Screwed up

Emily is the mother of one of my patients. She's from the north east of England, somewhere near Morpeth. Emily's parents, both in their late sixties, have come to stay for three months because Emily's expecting another baby. She brought them into clinic with her yesterday and they were suprised to be greeted by a fellow northener when I went to meet them in reception.

Her mother, Joyce, linked me by the arm and called me "pet" as we walked back down to my office. "Whay they're saying it's chilly but it's fine as far as I can tell" she said.

"Oh I don't know" I replied. "I went to bed in walking socks last night - the sort you buy in a shop in the lake district. It's warmer outside than in half the time - there's no heating in the houses". I can say this now because everyone but me is on annual leave this week.

Her husband, John wanted to know if I was going to stay. He can see the attraction but he knows from Emily's experience that it's not easy to start all over again, even if you're doing it to give the kids a better life.

"Thing is though" he said "there's such optimism here. We come over every year if we can and we always feel a sense of, I don't know what you'd call it, future I suppose. Things in the UK, well, I've never known them so bad. The government has screwed up and they know it. Deep down, they know it. Everyone's wondering how much worse things can get and thinking surely something's got to give soon. Problem is, there's no alternative - the tories are in no state to run things either".

Emily chipped in. "I know a family in Canberra who came to live here because their child had health needs and the NHS hadn't been able to provide for them. And they were podiatrists working in the NHS and they were fed up. It was stuff like speech therapy and equipment for their little boy they needed. Imagine that - giving up your whole life and coming down here because of the state of the health service. They've been here a couple of years but now I hear they're going back because they miss their family and friends"

"Well they'll have a shock then" was all I could think to say. In a country where I have a caseload of four or five children to see on two days a week, where I can give proper time and attention and make a real difference to their outcomes, to whether they can cope with mainstream school, it's hard to imagine the 25 kids I was juggling on three days a week at home and anyone who's ever run a community clinic single handed will tell you that's a small caseload, 75-100 would be nearer the average. I can't remember the last time I felt I'd made a difference to outcomes for a child, I just went into mainstream schools knowing the teachers didn't have the time to do what I'd asked, even if they had the inclination. And that was when they hadn't forgotten I was coming.

It's not hard to see why British health workers are considering moving down under in droves. In the past six months, two of my former colleagues have relocated to Australia and New Zealand, which is great for those countries because they didn't pay for their training. If you don't already read the link to NHSdoctor on the top right, you should have a look.