Halt the mass murder of doctors' motivation

Motivation is central to human behaviour. Yet although doctors and nurses begin as some of the most motivated people in the country, the NHS seems hell-bent on annihilating this drive.

How many colleagues can't wait to retire? It is sad to see gifted doctors and nurses desperate to leave - their talents decried, efforts opposed, dedication undermined and motivation stifled.

How does the NHS enervate us so?

First and foremost, it isn't considered sufficient that doctors are trained, motivated and dedicated: we must constantly prove it. In this way politicians and managers decry our professionalism and impugn our integrity.

Then they take advantage of our dedication. How often have they assumed that we will accept more work, yet for no extra reward? They would never adopt the same attitude with a non-professional.

They constantly and publicly belittle GPs' competence and imply that we are selfish, over-paid and not dedicated enough to work longer hours. They ignore our need for rest, and the needs of our families. Next, they fail to support our infrastructure: how many GPs cannot obtain finance for premises? Yet money is always available for inessential management or political purposes.

Finally, they produce change and upheaval, but without progress. The absence of joined-up policy frustrates any remaining drive to improve our abilities, practices and the NHS. For years the government has wanted GPs to become GPSIs. Yet the new Health and Social Care bill risks adding considerable administrative obstacles and the deputy director of the NHS has said publicly that patients want consultants, not GPSIs working on their own.

Contradictory regulations and attitudes like these serve only to destroy doctors' motivation. The DoH may think it has created a well-organised NHS but it has produced a dysfunctional organisation that constantly demoralises its workers.

To motivate doctors and nurses the DoH needs to produce clear goals, have a simple, supportive management structure, publicly value practitioners, encourage them to give of their best and reward them when they deliver. Oh yes - and respect their professionalism. It's not rocket science - but it's beyond Pluto as far as the DoH is concerned.

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