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» Big Up the NHS

So why do we need to Big Up the NHS?

Steve Smith

Let me start by being very clear – I don’t believe the NHS is perfect. As part of my job I see all the complaints for my hospital and they are heart-breaking. There is no doubt that some patients receive poor treatment, that staff can sometimes be uncaring and that on occasions things can go very wrong. I know that the NHS complaints process is clunky and ineffective and that it often leaves patients and relatives more distressed than when they started. I accept that we find it difficult to learn from our mistakes and that whistle-blowers can get a rough deal. Yet the NHS has a lot to commend it. It is the only health service in the world that is completely free at the point of need without any reference to financial means. Our outcomes are world class though we spend much less per head than most equivalent countries. National surveys show that more than 95% of users would be likely or very likely to recommend the department which performed their treatment to Friends and Family. It is one of the things that makes the United Kingdom a civilised country.

Nobody can deny that the NHS has had a bad press over recent years. A firestorm ignited by the horrors of Mid Staffordshire and fuelled by a series of subsequent scandals. Knocking the NHS seems to be a national pastime. It sells newspapers and builds viewing figures.

Sometimes even good news is reported as bad. Don Berwick in his report on safety in the NHS said “At its core, the NHS remains a world-leading example of commitment to health and health care as a human right” and that we should “abandon blame as a management tool”. The  headline in the Telegraph was “NHS staff will be prosecuted for ‘reckless neglect’ of patients.”

Currently the vast majority of national media coverage is bad while the service is recognised internationally to be largely good – and this is a problem.

Why is unfair and unbalanced reporting of the NHS a problem?

The main issue is that our patients’ experience of treatment is coloured by their expectations. If you think you will receive poor treatment you will focus on the negative, see the problems, be more frightened and probably have a worse outcome. Imagine you are about to board a flight and you read in the newspaper that the airline has faulty equipment, pilots are poorly trained and that you have a high chance of crashing. At the very least your enjoyment of the flight will be curtailed. Most people would decide not to fly or to switch airlines.

NHS patients do not have this luxury. Avoiding necessary treatment is harmful in its own right and few have the means to go elsewhere. They will have a more distressing experience as a direct result of the negative reports. Worse than that, there is good evidence that patients’ outcomes are influenced by their expectation of success. Complication rates will be increased and some may even die. The casual unjustified swipe at the NHS in the media will cause REAL HARM to REAL PEOPLE.

And there is also the effect of staff morale. The vast majority of NHS staff is caring, dedicated and sensitive. Indeed most clinicians are selected for these qualities at the start of their careers. Unjustified bad press is hurtful, it damages morale and desensitises the sensitive. Sickness rates increase, staffing levels fall and patients have a bad time. The press gets even worse. We hit a relentless downward spiral.

Is there a political agenda?

Many believe that the bad press is deliberately orchestrated by the government to undermine the credibility of the NHS as part of a plan to sell it off to the private sector for profit. This graphic has been widely circulated through social media. I am not a natural conspiracy theorist but I can see the logic of the argument.


I think is more likely that journalists simply do not realise the harm they can do. Sections of the public enjoy the feeling of righteous indignation that comes when they read of failings in others. We pick away at the scabs for the pleasure of the picking even though we know this is likely to be damaging and may cause permanent scars.

NHS bashing is a form of societal self-mutilation. The service is one of our greatest assets, we all depend on it from birth to death, yet we seem to want to cause it harm.

In the final analysis it is irrelevant whether there is a conspiracy to damage the NHS. The legal framework for privatisation is now in place and this will progress at a pace whatever we do. Bad press will make it happen more quickly with less predictable results. We may even have to endure a complete collapse of services. Positive press will give us more control of the process. It can help us sit up and take notice of what is happening.

What do I hope to achieve with Big Up the NHS?

I started Big Up the NHS as a twitter account in August 2013. The idea was to counter the negative press, raise the profile of the NHS, help improve morale, lobby for more funding and ultimately improve the experience of our patients. To reverse the downward spiral. This rather grandiose idea proved popular the account attracted more than 8000 followers in the first 6 months. This blog was started in January 1014 as was a Facebook group which attracted 350 members in the first week. There is a Linked in group which is just starting to get going.

The plan is to use these sites to disseminate good news. I hope to collaborate with others to promote the best of the NHS. The political debate is not off limits but it is not a primary purpose of the enterprise. Big Up the NHS has no political affiliations – just a commitment to supporting and promoting the best in the NHS.

What next?

I will be guided by others here. I have no current plans but it may be that we could look to developing a membership or at least recruit some like-minded collaborators. While I am really enjoying doing this stuff it is quite time consuming and I could do with some help (before I get sacked and/or divorced). Let me know if you are interested.

In the meantime please follow the various sites, spread the good news, feed me positive stories and BIG UP the NHS.

Steve Smith

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