In PreScribed, made by Viv Gordon based on verbatim text from interviews with GPs and research at the University of Bristol, there is an air of nostalgia for how healthcare used to be. The ideal seems to resemble the life of Dr John Sassall, an English country doctor whose dedicated, all-consuming approach to caring for the people in his community was captured by John Berger in A Fortunate Man (1967). But, as Dr Gavin Francis has written, 'in today’s culture of working-time-directives and the commercialisation of disease it would be almost impossible to sustain'. (It may have been almost impossible in the 1960s too, if Sassall hadn't had what was then called manic depression).
The voices of some of today's GPs, chosen and channelled by Gordon onstage as a medical 'everywoman' character, speak about lifetimes of (over) achievement, trying to meet parents' expectations, years and years of study. Once qualified, they then found the profession was even harder than they'd expected. They are constantly being squeezed by NHS funding cuts, the churn of government policies and the ever-decreasing time they have to spend with each patient. No wonder their own mental health can suffer as a result, but who can they turn to for help? Their GP? 'Telling someone who does the exact same job as you that you can't manage is impossible'.
Hearing only the doctors' point of view risks making the show a bit like a one-sided tennis match. The only other character on stage, the practice manager, remains silent throughout and patients are initially represented by jellies on plates, vulnerable and easily smashed. There is little counter argument or context. For example, the doctors believe their profession has one of the highest suicide rates in the UK. This is based on research, but in fact, the latest statistics show that male doctors are at a lower risk of suicide than the general population, and while female healthcare workers are at a higher risk, this mostly relates to nurses. This is not to diminish the importance of GPs getting support whenever they need it, but current mental health services in the UK fail many more people than just those who work in them.
There is no doubt, however, that increasing pressure on GPs and other healthcare workers while ignoring their own health needs can only damage the NHS. We can't go back to 1967, but for the future of the NHS to be sustainable, we need to support it properly, as well as the people who make it work.
- Michael Regnier
Links relevant to this diagnosis:
Who Cares for the Clinicians? Spiers et al - British Journal of General Practice (2016)
John Berger's A Fortunate Man: A Masterpiece of Witness - The Observer
Suicide by Occupation, England: 2011-2015 - Office for National Statistics (2017)
Help if You're Feeling Suicidal - The Samaritans