Happy Mother’s Day: Developing a nurturing environment in the NHS

Happy Mother’s Day to all of you.

This week has seen the celebration of International Women’s Day and ends with Mother’s Day in the UK. It has been a week of highs and lows, realising that so much has been achieved but that there is so much more to do to ensure parity for women all over the world and in every career.

Women and men are different, the basic difference is that we bear children. This is an amazing feat of nature and I have two children that make me immensely proud. This natural phenomenon of having children should not define us: women should be able to make the choice to succeed however they wish.

My mother was a great lady and always stated that there should be no reason why I could not do what I wanted to do (just like my father!).

My mother was born in India in the 1940s and lost her father when she was five. Bringing up 6 children as a single mother was a feat for my grandmother, especially when you consider that all six children were university educated in a system where you pay for your education. My mother was caught up in the atrocities when India and Pakistan separated and the whole family moved from Rawalpindi to Ludhiana. She walked with her cousin, crossing the border, seeing killings at first hand, surviving but never forgetting that time. She never really talked about it but just filled up with tears and so this topic was seldom brought up again.

She had wished to do medicine but as one of the oldest had to qualify and start earning, to help put her younger siblings through university. She mastered in politics and geography and rapidly became a Headmistress of a school in India.

My father had moved to the UK and settled in North Wales, finding the people welcoming in Penmaenmawr. In 1965, he returned to India to visit his mother and an unexpected arranged marriage meant that my mother left her fantastic job and returned to the cold, isolated village of Penmaenmawr, with no friends and no job! She tried to break into the teaching system in the UK but her qualifications were not recognised and all the possible jobs were in Birmingham or London.  She became pregnant with me in the second year of marriage and never taught again.

My mother spent her life working hard alongside my father developing skills that she could not have dreamed of doing in her life time. They refurbished a four storey house, developing this into a guest house and shop. My mother learnt to wall paper, put up polystyrene ceiling tiles, paint and sew curtains.

They opened a successful shop, named Wonderland in Penmaenmawr, when holidaying to the North Wales coast was the way to spend your summer! My mother became a stock taker, saleswoman and continued to be a great mother.

She worked on the markets with my father, supporting him and innovating the business. She put three children through school, embedding a culture of nurturing, success through education and responsibilty in all three of us. She loved people and ensured that all our friends were welcome and always well fed and is always remembered for this!

At every stage, when I questioned how I would achieve, she would encourage and just tell me to get on with it! This included my mad decision to become a Surgeon.

When I qualified in 1991 from University of Wales College of Medicine, there were very few female surgeons in Wales. Although I knew that this was the career I wished to pursue, I procrastinated about my career choice in my first year as a doctor. Luckily I had a supportive husband (boyfriend then) and also a great boss. Mr Kieran Horgan, a Breast Consultant and my first boss as a house officer, sat me down over a drink and said’ If you don’t reach for the stars, you will always regret it and wonder, what if…’

I was appointed as the first Calman registrar in Wales and worked hard, delivering 101%, ensuring that no-one could say that I was not up to the standard required. I had two children and returned to work at 12 weeks on both occasions as I did not want to let the team down, but also because I did not feel that I could take any more time away from work. There was no overt pressure to do this but the culture of surgery embedded this internally as there were no other women around me having children and a career in surgery. I was lucky to have supportive colleagues and although there were highs and lows in training, remember this time as hard work but enjoyable.

Just this week, I met up with four previous colleagues from Wales, four of us had worked together as juniors with our Senior Registrar and we came back together on a course. We remembered our time in Wales with happiness and all three females had felt encouraged by our peers. In the background of this picture you will see a painting that hangs in the Royal College of Surgeons of the Court of Examiners. What is striking is that although many of our old bosses are portrayed in this beautiful painting, that they are white and male!

The surgical environment is changing and now 11% of Consultant Surgeons are women but it is still not an easy career choice. Many students are put off by the myths that:

it is hard, a job for the boys, requires sacrifice of motherhood and a relationship, sacrifice of a social life amongst so many others.

 

These myths need to be dispelled as all jobs are hard and one does not become barrister, fashion designer, pilot, a success in business without hard graft. This is no different in Surgery and the difficulty is not based on gender.

What shocks me is that when we have had female Prime Ministers, Heads of Police and Fire Service, Presidents of Colleges, Chairs of Education and Business, female medical students continue to believe that a successful career in surgery is not achievable.

The Twitter campaign #ILookLikeASurgeon showed how women are great surgeons and combining all facets of their life with this ambition. Surgery is open to all and it is our responsibilty as the Surgeons to welcome medical students and foundation trainees into our daily lives, encouraging them by valuing them and supporting their career decisions.

The Royal College Women In Surgery held a successful evening on International Women’s Day this week, where many myths were dispelled by male and female role models. Professor Farah Bhatti is the Chair of WINS and is a great role model.

There are now increasing women in the Court of Examiners, as Chairs of JCST, members of College Council and this is much welcomed.

But surgery is a career that should be open to all and we need to encourage the new generation of Surgeons by embedding a culture delivered by my mother:

A culture of nurturing and supporting,

A culture of success through education and belief

A culture of responsibilty and value in the team

A culture where the belief that the sum of the whole is much more that the individual parts is all encompassing.

These are values that need to be embedded into Surgical Training but also into the NHS as a whole. The recent suggestion that NHS staff may achieve a 6.5% pay rise but at the cost of losing annual leave to balance the pay bill undermines the above culture. Unless there is a dramatic and rapid turn around in the value and belief in the NHS workforce, we will continue to lose amazing individuals that will innovate and advance our healthcare system, which has so far been lauded across the world.