Can you die of distraction? On a cold evening on December 29th 1972, 176 people were on board the Eastern Air Lines Flight 401 on final approach to Miami, soon to land for New Year celebrations with friends and family. Despite having a veteran captain with nearly 30,000 flight hours under his belt, and despite there being no faulty equipment, at 11.42pm the plane crashed, skidded and broke up across the Florida everglades.
After extensive investigations, the supposed fault was discovered: the landing gear indicator light had burnt out. But how could a mere fused light-bulb fell an entire plane? After all, the landing gear could easily have been lowered manually. Following scrutiny of the black box recording, it was realised that the real problem was that the pilots were so preoccupied with trying to fix the light that they had inadvertently deactivated the autopilot, and failed to notice the altimeter reading gradually falling. That night, 101 people on board died because of a failure to see the bigger picture.
The real NHS crisis: seven-day care, or privatised care?
During resuscitation training, such case studies are used to demonstrate the importance of not fixating on one issue to the detriment of the whole. For instance, a doctor trying to take a blood sample to help diagnose a sick patient could get so immersed in the process that she could forget to notice the patient's oxygen level dropping dangerously low. So it is drummed into us that we must remain aware of what really matters, and prioritise the many problems facing us if we are to avoid disaster.
But are we alert enough to do the same when it not a person but our entire health service on the brink of expiry?
The junior doctor contract protest has been a good thing overall, politicising thousands and creating widespread solidarity. However, right now the danger is some of our leaders are expending so much energy fighting with Jeremy Hunt over whether we need—and whether in fact we already have—a seven-day NHS that they are ignoring the real threat to the NHS: the deliberate dismantling of public services.
It is not enough to tilt at windmills (Jeremy Hunt) when the real enemy (privatisation) remains.
Contract negotiations: a manufactured crisis
Has the whole doctors' contract fiasco and the “seven-day care crisis” perhaps even been dreamt up as a distraction tactic; a sham battle with a foregone conclusion?
Even if our contracts are protected, even if Jeremy Hunt resigns, our battle will not be over. The real crisis affecting the NHS will not disappear. The past thirty years have seen a series of NHS reforms that have all led to a dramatic and regressive change in the NHS ethos—from post-war collectivism, to 21st century corporatism.
So our protest should not be a Hunt hunt. This health secretary is just the latest face of an older, and more dangerous, agenda. Health secretaries from both main political parties will come and go, but until we challenge their common belief that healthcare can be marketised like any other commodity—an ideology which is so at odds with that of the founding principles of our health service—then the NHS is doomed to fail.
In my eyes, there is only one possible outcome that we could fairly describe as a victory, and that is if the BMA demands that the government openly commits to the one and only principle that can save the NHS: that the health service should be publicly owned, publicly run and publicly accountable.
A zero-day NHS
The reason the government keep banging the drum of a “seven-day NHS” is because they want us to be distracted by it; to fixate on a detail that is as irrelevant to the fate of the NHS at the fused warning light was to the fate of Eastern Air Lines Flight 401. They want us to take our eye off the truth: that swathes of our beloved health service are being bundled up and put out to tender to private companies.
The government may talk of a seven-day NHS, but what they seem to be headed for is exactly the opposite: a zero-day NHS, a carcass for privateers to feast on.
We doctors must not lose sight of the bigger picture. We are one of the most trusted and privileged groups of workers in the country, and - as many of us are now realising - we must use this power to defend not only ourselves but the entire NHS.
We are now in a position to rally the entire healthcare workforce together to save the NHS. All we have to do is keep striking and add one crucial thing to our list of demands: a truly publicly-run NHS. The question is: will we?
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