hello and welcome to ways to change the
world I'm Kristin guru-murthy and this
is the podcast in which we talk to
extraordinary people about the big ideas
in their lives and the events that have
helped shape them my guest today is the
author of one of the most successful
books of the last couple of years is
called this is going to hurt and perhaps
more importantly he is a doctor what a
doctor and his book is about his life
was a junior doctor and why he ended up
quitting Adam Kaye welcome why did you
want to be a doctor did you were you
were do gooder it's a good question I
think about this a lot I think it was
like the default setting if I didn't
have a better idea for what else to do
my family had doctors in it I went to
the sort of school that churned out
doctors and lawyers and architects and
that sort of thing I was alright at
Sciences and to be honest it's a
decision you make when you're 16 you
know because the medical schools when
you to have certain a levels and you
choose those elavil that's a very bad
age to decide to do anything obviously
let alone my whole career particularly a
career with eat like the emotional you
know load that medicine has so I don't
know what I don't have a good answer to
that she didn't have a passion for it
wasn't the occasion probably not it not
at 16 it became my vocation and you know
ultimately you don't go to medical
school unless you want to help people I
mean that's that's what it comes down to
and that always has to be there and that
always always was there but I mean
you've got to be really committed you do
I mean it's a it's a long degree you
know all of your mates at university
leave halfway through your your degree
and then it's a very very tough job um
and and I was definitely committed to it
but ultimately I don't think I was we
talked about informed consents in
medicine you know before you go and have
your your operation on your I you know
they run through the risks as well as
the benefits I don't think the risks are
ever really explained when you're going
into medicine and I didn't really know
the emotional toll
it would take I mean you you I guess
make your living as much house of comedy
now yeah I guess I'm technically a
writer and a performer and that sort of
yeah I mean I saw your stage show which
is the station of your book a couple of
weeks ago it's an incredibly funny night
everybody loves it
were you always an entertainer I think I
was always the class clown that's I
think I don't have kids but I understand
the concept of parents wanting the best
for their their kids and even if I'd
have worked out earlier on that's you
know I I was a creative type I wanted to
be a writer my parents you know from a
old-fashioned medical must have a you
know monthly salary sort of thing would
have steered me towards a inverted comma
sensible job but I certainly had to the
virtues of medicine extolled but I
probably always was a creative type but
interestingly the medical schools want
you to have like extracurricular thing
so opponent is not enough just to have a
load of A's at a level you if you go
into any doctors mess in the hospital
you'll find you know the captain of the
hockey team and the cricket team and
lacrosse players and grade eight tuba
players and oboe players because that's
what the medical schools wanted this
sort of surrogate measure for are you
going to be a good doctor
they don't actually ask you relevant
questions it's about you know a are you
any good at the the oboe do you think
that they're good at filtering the
medical schools no I think they're bad I
think they asked the wrong questions
so basically straight A's at a level I
don't think I don't think the best
doctors the the cleverest doctors it's
not a job that where you're sort of
calculating biochemical pathways it's a
job you're communicating and I honestly
think if you drop to the grades to B's
rather than age you get a better caliber
of doctor and also you get doctors from
a broader you know the border of
spectrum of society I think they should
be specifically they should be very
honest a
what the job involves and then recruits
on those criteria like I get the
occasional not angry yeah angry email or
DM on Twitter from a parent saying you
put my son you put my daughter off
medical school by you know they read my
book and then now they don't want to do
it good because if that books gonna put
you off medicine if my shows gonna put
you off medicine the medicines really
gonna put you off of medicine um they
need to did they do ask the wrong
questions like a friend of mine recently
trained up as a train driver and as part
of that process they basically asked the
question if the worst happens someone
jumps out in front of your carriage are
you going to be able to deal with it
because that can happen there's no such
thing in in medicine if you want to be
an astronaut or pilots you know that's
part that's part of it you know under
there under the you know the like to the
metaphorical camera are you going to be
able to code if you want to be a doctor
it's just you got loads of A's right and
and do a little hockey but don't we need
doctors to be really clever I mean you
you know you because there is quite a
lot of yeah thinking it's not just
communication it's working out what's
the right things yes but I think it's a
I think we've we've we've gone too far
to 1ng I'm not saying we want our
doctors to be you know stupid but I just
think that they're the better the best
doctors aren't the cleverest doctors and
I do I do strongly believe that actually
I always used to worry that the because
I got a place at medical school and sort
of dropped out of doing medicine before
starting because I got a job in TV and I
similarly came from a family of doctors
and so was just gonna do medicine yeah I
don't think of anything else to do and
we've never really had a passion for it
but always said I was gonna be a doctor
I I always kind of felt that the sort of
the the class SWOTs could become doctors
because all you had to do was get the
exam results the class what doesn't
become the best doctor I really really
believe that so were you surprised I
mean but by by what the job actually
entailed once you became a junior doctor
yeah had you already kind of worked it
out during the course of
your degree I hadn't hadn't hadn't
worked it out and nothing really quite
prepares you for I mean it's like
learning to be a mechanic just by you
know reading the manuals you have to do
you have to work in the first car for
the first time and I wasn't prepared for
like that how difficult it was like
logistically just things like the hours
the the effect it has on the rest of
your life which is one thing and I
wasn't totally prepared for the
emotional side of things because you can
be in a communication skills lecture
where they teach you you know what you
do and don't do when you're breaking bad
news and here's how you sign post this
and you don't say this and DISA but
that's very different to you know being
bleeped away it's you know 1:00 in the
morning to to have you know the worst
chat with it with a family and but the
thing that really surprised me was the
lack of a safety net the lack of support
when bad things happen the fact that the
culture is very much a stiff upper lip
it's it's not one about opening up
talking about what's happened you go
back home and you know they ask how your
day was and he go yeah fine you're
trained to say yeah fine your dad was a
doctor yeah did he come home and you
know decompress or was it or do you
think it was bottled up um well my dad
was a radiologist what is a radiologist
he's still working radiologist actually
and so there's less drama
I suppose in his in his field because
it's diagnostic and he's not dealing
with people who are you know there's no
Christmas line yeah yeah if you like so
I don't think you had that same level of
compressed emotion yeah in his in the
course was daily daily life but we would
often argue about the sort of value of
what we were doing and I'm very
interested that you ain't that you ended
up quitting medicine and working in the
creative industries yeah because that's
the argument I used to have with him
about quitting medicine to work in the
creative industries used to have this
arguments about the value of our work
the arts have absolutely enorm
value and we do a very different thing
you know you know you're holding people
to account you know I'm making people
laugh or making people think or whatever
it is and I strongly believe the value
of the arts but it is so many steps
removed from coming home having saved a
life
and there's no no and you know life's
are big you know there's a big jigsaw
and you know pieces are important I mean
by way of instructions people who don't
know about the book or your story I mean
how would you I mean do you have a sort
of a way of summing up what your
experience of Medicine was I spent six
seven years as a doctor and foremost
that time I was working on a labor ward
and I worked my way up to senior
registrar which is one one notch below
consultants and so I'm sort of
reasonably you know I was reasonably far
on my way to finishing my training and I
kept Diaries whilst I was working which
in retrospect were probably looking for
the light amongst the the dark it was in
the absence of the system helping me
cope with the bad stuff I was doing it
myself by writing down the silly stuff
and the disgusting stuff it's mostly
this asking a feeling but ultimately
that didn't give me thick enough armor
enough of a buffer to deal with the
absolutely terrible stuff and without
going into too much detail all you ever
once on labor Ward is a healthy man plus
a healthy baby and I was the most senior
doctor on the ward where sadly we ended
up with with neither of those things and
I realized that I couldn't cope with
that kind of thing ever happening ever
again and you know I'd ended up in a job
that I I couldn't do and that there was
no there was no real support offered and
and I ended up stepping away from
medicine I thought I was only going to
be away for 6 or 12 months whilst I I
regrouped and but then I got I got lucky
with the writing I was I was doing and
I've and I've not gone back to medicine
did you ever want to go back during that
period or was it just something you
couldn't do it it really knocked the
stuffing out of me what happened and and
I knew that if I was
back to medicine I would it would have
to be in a different specialty so it's
something where that kind of day I could
never have that kind of day at work ever
again
which meant going right back to the to
the starts one of the problems they have
in medicine is you can't sort of move
laterally between between the different
strands you have it's like snakes and
ladders go right the way back to the
bottom so the book is incredibly funny
and so is your show did you find it
funny at the time yes I think I think I
did I think I did and I and I really I
really focused on there on the funny
because you need that you know when they
say oh how was your day at work the
truth is a really horrible thing
happened that's I'm just going to
internalize and so but my answer was you
won't believe you know what happens in
nineteen eighty clinic so would you
laughs not at a patient no I I'm very
good at poker what are the funniest
things that have happened he was a
doctor I think my very funniest moment
at work was a woman who decided one
February the 29th to propose to her
partner and she did so by taking
engagement rig and putting it in a in a
kinder egg and putting that kinder egg
internally and then hoping that her
partner would retrieve it and then she
would go down on one knee bla bla bla
unfortunately they the kinder egg
somehow managed to rotate itself
lengthwise and no matter of sugaring
from either of them would get this
particularly goose to let its golden egg
and so she refused to you know ruin the
surprise I tell her tell her boyfriend
what was going on so you know we all met
you know in a cubicle in A&E and I was I
retrieved the kinder egg relatively
easily with a pair of forceps and but
she didn't she didn't tell me what was
going on either so it was quite
confusing when she asked him to open it
ok the cubicles we brought so I gave him
a pair of latex gloves which sort of
ruined any remaining
man's and yeah and she she proposed and
he said yeah how did she explain the
kinder egg coming into hospital
oh she's people don't often they just
say what's wrong they say there's
something is stuck and I'm not there to
I'm not there to to judge so you know it
doesn't doesn't affect my management
quite how the kinder egg ended up there
so you never you never asked you would
you would never say well how are not why
on earth did you do this I mean you can
sometimes it's sometimes it's it's
relevant but we all know why their
patients always come up with reasons for
explanations for how things got things
got in place is that you call it I feel
syndrome I fail doctor I fell but wheel
wheel that I know they know that they
know that I know so it I don't I don't
need to have sort of embarrassing
discussions about have they sat down on
the sofa with the remote control it's a
weird angle or whatever it is I mean do
you think I mean you mentioned in the
show actually that you know doctors are
famously big drinkers do you think
that's because it's a really tough job
yeah it's a look there's a huge alcohol
problem because it's it's an easy coping
strategy it's on the shelves of every
supermarket there's there's a problem
with recreational drug use in medicine
that's there's just not really talked
about and there's a crisis with suicide
one doctor every three weeks takes their
own life personally I think that should
be a headline every single time it
happens in Britain yes there was an
article in the BMJ put together by
claire gerardo i'm looking at that and
it was one doctor every three weeks so
why do you think is so bad is it is it
the lack of support or is it the job
it's both it's both it's it's an
extremely tough job so I don't think my
door is painted like a relaxing picture
of being a doctor but those diaries
ended in 2010 in retrospect
that was the good old days since then
funding for the NHS until they last in
18 months or so it's the lowest it's its
bonus it's hard the concept of heads
like normally the NHS to survive any
health system needs a certain amount
more money every year three or four
percent it's known as health inflation
since 2010 for eight years or so it was
1% so there wasn't enough money going in
so that it could just tread water and so
eight years of that it got went from a
stretch system just Adam thin stretch
system and you know you know the huge
numbers of you know staff gaps there are
in medicine I think is now over a
hundred thousand across all disciplines
and when you're up work and and your
colleagues away and you're doing to
people's jobs that's annoying you can do
it for a week you can't do that
permanently you can't do three people's
jobs all the time and that makes it
extremely stressful I did to which the
emot-- on emotional stuff so what was
the hardest bit you know was it when you
were the most junior or when you had
more responsibility when were you
working the hardest do you think long
sigh I worked the longest hours when I
was right at the start because I think
there were changes in the way the
contracts were structures and and
whatever so I by the end I wasn't doing
the ninety seven hour weeks that's
looking back through my Diaries it was
quite sort of really did I do that but
it doesn't seem possible you see when
you talk about it and when you joke
about it you know that you'd have been
working pretty much around the clock you
might drive home or sleep in the car and
then start a shift again yeah yep often
I turn these into it sounds like a
saturation it does but ask doctors
who've that I mean it's like it should
be an exaggeration it should be
ridiculous and it shouldn't happen but
it just was what's happened and it and
it's and it's stressful it not any job
under those conditions would be
stressful but then what the job actually
is the you know the the life-and-death
aspect of it so so that's one side and
the other side is the support which of
which there's virtually no wide
I don't doctors use the same support
that is available to ordinary members of
the public which is what going to the
doctor going to a psychologist whatever
it might be I mean I mean I don't I
don't know yeah I wouldn't ask you if
you've ever tried to access NHS you know
mental health support but that is
probably one of the most stretched it's
doctors are very bad at seeking help
doctors are trained in a way just to
just to keep it in you're a bloody
doctor you bloody get on with it stiff
upper lip stiff drink off you March
that's really what the the man sure is
so you came to see me at the at the
theater and I was reading out from my
book and in the in the dressing rooms
and there and the corridors there are
these posters it's a theatre helpline
it's funded by the unions I think 24/7
365 days you've got any worries about
money or whatever it is you know phone
this number we'll we'll have a chat we
can refer you for counseling when I was
working as a doctor that just wasn't a
thing there was no such helpline because
the people at the top didn't think it
was a enough of an issue to to chuck
some some money behind if an awful thing
happens at work there is no you think
there'd be like a standardized protocol
so what doctor who loses patient know
whatever it is who is then in a
difficult you know place emotionally you
know that not occupational health should
have a person that you could speak to or
they could offer you X days or weeks off
and there isn't any of that which is
great I mean I don't ask for the book in
case people have read it yeah so we
won't talk about precisely what happened
with you but you've given her a good
sense of what happened
a mother lost her baby in the course of
giving birth and it was yeah it was oh I
only say a certain amount because
they're also legal confidentiality
things but it was what's known as a
placenta praevia which is a placenta
that so that's in the wrong place and
the and the placenta separated
from the from the uterus and the mom
lost enormous out of blood
tragically that you know the baby was
dead by the time we we did the cesarean
and mom lost in the order of 12 liters
of blood ends up losing her her uterus
and took there to remove the womb too
you know in an attempt to save her life
and she was she went off to intensive
care and I was warned to expect the
worst and it was that that isn't
something you expect is it's going to
happen when you're a 16 year old
choosing you're choosing your ailable
I'm not a fan of America in in in terms
of the health care so a big fan of
America well I think American health
care is appalling 400,000 people a year
going bankrupt was a medical bills 1 but
medicine is generally a postgraduate
degree so you're making that decision do
I want to be a doctor in your early 20s
rather than in your teens and you're
still an idiot obviously when you're 21
but you've got a probably slightly wider
perspective on the world you've left
home by then potentially had a
relationship we've had to earn some
money and I think that's when you should
make the decision I think younger than
that how can you know how you're going
to be able to deal with deal with those
situations what proportion of your
colleagues and friends in medicine have
gone through the same sorts of things
I'd say almost all doctors emotionally I
mean I mean obviously they will have had
similar experiences and they're in their
work but I mean with you you had a
particular emotional response so a
terrible thing that happened to you I
mean most doctors don't quit I'd say
that you know we all read out from my
from my Diaries often it's conferences
for doctors and sometimes I'll ask you
know when I was reading out that awful
diary entry how many of you thought back
to your own bad days at work and it will
be a pretty much a full house of hands
going up and then at least once a week I
get an email from a senior doctor from
you know a retired professor or a head
of a department in a hospital or you
know a GP partner always certain same
I've never told anyone this
I talked about this in my show I've
never told anyone this but and then
opening up to to me a stranger who's
just written about it in a in a book but
they didn't tell their colleagues and
their friends and their their partners
and their and their families because it
is just not what's done I get and I get
emails from even more often than that
from people at the other end who are
just just starting out in their first
few years telling me that they thought
they were the first doctor who'd ever
cried in the locker room and ever broken
down in the toilet who'd you know ever
sort of you know thought they weren't
coping because you're made to pretend
how much of it is to do with the way the
NHS works and resourcing and the fact
that you're working ridiculous hours and
all that kind of thing and how much of
it is to do with being a doctor it's a
very good question I thought it was all
the first but actually I now think it's
it might be just part of being a doctor
my book has now been like translated
into 38 39 languages or something which
I thought I was writing a parochial
sorry about being in the NHS in fact
doctors all over the world seems a
universal expense I get these messages
from Chad and Belarus and Venezuela from
these doctors saying I've read your book
and this could have been set in my
hospital I wonder if part of it is you
know you want your doctor to be God or
Google or whatever it is in
unimpeachably correct and so you end up
acting the part but you know doctors are
humans and doctors do make mistakes so
do you think doctors should just be more
honest with their patients when they
don't really know yeah you should never
never blag no that's absolutely
do you trust doctors and what they say
do you think we should trust doctors and
what they say or should we question
things more I think ultimately we can we
can trust doctors they've got no skin in
the game they're not in the pocket of
drug companies they're you know they're
they doctors want the best for for
patients and often you know very very
difficult
circumstances that's different to should
we question doctors because absolutely
we need to be certain that the doctors
doing the right thing and we've we've
asked everything and we're sure that we
want the same from the doctor once but
do you think doctors sometimes do things
or prescribe things or advise surgery
for things because they feel it's their
need to make things better rather than
just either saying I don't know or give
it time my dad is a doctor and he's very
very skeptical about medicine and
surgery
so whenever I've got anything wrong with
me he say he always says no didn't don't
do that ignore that just leave it and
it'll be fine and usually he's right I
don't I really don't believe that's that
doctors ever say you need surgery when
you're only surgery there are you know
for any given condition there will be a
number of ways of approaching its
treatment that might be surgery it might
be medical it might be conservative
measures like sort of you know physio
not professional therapy or it might be
you know nothing watchful waiting and
and it's the role of the doctor to
explain what they perceive to be the
benefits and risks of each of those
options um no I don't I don't really
think that things get pushed I mean the
waiting times for elective surgery are
so long but there's it's in no one's
best interest that a doctor words would
want to do an operation there isn't
isn't required I do I do really think
that doctors are in it for the best
interests of their patients and that
they're not going to recommend something
that's isn't what they honestly believe
to be the best course of action I mean
the reason I asked about what we know
what is it is it about resources is it
about resourcing or is it about actually
the job is Vicky know how it is how do
you make things better yes
which you're very involved with now
whether it's on social media or in real
life or in your show whatever it might
be yeah sort of a campaigner now as well
try you know I'm one of many many many
people who thinks it's a thinks it's a
big issue so in terms of making it
better you know do you have a list of
things that you would change I mean
you've already said we decide to become
doctors a little bit too soon yes so I
think there's that there's a whole bunch
of things
part of it if the NHS had enough money
there would be less stress on the people
who are working there they wouldn't if
there weren't all these scars on the
rotor you know where you're doing to
people's jobs we're having to stay an
extra 12 hours otherwise there's no
senior doctor on labour ward if there
wasn't that then things would be easier
and then the crisis and retention and
recruitment would would resolve a bit so
that's that's quite a that's quite a
major thing so yeah start at the start I
think we revisit the criteria to be a
doctor in terms of the of the grades I
think we're very honest about what the
job actually involves I think that my
book or a book like it should be you
know required reading for anyone who
wants to do the job not just for
financial reasons I think that it really
is a job you need to do with your eyes
totally wide open I think the interview
needs to really ask the question are you
definitely going to be able to cope I
think during medical school training
there needs to be built into it built
into it an aspect of psychological
preparedness for the job I think that
when you choose your specialty that
needs to that needs to be a big factor
every specialty is this sine wave of the
highs and the lows and I was in herbs
and guinea a Labour Ward the highest
highs of all but obviously the lows were
unbearable you know and I think
specialty should should acknowledge that
there are flatter and and steeper sine
waves I think that hospitals should all
have a protocol for when someone's had a
they call it being a second victim which
is a weird phrase but you know if you're
the doctor involved in an unlawful
incidence every action has an equal and
opposite reaction then there needs to be
a place that every doctors knows they
can go to to say this has happened and
the hospital needs to be able to provide
the thing you say your book should be
required reading or something like it
well what do you think your book has
revealed my book came out in response to
the junior doctor strikes a few years
ago I'd never intended it was going to
come out and for people who don't
remember the the junior doctors which is
anyone in hast
isn't a consultant so it's sort of most
most banks of doctors are known as gin
doctors ends up going on strike because
there was a new contract being imposed
on them which was basically unfair in
words affect working conditions and
patient safety and the government
claimed that the doctors were striking
as they wanted more money cuz they're
being greedy which was which was untrue
and and the and the doctors lost the
battle and lost the war because I think
the Public Allies don't really know or
understand what being a doctor actually
involves and I thought I'm not an expert
in anything other than what happened to
me but I thought that if I could just
publish a fair reflection of my life as
a doctor and I was lucky to have these
Diaries I'd kept that next time round
you know people would you know might not
might not believe it so I think what I
was trying to do was just lift the hood
a little bit and just show the toll that
the job takes one of the things you get
really angry about is Jeremy Hunt the
health secretary during that dispute and
you got to meet him how did that go and
how did it come about so this was two
and a bit years ago the book had just
come out and he was still in post and a
message came to me by my publisher
saying Jeremy Hunt wants to meet you and
my book is lowercase P political but at
the end I do write an open letter to the
Secretary of State for health explaining
why I think they got things wrong and I
understand why I'd been invited but it
turns out the answer was he honestly
thought that he could change my mind I'd
been wanting to speak to this man for
the best part of a decade we sat down
over a cup of tea and I was like okay
this and this and this and but this
wasn't the first time he'd been asked
those questions he's been held to
account by you know you and any number
of people and he had great answers to
all of them what were you trying to get
out of those questions my big thing was
you know what sure why did you go for
the junior doctors and would you do the
same thing again and it's
wanted to understand how this has been
allowed to happen and were you trying to
change his mind yes I was which was
naive of you both went into this meeting
with catastrophic aims yes exactly
exactly it didn't it didn't didn't go
particularly well he got fed up with me
asking my questions and the atmosphere
at the end the atmosphere was a bit sort
of tense that we've all done you've done
the tense atmosphere interview a lot of
times oh it was my first time and so at
the end I was like I needed to apologize
and I said I'm really sorry if I
came across nicer in my book than I do
in in real life and he said oh no I
think you've been quite consistent so he
said he said he was a it was a he was a
clever guy he had great answers to my
questions but I do fundamentally
disagree with what he did not just with
respect to the contract disputes but
also you know the the funding you know
he he was responsible for NHS funding at
1% when it needs 3% and we're still and
and live lives were lost I mean there's
no there's no way around it and I'm
angry because firstly he demotivated an
entire entire profession the the junior
doctors and secondly he's got blood on
his hands and I'm and I feel justified
in my anger but that's a very powerful
thing to say that he's got blood on his
hands yeah and you know exactly what
that means yeah justify that look at
their cancer waiting times look at the
ambulance waiting times look at the A&E
waiting times look at the number of
people awaiting routine surgery look at
any metric of how the NHS is performing
ask any doctor what they think this is
this is done in real terms to real
people because it isn't just you know a
statistic posted which says Oh
the the a any waiting times have fallen
to their luck
each each percentage tiny bit of a
percentage point of those numbers is a
person someone's someone's relative
someone's husband wife mum dad son
daughter and lives have been lost and
then I don't have the numbers to hand
but the numbers are are there and you
and your and your listeners can can can
look them up and there are but it takes
responsibility you know to say a man has
got blood on his hands is a direct line
of responsibility for somebody's death
in the health service to a politician so
yes and you think that's clearly a fair
thing to say obviously no your hospital
no government department works in a
vacuum
you know they will say you know because
of the you know austerity was brought in
because of the the world the global
economic blah-blah-blah-blah-blah and
yet it's his department
you know buck stops somewhere either
stops with him or he stops with the
Prime Minister but decisions were made
that cost lives and that's a fact
okay maybe you know it's not murder you
know he didn't he didn't do it himself
but it's a very very very direct effects
of making these decisions and you think
he had a sense of his direct
responsibility when you met him
I certainly didn't accuse him to his his
face of costing lives and and so I don't
have an answer to that
you're also in touch with his success in
that Hancock yes how's that come about
it came about from Twitter actually when
he got the job lots of people tweeted
him to say have you read this book and
he replied with a photo on his bedside
table or whatever it was when his desk
saying yeah and I'm reading it at the
moment and he invited me into to meet
him and how did he compare he had a very
different approach I think he was much
more keen to you know to get me onside
he yeah he he asked interesting quest
I think to a certain extent I met him he
was very new into the job he was I think
was slightly surprised how little
support there actually was for junior
doctors and he asked me what I would do
and which is interesting because that's
not what Jeremy Hunt asked you know so
the current health secretary actually
asked you for say you know yes yeah but
what I thought I would talk about is
this thing I care a lot about which is
the the well-being of junior doctors and
he said at the time that that was
something that he would try and do
something about and in fairness to the
guy there were deeds as well as words
and he announced expanding a program
called the practitioner health program
which does do the thing of providing the
you know a bit of a safety net and
support network for for doctors and so I
disagree with a lot of things that he
has done but I you know credit where
it's where it's due that was a that was
a good thing that he didn't have to do
and he named checked you know my book
amongst other things when he announced
this extra funding and I'm very grateful
to him for that are you party political
I mean we were you a Labour supporter or
were you open about your politics or I
voted for I've never voted conservative
but I think I voted for a director for
three other parties in the last few
years depending on depending on where
I've been living or who's more likely to
get in and so how do you feel about the
future the health service now is it in
safe hands I feel nervous I feel that
we're we're we're sort of it can go one
of two ways I hope that the government
asks us to put our hands in our pockets
a bit deeper so that the NHS can
continue to do what it was founded to do
71 years ago which is to be free at the
point of service based on clinical need
not based on your bank balance and if it
is to continue to do that then it needs
more money and there's no way around it
and what about all those people who say
of course it needs more money but it's a
bottomless pit you can keep throwing
money into it it's never going to be
good enough we need to change the whole
system but it it worked before I mean
there something changed you know in 2000
around 2010 and then it went from a
system that was that was really good and
also by objective measures like the OECD
and Savia they look at these things it's
an efficient system you know we've got a
significantly better life expectancy
than the state so like you can compare
us to lots of other countries but doing
really well but it did get underfunded
and then things got worse there's a
there's a correlation but it did work
before so when the common law says it's
it's putting in the biggest rise in
health spending you're history
every extra pound what does that mean
every extra pound is a very good thing
and thank you to any politician who's
ever increase the amount of funding in
theatres
however it's now somewhere between three
and four percent in real terms going in
every year so we can now provide the
same service we did the year before what
it doesn't do is make up for the eight
or so lost years where it wasn't getting
enough buy I'll buy huge amounts and so
yes it's good that more money's going in
but it's it isn't it isn't enough - it's
like starving so part improves what
you're saying no can only stand still
with the amount of money that's going in
at the moment correct
and despite pronouncements of you know X
dozen extra hospitals that you know sort
of tens of thousands of extra nurses you
know it needs more money than that to
get us back to where it isn't a
bottomless pit it does get more
expensive every year we know that
populations get older new drugs new
technologies and that's incorporated in
this three or four percent which is
which is what we need and you think
running it this way centrally funded by
government free for everyone at the
point of need is the right way to go
about doing it so there wouldn't be a
more if it because there are all sorts
of things you want to change about the
way doctors are trained yeah but they're
quite revolutionary
can you imagine there being a
revolutionary approach to the NHS I can
imagine quite easily that the NHS will
change to some sort of insurance funded
you know
to tier system and you know you'll be
fine
I'll be fine what jobs you know anytime
there's a two-tier system the people who
suffer the most of the people who have
the least who have the quietest voices
we need to fight for the NHS we need to
if it's privatized it will be done very
stealthily
I think it can and should continue to do
exactly what it was founded to do and I
really honestly do believe that and what
do you think of this privatization
argument because you know services get
very angry constantly being accused of
wanting to privatize the NHS and with
some you know some logic they say this
is a stupid thing to accuse us off you
know why on earth would we want to do
something just erect something that is
so fundamental to the nation something
that everybody believes in that would be
politically catastrophic for you know
you know politicians have been known to
do catastrophic you stupid things
I think the brexit will be disaster for
the NHS and that's where I'm coming from
with that what I'm basically two reasons
first of all is is staffing there's one
thing we do know which is that as soon
as the vote was cast a EU Nationals went
back home and the NHS can't afford to
lose any more stocks and also people of
people who aren't EU nationals people
who are born other corners of the world
are going back because they suddenly
feel unwelcome so you think we'll end up
with more people from India Africa and
those those come in Australia those
countries as a result I don't know
what's going to happen all I know is
that the staffing crisis is getting
worse and worse and worse and the
problem with people going back to Atia
nationals going going back to where they
were born either is a significant
contributor so that's one thing and
another thing the NHS is not for sale
we kept hearing sure I mean there isn't
there's no deal you can do that sells
off you know my local hospital to to
some american organization i don't
believe that's going to happen but drugs
are a huge amount more expensive for the
same drug in the
States and here and the drug companies
with more some drugs and some drugs are
cheaper I I don't have then I don't have
the numbers but I was reading them a
couple of weeks ago and basically the
what the drug bill would look like if we
were subject to us prices would be you
know hugely higher so I dare say that
there are there some up and some down
but from from what I've read it will be
enormous ly costly to the drugs bill and
the money comes from one place you know
it's centrally funded there's not
there's not a separate infinite pool of
money to pay for more money fear
ventolin or whatever and so that if the
money is spent on on drugs because the
because the drug companies want more
more money then that's less to be spent
on everything else I mean this was
obviously an arguments in the election
yes and and what people on the other
side said was well if they're more
expensive in America we won't buy them
from America mm-hmm so why don't know
where we I don't know why where we buy
them from then it isn't my area of
expertise but the reading I because you
know it's sure that it's a bad thing
I mean from my from my reading I'm not
I will never claim to be an expert on
health economics but I'm yet to read an
argument that it's going to be a good
thing for the price of price of drugs I
mean this is a slight dogleg I suppose
the question which was you know what why
do you think there is a suspicion that
conservatives would wreck the NHS when
it would be such a stupid thing to do
politically I don't think they they
necessarily want to wreck the NHS I
think potentially there are people with
with skin in the game who you know who
might benefit from you know an increase
in the in you know insurance or medical
insurance and private hospitals I'm just
slightly your that cynical about the
politicians I'm still about all
politicians but then you have then you
have to I'd like I would absolutely love
to be totally wrong
but I
it was very nervous about the the NHS
you said you having left the profession
still have periods where you miss it and
miss the the reasons you wanted to be a
doctor yeah what did your family think
about you leaving medicine yeah they
were particularly impressed and in
fairness to them I didn't tell them why
I'd left I said I basically said I want
to I want to have a go at writing
whereas because I didn't tell anyone
about what had happened because of the
shame I guess did you feel you had
failed yeah I really did failed because
you'd failed to cope with it
psychologically yeah just I felt a huge
amount of shame for the failure of
because I thought that everyone else was
just coping and how long did it take you
to realize that you haven't failed um
it's actually a read since the books
come out since I've started hearing from
loads and loads of other doctors telling
me their stories are you sure that you
did I mean you don't sound completely
convinced now I'm not oh no I'm not I'm
not actually 100% convinced I do and you
still have doubts
I suggest yeah well I objectively I did
fail I wasn't able to do the job that I
signed up for and I feel very bad about
that but um I know that I'm not the only
one and I know that it wasn't simply my
fault it was also the fact of the system
that isn't very good at supporting and I
think there is a world in which I'd have
been a I'd have been able to be in help
through so how do you see your future
now don't really know it's taking such a
number of turns over the last few years
I don't and I love writing and I'll
continue writing books I've got a a TV
version of my first book coming out the
BBC and ultimately I would love to go
back in some capacity
think I've probably done my last
cesarean section I probably done my last
ward round but if there's something I
can do in a formal way to help with
teaching or help with policy or
something
I'd love to because every author's got
their sell-by date as you know and when
I've reached mine and no one wants to
you know to have me publish anything or
you know be interviewed by them then I'd
like to I I'd like that to be in my
future we've talked a lot about how
you'd like to change medicine and how
you would like to sort of influence
training in the future you know
everybody on this interview gets to sort
of wave a magic wand if you could how
would you change things overnight for
medicine author of the world where for
all my moaning about the NHS we are
extremely lucky with our with our health
in this country on a looking on a global
scale obviously and I suspect that the
world has enough money to to tick over
for everyone to have decent health care
and I don't know their numbers I don't
know if they're if the
multi-billionaires do have enough but I
think probably most of these guys could
make do on 1 billion and so if we
stripped all of that and put it into
world health care I suspect and that
would save more lives than than anything
else and international yeah NHS what
we've got a really great thing and it's
precious and we need to protect it and I
think more countries could could benefit
from it and I I'm sure there's enough
money going around the world to be able
to do that adam kay thank you very much
indeed for coming in and sharing your
ways to change the world and your
remarkable story I hope you enjoyed that
if you did them please do give us a
rating and a review you can watch all of
these ways to change the world
interviews on the Channel 4 News YouTube
channel our producer is rachel evans
until next time bye bye