In the December of my first year as a doctor, there was one question from patients that filled me with dread and frustration.

It did not matter whether it was asked by the sweetest or the most cantankerous patient. ‘Will I be going home for Christmas?’

How could such a simple question generate so much guilt? For those I had to tell they were staying, I hated seeing the hope drain from their eyes.

No amount of mince pies or forced jollity in Christmas jumpers could make up for that. Every single time I had to puncture someone’s hopes, I said sorry.

But I’ve often wondered exactly what I was saying sorry for. Perhaps it was the guilt when I had, against all odds, managed to secure some days off over Christmas for myself.

That guilt extended equally to my colleagues left behind. Perhaps it was the knowledge that, on the care of older people on the ward, there were plenty of patients who were medically fit to go home, but their family circumstances and the pressures on the social care system meant they couldn’t have a good and safe Christmas if they went there.

That ‘sorry’ was the best I could do for them. A word sometimes shunned for fear of litigation, a word we sometimes hear on the evening news when it can have huge significance following some kind of catastrophe. But this was a different kind of sorry.

It is one of the small but essential ones which junior doctors often find themselves handing out. There is the sorry for the delay in seeing a senior doctor. A sorry for the patient left in pain because there are not enough nurses to give breakthrough analgesia in a timely fashion.

A sorry for the food, for the ambient temperature, for the incessant beeping of the drip stand that finished its bag of fluid two hours previously, but no one had got around to turning the machine off yet.

I know I shouldn’t say sorry so much. I definitely shouldn’t be apologising for Christmas. And I should not have this constant feeling of guilt and shame about the health service I love and work for.

But with intense pressures on the system, exacerbated by winter, it is that constant stream of quiet apologies which are trying to resolve the huge gulf between the health service we have, and the one we would want for our patients. Until it gets better, I will just have to carry on saying sorry.

Joe Sharpe is a foundation doctor 3 in ambulatory care in Greater Manchester