Who cares for our NHS carers?
Matt Hancock's speech at East London Foundation Trust, at the launch of Health Education England's NHS Staff and Learners’ Mental Wellbeing Commission report
I want to talk today about Lauren Phillips.
Lauren wasn’t always going to be doctor.
She was a talented violinist. She had been invited to join the Bristol Symphony Orchestra. She had huge talents and amazing opportunities. She had choices.
She also had a powerful vocation. She came from an NHS family. Her father is a doctor. Her uncle and aunt are doctors. Her mother works for the NHS.
Lauren’s father, Jonathan, said: “She chose medicine over music because she had a strong sense of social justice and felt she could help people and give something back to society.”
So that vocation, plus her remarkable talents, led her to becoming a doctor at Southmead Hospital in Bristol, a hospital that I know well.
But the job took its toll. The hours. The work-life balance. The pressures.
It wore her down. Gradually, Lauren became more withdrawn, and then one day she didn’t turn up for work.
Her car was found a 100 miles away on a beach in Devon. Her body has never been found.
Lauren’s father said:
"During the short time she worked for it the NHS succeeded in sapping Lauren’s strength. Undermining her self-confidence. Attacking her professionalism. And devaluing her commitment.
"It was not there to give her the help and support she needed to stay alive."
He’s right. And I want to apologise. As Secretary of State, and on behalf of the entire leadership of the NHS, I’m sorry.
I want to say sorry to Lauren’s parents, and the families of every other member of the NHS family, who we didn’t do enough to help when they needed us most.
We can never know all the reasons why someone decides to take their own life. But, hand on heart, it’s impossible to say we did enough to care for Lauren.
Across the NHS, we don’t do enough to care for our carers. And for that I am sorry.
Now, I don’t want anyone to point fingers and blame people.
That’s not what Lauren’s father wants either. He knows first-hand the unique difficulties of being on the NHS frontline. But he also believes, as I believe, that “you can’t look after your patients, unless you look after your own wellbeing”.
Instead, there is something else I want us to take from this tragedy. I want us to take resolve to make the changes needed so we can care for our carers, not just in pockets, but throughout the NHS.
So I welcome today’s report from Health Education England. And I look forward to working with the NHS to put the recommendations into practice.
There’s no silver bullet. But just because there’s no one solution, let’s not fall into thinking there’s no solution.
There are 3 things in particular from the report I want to draw out.
First, something that Lauren’s father said has really stuck in my head.
Jonathan believes just being able to play the violin with an orchestra would have made an enormous difference to her mental and emotional wellbeing. But Lauren couldn’t commit to a few hours a week for rehearsals because she never knew what hours she was going to be working.
I felt that was shocking, and desperately sad. Rota practices like these are antediluvian.
I have doctors in my family who sometimes can’t make an incredibly important event, not because they’re unexpectedly stuck caring for a patient whose life is on the line – that happens and is an important part of the job – but because the ‘rota says no’.
Now, we’ve changed the rules at a national level to allow for modern, smart rotas. Well-led trusts have embraced those changes, but they haven’t been rolled out everywhere. And that has got to change.
Second, the report makes it clear that we need to place as much importance on the care of the carers as the patients.
I firmly believe this is the right thing to do.
Adam Kay recently said that working in the NHS: “You’re forced to build an emotional forcefield because no one is caring for the carers.”
He’s right. I pay tribute to the work Adam has done to highlight some of these problems, using humour to make people listen. I was actually reading Adam’s book when I became Health Secretary, and it’s shaped how I think of things.
But I didn’t reach the last chapter until after I was in this job. And the anguish and the pain in that last chapter hit me like a kick in the stomach.
So thank you Adam. Keep fighting the good fight. Because no one should have to build an emotional forcefield around themselves. And no one can do their job properly if they do.
And the third thing I want to draw out is that, to recruit and retain more staff, we need to change the culture of the NHS.
Why is it that when 1.3 million people have devoted their lives to caring for others, the collective system is uncaring to some? We need to change a culture of carrying on regardless, not asking for help, not looking for signs of burn-out among our colleagues, thinking everything’s OK as long as someone turns up for work and does their job.
That isn’t good enough.
No one, no government, no party owns the NHS. We’re merely custodians, looking after it, to pass it on, fit for the future, to the next generation.
I feel that duty every morning when I awake. Because I care. I care deeply about the NHS.
It’s been there for me, and my children. It was there for my grandparents.
Staff at Southmead Hospital, where Lauren worked, saved the life of my sister.
The tragedy of what happened to Lauren has a personal poignancy for me, because Lauren could have been one of the A&E doctors when my sister was brought in with a serious head injury. And my whole family owe a huge debt of gratitude to Lauren’s colleagues.
It horrifies me that those brave doctors and nurses, who face trauma every day, could be going through what Lauren went through.
So, throughout the NHS we must act, and I promise you, I will do all I can to protect and pass on this great British institution to future generations in a better condition than I found it.
And the only way we can do that is by caring better for our carers.
By looking after the people who look after us.
By making sure that when somebody needs help, there’s someone they can turn to, someone they can talk to.
By valuing our NHS staff.
By building a just, caring culture.
Apologising when we get it wrong, and learning from our mistakes.
Because the NHS isn’t run by people, the NHS is people.
And I will do everything in my power to give you the support you deserve.