Abstract
What will a new government bring for health? The likely answer is more of the same. An underfunded service, whose culture of cuts was laid bare by the circumstances of last month’s ransomware cyber-strike, will continue to put pressure on clinicians and managers to deliver the best care in an environment of spiralling demand. The Health Foundation estimates that although demand is rising by 4%, NHS funding is rising by 1%. 1 When you add in the funding woes surrounding social care, things can only get worse. The long-term financial health and sustainability of the NHS is an urgent question that the new government must address.
With these chronic financial pressures, patient care will be hard to deliver satisfactorily. Indeed, Natasha Davendralingam and colleagues argue that we are in the grip of a crisis of caring. 2 They make the interesting observation that the notion of caring is beaten out of medical students by the time they qualify. Medical school applications and interviews were once filled with dedications to caring, and although the application process is now more earnest, it’s a fair supposition that kindness and concern for others remain frequent motivations for a career in medicine.
What is it then that dehumanises many young doctors? Does medical school create humanoids, robots with a human face, eager to systematise problems and crunch data? Taking a systematic approach to problems and using data are good habits. But in a caring profession, when the practice of that profession devalues human emotions and preferences, it is time to rethink how we select, train, and develop people working in that profession. Medicine is in such a predicament, and the stark funding challenges in the NHS only serve to magnify this crisis of caring.
Medical journals can feel dehumanised. Research lends itself to an emotionless reporting style, which in this case is a good thing. We don’t want emotion or feeling in research reports. We want cold, unemotional appraisals. We also want structure and a sense we, the readers, are being better informed. Brian Haynes, a leading thinker in evidence based healthcare, and in particular on deciding which evidence is meaningful for clinical practice, describes how research abstracts became more informative. 3 His journey is a very human one of progress in the face of opposition and obstacles. In our world, nothing comes easily to humans.