Will Generation Z save the NHS?

Dr Seema Haider on whether or not the newest generation of doctors will break the patterns of general practice, and change the face of the NHS

Recently I met up with my medical school friends and, as expected, the NHS was high on the agenda. As we reminisced about our experiences of training, recurrent themes of race, gender, class, and hierarchy weaved their way through the discourse. While we all trained at the same institution, our lived experience was unique, yet each person’s story remained valid.

We exchanged tales of teaching by humiliation in eminent London hospitals and micro-aggressions of all forms – some we have only come to recognise and label as such now we are senior doctors. There was a palpable feeling that Generation Z would not have tolerated what we had and there was consensus that this demonstrated progress. However, opinions started to diverge when we spoke about Gen Z’s attitude towards work.

This generation seems to have clearer boundaries for workload, and aren’t reticent about enforcing them – much to the ire of their seniors. Some felt their work ethos is in direct conflict with public sector working, inextricably linking the characteristic of going above and beyond to a doctor’s identity and professionalism.

At the same time, it has been galling to see NHS chief executives create such a media raucous about GPs limiting appointments to 25 patients a day. When did GPs become the enemy for simply opting to fulfil their contractual obligations? Sometimes it feels like our dedication to the vocation is spilling into a martyr complex which only serves to feed into this nightmare. 

As the next batch of Gen Z enter the NHS this summer, I am contemplating the extraordinary things they have experienced in their relatively short lifetime – the Great Recession, a digital/social media revolution, and of course a global pandemic. These are experiences that will have shaped their upbringing, impacted their mindset and approach to work and wellbeing.

The first insights into the enigmatic Gen Z are being captured in market research. This has been eagerly awaited by the business world as Gen Z will be powerful consumers and this will have ramifications for economy, politics and of course healthcare. So what do we know about them?

Research shows Gen Z are left leaning and more politicised than millennials, likely a response to the current socio-political landscape. So at the very least, we may expect to see more militant industrial action if working conditions fail to improve. The NHS is a powerful political football so perhaps we will see increasing numbers of doctor MPs which may not be a negative (provided they don’t get sidetracked by the politics game).

Unsurprisingly, Gen Z are also more racially diverse than their predecessors and considered to be the most progressive and liberal in their views – with surprising caveats on gender. There have been some notable leaps with regards to gender equality and racism in the NHS, but I would like to see Gen Z flatten medical hierarchies, weed out workplace inequality, and tackle climate issues within healthcare. The anti-woke among us may snigger at the thought of these left leaning fighters for social justice. Snigger away, I say.

It’s not just their political prowess that is of interest, but also their digital literacy. Gen Z are digital natives; the ‘Amazon Prime’ generation, wanting everything on tap yesterday. Surely they will bring a long awaited digital revolution to the NHS.

Perhaps the biggest challenge we face is supporting the mental wellbeing of Gen Z. This generation hinges their self-worth on social media likes and followers; curating flawless images and perfect lives that can be so far removed from the truth. If you pair their endless doomscrolling with NHS pressures, then this is a potent combination for mental illness. There will inevitably be more sickness, burnout, and ‘Drexit’. We will need a coordinated approach to support the wellbeing in this particularly exposed group of doctors.

Still, it remains a rite of passage in life to be told ‘it wasn’t like this in my day’ and research has also confirmed this tiresome tradition of hating young people, with Millenials forsaking their title as one of the most derided generations in favour of Gen Z. However, during my social media lurking, I have also seen a counter narrative emerging: the sense that older generations have sold out the younger ones. A feeling that they have allowed the profession to be undermined – by allowing GPs to become the house officers for secondary care or more recently the PA debate. This coupled with an inertia and apathy about change has been the final nail in the coffin. This is not to be divisive or create inter-generational war but it was a perspective I hadn’t considered – probably because I was too busy whining about how ‘it wasn’t like this in my day’.

Generational research is complex. Afterall, we cannot make mass generalisations about a population based solely on the year they were born; human beings are far more nuanced than that. But it is hard to notice the patterns exhibited by this new generation and not feel that maybe they are onto something. Afterall, absorbing endless work like a sponge and running the NHS on goodwill has not proved to be a successful strategy. In fact, it has allowed us to be manipulated in quite a profound and insidious way. I believe if we keep doing what we have always done we will get what we always get. Generation Z will do things differently and maybe they will be the change we want to see in the NHS. 

But what do I know – I’m just a millennial snowflake after all.

Dr Seema Haider is a GP Partner in Havering and a freelance writer with an interest in coaching for equity & transformation. You can find her on X (formerly Twitter) @SeemaHaider1