Owen Yang
It is already surprising when I speak to the ‘member of the public’ about my ridiculous working condition in the hospital. I could not believe it when I learnt the consultants are suffering, too.
Doctors on the hospital wards do not really have enough computers to work on and constantly have to queue to find a working computer to view patient lab results and previous clinical records. In many departments there is no dedicated desk for doctors to complete the huge amount of paper work.
But hey, a lot of time I feel better when there is not enough computer, because this probably means there are enough doctors and nurses. When it is so under-staffed and there is only one doctor and one nurse, you can obviously use the two computers as you wish. You wish.
There is no appropriate space to rest and to eat, and to leave our belongings. There is no place to change clothes (apart from toilets). There are signs everywhere to warn junior doctors not to use this space to do what, and to clean the space after using it, or there will be consequences. This sounds ‘reasonable’ out of context, but it will very difficult when 10 or 20 doctors or nurses share a small space. I mean, the only way to ‘keep clean’ is to drink a cup of tea in one go and clean the cup and then put it back into your bag immediately.
There are a lot of time I feel it is just my hospital that treats doctors (and other staff) in this way, but after sharing experiences with others it appears to be a common condition (although not universal). So perhaps we should not complain about this, perhaps either take it or leave it.
In the hospital I worked in, at least consultants had their own desk. Consultants have incredible amount of paper work, and it would be really unthinkable if they have to hot-desk. I only learnt recently that in many hospitals and in some departments in my previous hospital, consultants have to hot-desk, too. I do not know how they survive this.
How it has happened: the cliche
The macroscopic issue is there is lack of resource or lack of funding. As far as I feel, when there is a little bit funding to spend, the government may not be genuinely trying to use the money to improve NHS, but trying to use the money in the NHS to boost economy, hoping improving NHS can come out as a by-product. It makes some sense to booster the private sector because the multiplicative effect on the economy is better (or is it? I know it from macroeconomics courses 20 years ago), and in this narrow economic sense it is always better to utilise private sectors as much as possible. It can be the actual clinical work that can be privatised. It can also be the managerial work. I do not know whether this is a right thing to do, but I feel the money is not genuinely spent on the NHS. Am I wrong?
If we look at it microscopically within the organisational dynamic in a hospital, my feeling is that because junior doctors are constantly rotating, no one is able to speak for doctors when a space is being re-designed. Over a period of time, therefore, there may still be some space for nurses and administrative staff preserved (still very limited, I know), but the space for doctors is gradually eroded.
The good old time and indicator inflation
When I worked in Taiwan as a doctor, every ward or every other ward has a place with beds where doctors can rest. Although the doctors should behave and keep clean, it was not the doctors job to clean. There was also at least one doctor’s office on every ward. It was 20+ years ago and I am not updated with the condition yet. It will be in my to-do list.
However, this is really not a direct comparison. The paper work required for a doctor in the UK is phenomenal. In my diagnosis, this is a result of career managers trying to create something to prove their worth. Someone creates an indicator which seems to improve something, and then another one creates something. They all seem to improve something in isolation, but in the end there become 10,000 indicators to use, 10,000 paper work, ending up requiring to hire more managers to manage these indicators. Then someone now things we should use AI to manage these 10,000 indicators. The fundamental issue is that most of these indicators were not assessed comprehensively to include the cost needed to address these indicators. But this is probably another topic to discuss.
Compared to other things such as under-staffing, pay erosion, and generally lack of respect, space is really not at the top of the list. It is just a reflection of the current NHS condition.
