David Zigmond
"If you want good personal healthcare - see a vet."The Perils of Industrialised Healthcare: Exploring the limitations of the King’s Fund report:
“Reforming the NHS from Within”
The King’s Fund’s report Reforming the NHS from Within questions the wisdom of decades of structural reform within the NHS. The report’s author, Professor Chris Ham, argues that a confused cocktail of markets, regulations and targets has detracted from more positive possibilities. He offers a more human account of the kinds of changes that would help strengthen the NHS.
But does the King’s Fund’s critique go far enough?
David Zigmond argues that there are even graver issues to consider. The National Health Service, at its best is about supporting and sustaining thoughtful, caring and knowledgeable relationships between professionals and citizens. But too many managerial initiatives undermine agency and harm relationships. Treating staff like robots, or patients like items on a conveyor belt, is dehumanising and dangerous.
Much more attention needs to be given to the factors that strengthen our relationships:
- Doing things at a human scale – not progressively more giant
- Working with trust and flexibility – not meaningless regulations
- Providing security and freedom – not financial penalties and incentives
Zigmond’s work explores the limits of industrialised healthcare and calls for fresh thinking about how to restore and protect the human dimension of the NHS.
Dr David Zigmond beautifully explains what’s wrong with general practice, writes Dr Zoë Neill
This book is a cri de coeur from the very soul of general practice. That feeling you’ve had about why it all feels so wrong – the answer is here. Industrialised, standardised healthcare with guidelines, protocols and tick boxes has removed the immeasurable but invaluable from general practice. Zigmond (a GP and psychotherapist in Bermondsey) asserts that: ‘the underlying reservoir of alienation, resentment, mistrust and anomie [amongst doctors] remains largely unarticulated, and little understood.’
This book is a journal – vignettes from a lifetime of work in a small room – and is fascinating simply as a book of short stories, snapshot narratives on the lives of doctors and their patients. Inevitably, the themes emerge and coalesce around the central one: that humanity has been eroded out of the practice of medicine. We have lost our humanity: for our patients and for each other, our fellow clinicians. He laments the loss of humane care, ’Compassion may be powerful in effect, but it is fragile in viability: it needs a mindful and respectful space and ambience to survive.’ It is also letters, thoughts and conversations.
Above all, his book serves as a handbook. Its gentle persuasion shows, not tells, that just about everything we’re headed towards is unwise. He recalls the precious liminal space of our consulting rooms, our ability to ‘drink a person in’, detecting with a lifetime’s intuition what might be our role, and recognising that people are people, with complex histories. It is a rallying cry for continuity, for permission to care again. This book is the wisdom of a lifetime but most importantly, this book contains the language for revolt, the vocabulary to articulate your unease and express what really matters. We have all got it wrong, and Zigmond is very clear why.
Rating: 9/10
“This book should be on every health professional’s desk.”
“Read this book with the attention it deserves and you will not see healthcare in the same way again. Be prepared to join The Revolution!
“This remarkable book will invigorate anyone interested in the personal meaning or politics of healthcare.”
Contact
For book sales enquiries:
info@filamentpublishing.com
Information and personal contact:
davidzigmond@icloud.com