Preview A Guide to Medical Leadership & the NHS 2018-19 [PREVIEW] A Guide to Medical Leadership & the NHS_ | Page 5

Chapter 1: Introduction
1.01 ‘A moral and professional responsibility’
On the 5 th July 2018 we celebrated the 70 th birthday of the NHS. The milestone was
marked with an outpouring of love, appreciation and concern in the same manner that we
would for a grand elderly relative - a government announcement of some increased
funding. At an age when most people would be retired and enjoying life at a relaxed
pace she is having to work harder and harder than ever before. More and more is
expected from more and more people with restricted resources. Without a doubt, she is
experiencing some health problems of her very own. It all makes you wonder: What is
the life expectancy of an NHS?
Though many commentators openly speculate, the simple answer is that we don’t know.
No-one has ever had a patient like this and certainly not one with these symptoms – or
have they? We will consider that when we explore the history and how we have ended
up where we are in Chapter 4.
The NHS is huge and complex. The numerous organisations which form its constituent
parts continually evolve, divide, grow and merge. Its functions are tangled with politics,
legislation and the various regulators who govern healthcare in the UK. Processes,
authority and responsibilities forever shift with each change of the political winds. How
can any single person ever expect to exert a worthwhile degree of influence, even if they
wanted to?
Ultimately, every clinician wants to provide the highest quality of patient care and
practice to the very best of their abilities. Patient care, however, never happens in
isolation. Each moment that a doctor is engaged with their patient is enabled – or in
some cases hindered – by numerous systems: regulation, financing, resourcing and
quality control to name but a few.
In the foreword of NHS England’s 2014 booklet ‘Understanding the New NHS’, Professor
Sir Bruce Keogh, then National Medical Director, eloquently communicated both the
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