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This Christmas Day, as you sit down for lunch with your family, or perhaps gather around the TV to watch the Queen’s speech or Gavin and Stacey Christmas special, spare a thought for those who won’t be spending the day at home or in the company of loved ones.
Instead, thousands of people across the country will be in hospital, from those with long-term conditions or recovering from operations, to those admitted in emergencies after accidents or with unexpected conditions. None of these people want to be there, and would much prefer to be enjoying festivities elsewhere – with families and friends – and this makes a distressing experience all the more difficult.
But alongside the patients, are the hard-working NHS staff, providing vital care and keeping services running, doing their best to make Christmas as comfortable as possible for those unlucky enough to find themselves in hospital over the period.
This year, as I have the past two Christmas Days, I’ll be one of those staff, working in paediatrics at a hospital in the north of England.
Working as a doctor in paediatrics – or the children’s ward – over Christmas can be heart-warming and heart-breaking in equal measure. Children have a way of finding the magic in even the bleakest situations, and seeing their smiles as staff rally around, wearing elf hats and singing carols, almost makes up for the 13-hour shift and three-hour commute. Some are even well enough to go home – even just for a few hours – to spend the day with their families. But for others, they are too sick, and will never go home at all. Seeing children at their most poorly is always hard, but at Christmas it seems all the more unjust.
All patients using our under-resourced, under-staffed NHS are currently facing record waits, and this is no different – and even exacerbated – at Christmas. On the other side of the hospital from me, some patients in the emergency department might face waits of up to eight hours to be admitted or discharged. I should know – as two years ago I spent Christmas night working in another hospital’s emergency department. Again, these people do not want to be there – this is the last resort for people in need of urgent treatment on a day when they should be enjoying themselves.
There is a workforce crisis across the NHS, and at Christmas, hospital wards will be staffed by even fewer doctors, with departments often propped up by junior medics, working as hard as they can to manage demand in what is already the busiest time of year. Without enough doctors, the quality and safety of care cannot be guaranteed, which is why the British Medical Association (BMA) is calling on the new Government to introduce safe-staffing legislation to protect both staff and patients, and meaning that individual doctors are not blamed when things go wrong in a pressurised environment.
Recent analysis revealed that the number of hospital beds in England has reached a record low, dropping by 17,000 since 2010 – and the BMA estimates that we need an extra 10,000 beds just to get capacity back to safe levels. You will have all seen recent pictures of a small boy lying in a hospital corridor as he waited for treatment, and for me, in paediatrics, the current shortage means there are no beds to assess children arriving on the ward – so we have to do this on chairs in a waiting area.
To provide these beds, we need more investment, and it is unlikely pledges by the newly-emboldened Conservative government will go far enough. The Institute for Fiscal Studies (IFS) estimates that the Government’s guarantee to pump £33.9bn a year into the NHS by 2023-24 accounts for an average annual increase in health spending of 3.1% – lower than the 4.1% the IFS and the Health Foundation say is needed to put services on a sustainable footing. The BMA has worked out that this means a shortfall of £6.2bn a year by 2023-24 – so the Government must be realistic of the challenges ahead.
Alongside the NHS, the Prime Minister says his priority is to “get Brexit done”. As someone born and educated in Romania, I am one of the thousands of lucky people to have been afforded the right to travel and work anywhere in the EU since 2007 – and membership of the bloc has allowed me to come to the UK and contribute to the NHS that is as much my own as it is any British citizen’s.
At a time of workforce crisis, the health sector relies on people from across the world to provide care, share learning and keep services running, so to see these rights threatened for a whole new generation of people from my country and the wider continent is infuriating – not to mention the rising anti-immigration rhetoric that has for too long dominated the political landscape.
In fact, the reason I’ll have worked three Christmas Days in a row is to allow friends and colleagues to have the day off to spend with their families, seeing as mine are more than 1,000 miles away.
Being so far from home at Christmas is difficult at the best of times, but doing so in such a tense environment can have a real impact on your wellbeing*.
As a child, you go to bed on Christmas Eve excited, wondering what presents await you in the morning. This year, I will likely spend the night before my shift alone, not knowing what faces me on the ward the next day, while the children there will be sleeping in hospital beds rather their own.
Of course, NHS pressures are now year-round and not just at Christmas. If the Government wants to give healthcare staff the best Christmas present, it would give them proper resources and support, so that they can go on giving patients the quality of care they deserve in a health service they are proud of and that is fit for the future.
Dr Cristina Costache is a junior doctor, and a member of BMA Council and the BMA’s Junior Doctors Committee
*All doctors and medical students can access the BMA’s wellbeing services 24/7, including Christmas Day, confidentially and free of charge on 0330 123 1245. More information is available at bma.org.uk/yourwellbeing