Medicine is a ‘profession in crisis’, says former junior doctor Adam Kay at the Book Festival

When Adam Kay left medicine in 2010 “...no one left medicine. I was this glitch in the matrix. Now I can’t look on social media without seeing brilliant doctors leaving. It’s a profession in crisis.”   The comedy writer and performer was speaking today at the Book Festival, to promote his bestselling memoir This is Going to Hurt.

Based on diaries he wrote while working as a junior doctor, the book depicts him and his colleagues as poorly paid, undervalued and neglected professionals. From his current outside position, and the ongoing feedback he receives from other doctors, he believes the NHS is now “a very different place” from when he left it. And not in a good way.

The solution, though, is simple. “It comes down to money,” he said. “Historically the NHS had what was called ‘Health Inflation’, what it cost year-on-year to provide the same services. Health Inflation is about 3% in real terms. Over the last eight years it got 1%. Independent think tanks of all political colours have said it now needs 4%; it got less than 4% in this ‘Brexit Dividend’. It needs more money. It’s had eight years of underfunding. The NHS is fit for purpose. Of course there are efficiencies that can help it, but without proper investment the NHS can’t function.

“What we need to do as a country is have a big grown up discussion: what do we want the NHS to provide, and how do you want to pay for it? If we want the NHS to provide everything, un-rationed, and not sort of ‘knocking the corners off’ – and that’s what I hope we want to do – then I think we’re a rich country, we can afford this. It’s malicious when they say we can’t afford it. We can.”

Kay’s firmly of the opinion that no politician should be put in charge of the Department of Health without spending at least a full shift genuinely working on the hospital front line. He also believes that more needs to be done to consider the mental health of everyone working in the NHS – regardless of what some, older doctors might think about “manning up”. 

“America does medicine almost completely wrong, but the one thing they get totally right is that medicine is pretty much a post-graduate degree. Whereas here, you decide when you choose your A-levels when you’re 16—a very bad age to decide anything, let alone what you’ll have to do for the next 40 years of your working life.”

Kay’s career as a doctor ended after a medical procedure went horribly – albeit unavoidably – wrong. “The feeling is that you just have to somehow deal with it,” he explained. “But I didn’t deal with it. In truth, I probably couldn’t deal with it. I wasn’t convinced I wanted to be the kind of person who could just compress these thoughts away and push them down.

“I realised then that I could never deal with that happening to me again. So I quit medicine.”