A somewhat personal blog post this week, about how the NHS is failing our children – I felt a need to express how troubled I am by the cuts to children’s services, from both a professional and a personal perspective.
Why I Had To Change My NHS Role
I used to work as a full time speech and language therapist for the NHS, and I never envisaged that I would work in a different way. However, the impact of cuts to funding is ever more apparent and the role of a speech and language therapist is very different now to what it was even five or six years ago. I left the NHS in 2014 without a clear plan of what I was going to do, but feeling strongly that I wanted to work in ways that were no longer possible in the NHS. I have seen many practitioners lose motivation and compassion, just going through the motions of their daily routine having lost touch with why they trained to do this job, and I never want that to be me.
Two years on, I work part time for the NHS (in a different geographical area and in a different role) and also as a part-time private practitioner. I value both my roles very much and have good reasons for working in both sectors. I cannot do direct work in the NHS as this has been cut back so much, but I can do this as a private practitioner. I work with some wonderful children, families and professionals and I can do my job in the way that I want to do it with no restrictions on me. I am very much a team player, I do not like to work alone and I love the team I work for in the NHS. Despite the challenges of working for the NHS, they are always positive, always striving to help our clients and I have the utmost respect for them. I work with a highly skilled Consultant Paediatrician, and I learn something every day, which enhances my skills and knowledge. I love both parts of my job.
A Skeleton Service
However, for the first time ever, I have felt ashamed to say that I work for the NHS. I feel a growing confusion about what is happening to many services and what this means for children and their families. Services like CAMHS (Child and Adolescent Mental Health Services), Occupational Therapy, Speech and Language Therapy, and Educational Psychology have been chipped away so much that there is not much left, just a skeleton of a service with no meat on its bones to meet the needs of those that need help. It is soul destroying to meet families who are passed from pillar to post only to find all doors are closed to them.
The Impact of NHS Cuts to Children’s Services
Try as we might as practitioners, many services are no longer needs driven, strict care pathways dictate what a service can offer and those cannot be veered from. For parents to get their children onto the case load of most services (and I am not just referring to speech and language therapy caseloads) is a huge hurdle with no guarantee of getting any help. The papers are full of stories showing very clearly the impact of cuts to CAMHS. Where I live, families have told me that they have waited a year or more for speech and language therapy on the NHS and then they might get four sessions and they are discharged. Many trusts have no social communication pathway, so if your child has autism or social communication difficulties you have to work that one out yourself. And some parents do. I have met fantastic parents who have figured out what helps their child and put this into place. One amazing mother worked out that her child responded most when she copied him and joined him in his world, rather than trying to force him into hers. She told me that she lay down on the floor in Asda with him and copied what he was doing! Actually, without knowing it she was using an approach called Intensive Interaction – clever mummy!
A Box-Ticking Culture
All services are putting more and more onus on families and schools and for many of us our roles are shrinking. People don’t realise how far ranging the cuts to the NHS are and the impact they are having unless they have a child who needs help. The bottom line is cost, funding, and it can feel like the child has been forgotten. The child is rarely at the heart of decision-making, and the men in suits do not care about a child’s well being. They care about money, saving money. Ticking the box to show what an effective service they are, even though they do very little contact work with children and families and offer very few support sessions.
Cuts, Restrictions, Funding Difficulties, and Low Morale
How can you work in mental health and not understand a parent’s pain? How can you work with very unstable and complex children and not see their difficulties? How can you think it is ok to deny funding to help these children? But it happens all the time, you only have to look at the front page of the papers, you only have to turn on the radio. The NHS is a shadow of what it once was and an uncaring culture is growing through certain parts of it like a rampant weed. Of course, there are many amazing, deeply caring and committed professionals within the NHS and I am lucky to work with many of these. However, they often stand out like a shining beacon against a depressing backdrop of cuts, restrictions, funding difficulties and low morale. I hope things will improve, but the disparity between the quality of services in big cities and in rural areas seems to be growing. It is a postcode lottery.
Have You Been Affected?
I know that many parents and children I see have been affected by the cuts to NHS services. I have a sympathetic MP who is trying to help my own family, and I would urge anyone who feels strongly about cuts to services to contact their MP and express their concern. Now more than ever, it is important for parents’ voices to be heard, to stand up for our children who are being failed so abysmally. Write to your director of NHS services, write to your MP, write to your local paper, and let’s hope we can restore the NHS to the one that we used to be proud of.