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Letters To The Other Chair

Dear NHS…

Dear NHS,

It’s not you, it’s me. Or at least I thought it was for a long time. The inability to get everything done within the working week; constantly worrying about the never shrinking to do list. I thought it was all about me and my failings – and given my vulnerability to feeling this way, I just worked harder. And harder. Until things changed. 

Major life events have a way of doing this to you. They tip everything on its head and force you re-evaluate. Becoming a parent, losing a child and parenting so soon after loss – they all made my skin paper thin. They left me feeling all the things that overworking had locked away. They helped me to see what I could and could not do. And more importantly they showed me that my well-being mattered too.

I love my career. It is something that defines me as a person.  In fact, I’ve dedicated so much of my life to training and working in psychology, that I don’t know who I am without it. The NHS has played the biggest part of this: almost fifteen and a half years, seven Mental Health Trusts, twelve placements / jobs all over the country and many, many clients. I’ve worked with adults, with children, in secure forensic wards and prison, in the community and in people’s homes. I started before the major salary restructures, before the recent years of austerity and I have seen services cut, cut and cut again, with staff being asked to do more and more with less. Or, worse still, learning to say no and close the doors to those who need it most.

Guilt becomes part of the work.  Guilt that you cannot give people what they need.  Guilt that you cannot do what you are trained to do. You dread the conversations about waiting times, about endings and about thresholds.  You desperately look for something or somewhere to fill the gaps between services, the huge gaping holes down which those in need fall.  You try to refer on to somewhere else in the desperate hope that they will have the space and capacity to help, whilst knowing that this is just shifting the issue.  So much need, so little resource.  And that resource is another group of humans desperately giving everything they have of themselves to help others.

And this is where I struggle with the romanticizing of the NHS.  Of course, I wholeheartedly believe that we are lucky to have it, having been a patient as well as a member of staff.  But the reality of being an insider is so very different.  The relationship between you and the system can be complex, and at times abusive.  Overworking becomes the norm; not because flexibility isn’t an option, but because the need is so huge.  Colossal. People in the public sector don’t overwork because this will lead to bigger and better things for themselves –  they do it because if they don’t, then people do not get the care they need.  Matters of life and death are real, even in mental health services.  Anxiety and stress is high and feelings of inadequacy and ineffectiveness can creep in.  You can become squeezed, stretched, burdened and at constant risk of burn out.

As a manager, you become trapped between the needs of your staff and the demands of the higher beings. It is a place where you cannot win and where you can forever feel like the bad guy. Often feeling as though you are letting people down. Never getting anything right. And how can that not leak into your confidence? How can that not impact on your desire to make a difference? Because ultimately this is what drives almost everyone in a caring profession.

I have toyed with the idea of leaving for so long, but where do you go? And how do you manage the sense that you have let people down and abandoned those in need?  It is like trying to escape a complex relationship – one where you try to convince yourself that it will get better, yet knowing deep in your heart that this is unlikely.  Impossible until there are more resources. And then more resources again.

My recent positions have shown me the positive impact of being able to work dynamically, to find new and innovative ways to help communities outside of the confines of the therapy room.  I’ve been so lucky to have these opportunities, and they have undoubtedly extended my NHS career as a result.  They don’t fix everything, but they can and do make a difference.

And for the first time, I feel brave enough to take a leap and do this by myself.

I am not leaving because I hate my job – far, far from it.  But I am leaving before the job breaks me and therefore my family.  I love what the NHS stands for with all my heart, but love isn’t always enough.  Love doesn’t always make things right.  And life has taught me that there are options.  Loss has shown me that I can be courageous and take bold moves.

So, NHS, when I say it’s not you, it’s me, I think I actually mean it. But now it’s not about failings or an inability to make this work. It’s about me learning to put myself and my family first. To trust my instincts and my confidence that I am able to do something different.

And finally, after much emotional turmoil and working through this decision, I think I’m okay with that.

Therefore NHS, for now at least, it’s goodbye. I just hope that what I have planned will go some way to ease even a slice of pressure you carry each day.

Michelle x

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