This week, Matt Hancock, the Secretary of State for Health and Social Care, called for radical change in the NHS workforce in order to support doctors and nurses who experience trauma in their daily work. Indeed Mr Hancock went so far as to say that the lack of support given to NHS staff was “astonishing” and that this issue would be a priority for him as Secretary of State. He was also ‘astonished’ that significant improvements in how we treat mental health have not yet been applied to professionals themselves.
My first, admittedly uncharitable, response to this article was that it was not unlike the astonishment that we may expect to hear from a fox when considering how hens are being treated so unfairly by being locked up in pesky meshing. But, putting aside cynical animal metaphors for a second, it was not the astonishment itself that struck me as unusual, but the level of astonishment that he reported. The reason that I say this is due to the sheer extent of the shock and astonishment his predecessor had also experienced when he was in post.
Jeremy Hunt routinely found himself shocked and astonished at a lot of things during his tenure as Health Secretary. For instance, in 2015 he found the NHS failure to probe deaths ‘shocking’. In this instance, he was “profoundly shocked” by a report which found the NHS failed to investigate the unexpected deaths of more than 1,000 people.
In 2018 he also revealed his shock at statistics on NHS mistakes, including medication errors and hospital infections. He commissioned an investigation into the scale and impact of medication errors in the NHS and noted that, ‘frankly, the results came as a shock’ – and showed the issue is more widespread and deep-seated than any of us realised. So much shock did the previous Health Secretary encounter that he came to be described as ‘the great shock absorber’. Shock upon shock upon shock.
Even six years into the role he was being shocked and astonished by some aspect of poor practice in the NHS. So, one would imagine that when Mr Hunt met with Mr Hancock in the handover of his role he would have counselled his colleague on just how shocking the role of Health Secretary can be. But alas this appears not to have been the case, as was revealed when Mr Hancock has described his astonishment at how little support staff have.
Now a cynical observer might suggest that Mr Hancock, in his concern for this latest failure of the NHS, might be beginning to perpetuate the recent tradition of political and media imaginaries of the NHS that have worked to destabilise it’s symbolic authority in the public consciousness, to the extent that any radical changes proposed are received with fatalistic compliance. Some would argue that his predecessor tapped into, and mendaciously appropriated, the natural inclinations of the British Press to peddle a typically conservative and largely hostile stance to the welfare state and public services.
In such accounts, the tone, focus, intensity and regularity of media framings of the NHS have coalesced around representations of doctors as overpaid, underworked and in grave need of being brought to account in order to protect deceived taxpayers. And these are the more positive representations. Research a few years back suggested that in the late 1990s doctors became the victims of a media assault by newspaper editors keen to expose a world of ‘gropers and butchers unable to keep their trousers up’. Indeed during the passage of the Health and Social Care Act (2012), there was a reiteration of themes of high salaries, money grabbing GPs, limited working hours, with the routine presentation of a need for radical health reform mobilised through routinely exaggerating ‘facts’. Critics might suggest that Mr Hunt and Mr Hancock’s shocked critiques of the service represent a more subtle but equally effective attack that fits into the canon of critiques of the service as unfit for purpose and requiring radical reforms.
There is, however, another option.
The other possibility here is that Mr Hancock, in his fierce desire to help NHS staff, may have missed out on his own support needs. Making remote diagnoses is always a controversial thing to do but the other possibility is that like Mr Hunt before him, Mr Hancock, is showing signs of suffering from Perpetual NHS shock syndrome (PNSS). Although yet to be categorised in the DSM Manual for Psychiatric Disorders (perhaps about the only highly speculative condition not categorised in there), this is a chronic and debilitating ailment that curiously and disproportionately affects politicians in the Department of Health. Its main symptoms appear to be 1) to continually forget about the supposed manifest failings of the NHS, 2) to experience disproportionate and debilitating astonishment, and 3) to need to compulsively express this regularly in the right-wing press. Like Guy Pearce in Memento, its sufferers are compelled to live each day anew with no memory of the incapacitating astonishment that blighted previous days when someone told them about a supposed failure of NHS functioning.
Mr Hancock believes that doctors and nurses need further support with the trauma that they experience in the lines of work that they are engaged in. And this sounds like a perfectly palatable suggestion. He said
“I want to bring a radical change to the workforce who have witness traumatic events including better training, everyone having access to the support they need outside of their line management and much more support to NHS staff with mental health difficulties, many of which can be caused by their work.”
In the same manner that Mr Hancock is unwilling to stand by this latest failure of the NHS to support its staff, we similarly cannot stand by while his central nervous system is mauled by the emotional barrage of astonishment visited upon him by this wretched institution. Perhaps Mr Hancock should receive better training and access to the support that he needs outside of his line management. His astonishment certainly corresponds with many critical insights that social scientists have been making of government policy for years. Indeed, Mr Hancock may be in his job for a number of years and we must ask whether we are prepared to stand by and allow him to suffer as Mr Hunt did for so many years. I for one don’t think we can.