A junior doctor’s gripping account of working on the NHS’s frontline is likely to cause discomfort for Theresa May and the health secretary Jeremy Hunt.
Dr Rachel Clarke’s book chronicles how rota gaps, exhausted staff and risks to patient safety make a mockery of ministers’ claims to be creating a “world-class” health service. Leading medics believe that the honesty, humanity and unflinching detail in Clarke’s book, Your Life in My Hands, which is published this month, will deepen public concern about the state of the NHS as it enters the 70th year since its creation by the postwar Labour government in 1948.
“Dr Clarke has written a blockbuster, a page-turner, a tearjerker,” said Professor Neena Modi, president of the Royal College of Paediatrics and Child Health. “This is a from-the-heart account of the wanton erosion of a magnificent ideal – healthcare free at the point of need, funded through general taxation and available to all. It is a love song for the wonderful National Health Service that has embodied – to an extent unequalled anywhere in the world – the principle that healthcare is not a commodity but a great duty of state.”
Clarke’s publishers, John Blake, describe the book – part autobiography, part cri de coeur for an increasingly fragile NHS – as “a powerful polemic on the systematic degradation of Britain’s most vital institution”. She finds humour in sometimes bleak situations, is said to take the reader on an emotional rollercoaster, while being enraged by dubious government claims about the NHS.
While growing numbers of doctors are appearing on television screens in programmes such as Hospital, Embarrassing Bodies and 24 Hours in A&E, Clarke, 44, has gone in the opposite direction. She was a current affairs and documentary producer with ITN before switching direction in her 30s to study medicine. Now a palliative care specialist in Oxford, she has drawn on the storytelling skills developed in her previous career to convey in her first book what she says is the truth about the NHS – that its own health is perilous, its very survival under threat.
A recurring theme is Clarke’s gnawing anxiety that the pressures of working in such an overstretched service mean that doctors no longer have the time to display the virtues that made them choose medicine in the first place – kindness, empathy and communication with patients. She describes how, in a health service hugely under-doctored by international standards, the tyranny of a pager constantly bleeping limits the time doctors have to assess, analyse and talk to the patient and their relatives properly about their diagnosis, treatment and prospects.
Dr Taj Hassan, president of the Royal College of Emergency Medicine, which represents A&E doctors, says Clarke’s book is “a powerful and thought-provoking portrayal of life on the very frontline of the NHS. Her past career gives her brilliant tools to describe most eloquently the joys, angst, black humour and at times sheer heartbreak of working in our beloved health service. Her insights are at times brutal but also put across so beautifully the sheer decency and dedication of our young doctors and all the other staff who make up the NHS.”
Hunt is unlikely to put the book on his summer reading list. Clarke, who was jolted from previous apoliticism into NHS campaigning by the junior doctors dispute of 2015-16, loathes him. She blames him for triggering and prolonging the bitter battle, accusing him of using spin, evasion and dodgy statistics. Last week, Clarke berated the health secretary for voting to maintain the 1% public sector pay cap while, wearing his ever-present NHS lapel badge, asking: “Will NHS understaffing be the government’s next Grenfell?”
Hunt, who so far has appeared blind to staff shortages and insists the NHS has received generous funding, may accuse Clarke of exaggerating the NHS problems. But Professor David Oliver, the Department of Health’s ex-older people’s tsar, says she is telling it like it is. “The NHS faces pressures around capacity, demand, public expectation and funding, and frontline clinical staff are caught up in a high-stress environment. There are fantastic people with a fantastic ethos in the NHS but both they and the service are struggling. I wouldn’t call that shroud-waving,” he says.
Clarke hopes that her vivid, urgent prose will prompt the public, and especially politicians, to recognise the depth of the crisis engulfing the NHS and act before it is too late. Modi adds: “This compelling real-life tale will leave you wondering ‘why?’. Is the erosion of the magnificent NHS a reflection of politician ineptitude on a staggering scale, or a machiavellian plan to turn UK healthcare into yet another for-profit industry?”.
Rachel Clarke is among panellists at a Guardian debate about the NHS at Conway Hall, London, on Tuesday 18 July
