Preview A Guide to Medical Leadership & the NHS 2020-21 [PREVIEW] A Guide to Medical Leadership & the NHS | Page 8

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. This milestone was
marked with an outpouring of love, appreciation and concern in the same manner that we
would express our feelings for a grand elderly relative. There was also a government
announcement of some increased funding. At an age when most people would be
retired and enjoying life at a more relaxed pace, this grand old lady is having to work
harder and harder than ever before. More and more is expected from more and more
people but with restricted capacity and 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 a publicly funded National Health Service?
Many commentators openly speculate on this question. But 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
recognise 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 and
those winds seem more turbulent today than we have experienced before. How can any
single person ever expect to exert a worthwhile degree of influence, even if they wanted
to?
Ultimately, every healthcare professional wants to provide the highest quality of patient
care. We all want to practice to the very best of our 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 just a few.
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