David Boyle

Medicine without relationships

Speech to Liberal Democrat conference, Bournemouth, September 2004

There’s nothing wrong with choice in the NHS.  It’s important.

But my wife had a baby recently, and in the darkest and most painful part of the labour, I suddenly had a terrible vision of what the NHS will be like if it raises choice above everything else.

There we were, two hours after she’d confessed that she could cope with the pain no longer, when the anaesthetist finally arrived.  But he then gave us a loud ten-minute lecture on the risks of epidurals, the detailed statistics of serious side-effects, and a handful of horror stories.

It’s not that patient consent is a bad thing.  Far from it.  But an NHS that believes in nothing but choice can’t see beyond it.

That’s a fearsome future where nobody will give you advice.  Nobody will say, well actually most people in your circumstances tend to opt for pain relief.   They will just give you statistics – and really what do you do with them? – and ask you to make up your own mind.

It is medicine without relationships. Without advice.  Without a friendly face.  Without roots.  Without the same doctor you saw yesterday.  Without community.

Just drifting consumers in search of the best statistics or the fastest service.

And it is also doomed, because those human aspects are the hidden assets that actually heal people.

There are two great assets which the NHS ignores and which – as this motion sets out – are the potential resource to get us the sustainable health we need.

One is its front line staff, with their knowledge and individual experience.  The other is its patients and their neighbours.

Whitehall targets are all designed to keep these at bay, but they are the forces we urgently need. 

Real relationships, in fact.  Not targets, not professionals, not really even drugs, at least in isolation. 

For the last five years I’ve been involved with time banks in health centres, which provide a basic infrastructure whereby patients can support each other.

Check up if they have food in the house when they come out of hospital, change a light bulb so an older person doesn’t have to sit in the dark, give lifts, keep in touch by phone.

And let me tell you what the research says: the health benefits go both ways.  People get healthier when they help even more than when they’re helped.

Why?  Because feeling useful – a feeling we deny most people over retirement age and many below it – is actually a basic human need.  And it can be transformative.

Isolation makes sick, but relationships heal.  Communities keep people well.

And really this is good news, because we have massive untapped resources in the UK to bring to bear on this problem – if we dare. 

The time, experience and ability to care of patients and their neighbours.

We just need an infrastructure that can inspire and use it.  Which measures and rewards recognises people’s efforts. 

Time banks, expert patients, mentoring – that’s the future for health.  Providing services that professionals could never provide, even if we had the money.

So I welcome this motion and its recognition of this crucial truth.

A Liberal health policy is one that looks beyond the current stand-off, the exhausted professionals, the disempowered patients for whom time hangs heavy – and sees where the assets lie that can make us healthy again and keep us well.

The time and willingness of patients.

Their need for useful activity.

And the knowledge and experience of frontline staff, set free from targets and liberated from the new factory hospitals.

Those are the key to a sustainable health service.

title: books by David Boyle
Broke Voyages of Discovery Money Matters Blondel's Song Leaves World to Darkness The Little Money Book Funny Money The Tyranny of Numbers