Low morale among doctors not addressed by politicians

May 1 2005

The improvement of public health services in the UK is hampered by one single, but probably the most important factor, the collapse in morale among doctors, and none of the UK’s main political parties have attempted to address the issue in their election campaigns.

An editorial in the current edition of The Lancet says politicians have put the patient before everything else in the quest to achieve effective health care and this is a strategic mistake. Debates about the NHS have been based on a set of entirely false notions about what matters to patients while doctors have been left demoralised by targets that compromise patient care, shift work that compromises professionalism, and a massively over-managed health service.

Health Secretary John Reids vision of a “personalised health service”, where the patient takes control of decisions about the prescription of medicines and the selection of surgical procedures, is an attitude which is ' manifest nonsense '. If doctors have any role at all, seemingly unlikely in Dr Reid’s world view, it is to establish a partnership with the patient based on mutual respect. Respect by the doctor for a patient’s anxiety and care preferences,and respect by the patient for a doctor’s skill and professional expertise.

Medicine in the UK needs a new and stronger political voice that is more concerned with augmenting professional standards than with protecting professional status. Doctors want to strengthen their professional morale because they know that a more robust and motivated profession will mean better outcomes for patients.No politician currently recognises this and the election on May 5 will not be about democracy at all. The public will be voting in a vacuum of fact and health services will suffer the consequences.