A senior doctor, Novika Ramaiya (a pseudonym), has written a piece for The Independent this week in which she questions how long the NHS can continue. In it, she also bemoans the erosion of appreciation that has contributed to more doctors leaving for overseas positions.

“When I entered the NHS back in the early Nineties as a junior doctor, it was a completely different world. Patients received excellent care, by and large, numbers were manageable and doctors, while overworked and underpaid, felt valued and appreciated.

“Sadly, this is no longer the case. Since those relatively halcyon days, I have seen the slow but inexorable decline in standards – which has resulted in the NHS turning from the “envy of the world” to the sick man of Europe.

“There are many reasons for this downward spiral – but the way doctors, nurses and healthcare staff are treated plays a huge role. Working conditions for doctors have deteriorated to such an extent that both newly qualified doctors as well as long-established senior doctors, including GPs, are fleeing overseas, where they feel healthcare standards are better and they are cherished as important members of the team.”

According to the doctor, the situation is resulting in more deaths – the deaths of doctors.

“The rights and privileges that doctors once had have been slowly eroded over the years – many things that contributed to wellbeing and job satisfaction have been summarily removed. No longer is it mandatory for trusts to offer on-site accommodation OR on-call rooms for juniors, and many a doctor has ended up losing their life as they drive home from a late-night shift having fallen asleep at the wheel, with two in five doctors admitting that they have fallen asleep while driving. This has not been dealt with, despite it having been repeatedly brought to the attention of the powers that be. Trusts no longer routinely provide hot food for doctors, and juniors on night duty have to fend for themselves or starve.

“Increasing work pressures mean that there has been a spate of doctor suicides, particularly among juniors unable to cope with the stress.

“Bureaucracy has increased to a stifling degree. The introduction of futile time-wasting measures like appraisals and revalidation, initiated after Harold Shipman’s crimes, have meant that doctors spend an inordinate amount of time paper pushing – time better spent in clinical care – while the exercise does nothing to detect or inhibit the sociopaths who have given medicine a bad name.

“Expanded managerial oversight, with impossible clinical targets imposed on the medical profession by people that are not medically qualified, has added to recruitment and retention problems. Targets inevitably mean that shortcuts will be resorted to, and will result in less than desirable clinical outcomes.

“The NHS is no longer a happy place to work in – hordes of doctors are leaving the profession, either to emigrate, retire early, or change career – and this has only exacerbated the situation. The declining standards and the general discontent in the NHS are thus affecting staff numbers, which has then led to a further decline in standards and a poorer service for patients.

“Meanwhile, the great and the good of the NHS have launched a campaign to change job titles for juniors, in an alleged attempt to give them respectability. This completely ignores the wider problem of disaffection.”