Garden of Surgery

Imagine that you have a big house with a large and beautiful garden with lawns and flower beds, a water feature and even a vegetable patch and fruit trees.
You have employed a team of gardeners to tend to your garden with the vague instruction to “do the garden”. So the gardeners organise themselves into special interest teams: the rose experts, bush and shrub experts, water feature expert and so on. It becomes apparent that although the special areas are looking good, the rose beds, orchids, fruit trees etcetera there isn’t anyone attending to the weeding or cutting the grass and the garden is in disarray. When you confront the gardeners about this they each cry out “But I am a specialist, not a weeder or a grass cutter”.

Now imagine that you are NHS management and your gardeners are surgeons and your garden is the unwell population that you serve.

Weeding and cutting the grass are the most important jobs in the garden although they are not glamorous or rewarding in terms of impressive results. The NHS needs the rose experts and shrub guys, of course it does, but not at the expense of the grass and weeds. There are too many surgeons fannying about with their roses when they should be getting on with the real work, the acute service and the boring elective work (gallbladders and hernias instead of laparoscopic all singing all dancing extravaganzas). NHS management needs to get control of their surgeons and start telling them what to do and the politicians need to make emergency care the priority and not these stupid and meaningless waiting list times.

I’ve been cutting the grass and weeding for the last month in my job, a 4 week block of on call, and I’ve done more good and helped more of the ill people that I serve than a month of elective work ever does. Not that the politicians care or that management cares; all they give a shit about is the clinics that have been halved in my absence.


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