What does compassion really mean when it comes to improving the NHS?

In one of his more obtuse replies to opponents of the Health and Social Care Bill, David Cameron is apparently going to tell the Tory faithful that ‘true compassion means taking tough decisions’.

As cliché’s go - that’s right up there with ‘no pain no gain’, ‘you always hurt the one you love’ and ‘it isn’t you, it’s me’. Compassion is a strange choice of words to explain what should be a decision based on fact, evidence, expert opinion and realistic forecasting. Unfortunately, just because a decision is tough, it doesn’t mean it is right.

And what about ‘true compassion’? The Oxford English Dictionary defines compassion as ‘sympathetic pity and concern for the sufferings and misfortunes of others’. I guess therefore that true compassion must mean true sympathy.

But what should compassion really mean in the context of NHS reform?

For patients: To be treated with dignity, care, courtesy and respect by every member of the medical profession, allied health professions and administrative staff.

For NHS staff: To be valued, informed and supported. To have your voice heard and your views respected noted and considered within the planning process.

For GPs: To recognise that not all GPs support the Bill. For those who want to form Clinical Commissioning Groups , clear guidelines, soft control, information, education and support. For those who don’t, to be valued for their expertise and commitment to patients, even if they don’t support the Bill

For Medical Colleges (such as Royal College of GPs and Royal College of Surgeons): To stop patronising them or ignoring them and to listen, note and act on their recommendations and concerns.

For consultants: To recognise that they are a vital part of the care pathway, that they are experts in their field and, like most GPs, care deeply for their patients and their clinical teams.

For Andrew Lansley:To accept that he means well but let him down gently and give him the tools (i.e. an experienced, pragmatic and influential team) to sort out the mess of his creation.

For David Cameron: To acknowledge that he thought he was doing the right thing when he handed a £100 billion budget to an intransigent Minister of Health, without realising that he would pass most of it on to just one link in the healthcare chain.

For the general public: To be reassured that their loved ones will be cared for properly, that budgets will be allocated sensibly and that quality will be the driver in every change applied to their state funded health system.

Maybe this on-going conflict between politics and care explains why compassion fatigue is high on the list of contagious diseases right now.