortionate sums of money is guided by a compassion? I don’t think so. Not unless you’re sufficiently accomplished in some quite astonishing intellectual gymnastics.
By now, I’m sure that you’re starting to a pattern. One where the rhetoric and the reality don’t align, and really this begs the question: Do we really need a Values Week, complete with its own twitter hashtag #livingthevalues, in the first place? No, we don’t, and that is because we already have a perfectly good set of values for the NHS, and those are simply that the NHS should be a national public service, which is universal, comprehensive and free at the point of use, irrespective of one’s ability to pay. These were Aneurin Bevan’s founding principles for the NHS. In 1952, ‘In Place of Fear’ , he wrote the following:
“The collective principle asserts that the resources of medical skill and the apparatus of healing shall be placed at the disposal of the patient, without charge, when he or she needs them; that medical treatment and care should be a communal responsibility that they should be made available to rich and poor alike in accordance with medical need and by no other criteria. It claims that financial anxiety in time of sickness is a serious hindrance to recovery, apart from its unnecessary cruelty. It insists that no society can legitimately call itself civilized if a sick person is denied medical aid because of lack of means”.
We don’t need a Values Week. We just need to recover the ones that we’ve lost.