Our National Health Service was 69 years old on July 5th.
I missed the occasion on social media as I was occupied with other health matters. July 5th was the first of my fourteen days of chemotherapy tablets. But catching up later, there were some lovely and well deserved tributes to our NHS on Facebook, Twitter and various websites.
My first encounter with our NHS was at birth.
When I was a baby my dad’s special name for me was “Workus” because he always said that I’d been born in Barnsley workhouse. In a way this was true because the maternity hospital where I was born was situated in the infirmary building of the old workhouse. By the early 1950s the infirmary and other workhouse buildings had become part of the NHS. Fortunately, the nick-name didn’t stick!
Over the next few years I had the usual childhood ailments and visits to the doctor. Measles was common in the 1950s and I had it quite badly in early childhood. Polio and diptheria were still rampant and cases of polio could climb as high as 8000 in epidemic years, with cases of diphtheria as high as 70000 resulting in 5000 deaths. Fortunately in 1958 our NHS introduced polio and diphtheria vaccines from which I and thousands of other children benefited.
I also had persistent tonsillitis and in 1957 went into hospital to have my tonsils and adenoids removed.
Children in hospital were usually treated alongside adults. Child patients were only allowed to see their parents for an hour on Saturdays and Sundays and there were few attempts to explain to them why they were there or what was going to happen. That was certainly my experience when I went to hospital for the tonsillectomy. Fortunately paediatricians Sir James Spence in Newcastle and Alan Moncriff at Great Ormond Street began to take steps to change this. They showed that separation from parents was traumatic for children and, as a result, daily visiting was introduced. Dedicated children’s wards were introduced too and by the mid Sixties when my younger sister went for her tonsils out, the arrangements were much more as we’d expect to see today.
I gradually forgot about my childhood hospital experience and didn’t need to stay in hospital again until 1983.
However, in 1960 I became a recipient of one of the worst NHS offers of all time.
Not that there’s anything wrong with ensuring that all children have their eyesight checked regularly and providing glasses if necessary.
But the horrible, little, round, wire frames covered in flesh-coloured plastic with flexi-wire hooks round the ears were awful. The specs may well have improved vision but who wanted to wear them?
“Specky Four Eyes!” was an oft repeated playground chant and a favourite playground game was to chase the specs-wearer with a view to snatching the glasses and running off with them. Surreptitious pointing at the specs-wearer in the classroom and making circles with fingers round eyes when the teacher wasn’t looking ensured that the new specs were quickly discarded.
In addition to being a massive design failure the NHS specs were indestructible. Twisting the ear hooks just made them lop-sided; the screws holding the specs together were irremovable; thrown out of the bedroom window they merely bounced; and two bricks piled on top of them had no effect whatsoever. Fortunately, secondary school brought the present of a leather satchel from my grandparents: ideal for hiding the offending specs from the start of the school day to the end. Eventually I progressed to some more sophisticated frames with Edna Everidge wings and later on in the Sixties some super-cool black frames.
One of my favourite books is “The Britain I Want” by E. Shinwell MP.
The book was written in 1943 and it’s a fascinating indication of the Labour Party’s emerging plans for post-WW2 reconstruction and transformation. I’ve read “The Britain I Want” several times over the years and never fail to find some new insights within its pages. I always like this quote Shinwell made from the Beveridge Report:
“Restoration of a sick person to health is a duty of the State and prior to any other consideration.”
And this example of Shinwell’s own words still resonate today:
“There is nowadays a great awakening of the national conscience to an awareness of the social and economic horrors of the past. A fire has been lit that in its cleansing power will turn the minds of all right-minded men and women away from the filth, gross injustice and sheer inhumanity of the unthinking past, and give to social security the driving power and inspiration of a living gospel. In this conception there is no room for compromise and the hypocritical shufflings of half measures, no temporising with the grim monster of want, and no countenancing of moral and governmental cowardice.”
Of course, the book is no longer in print but second-hand copies appear in on-line bookshops from time to time. My copy was originally owned by Mr William P. Inglis who lived at 17, Partickhill Road, London, W1 according to the inscription in the flyleaf. The book is hard-back and still has its original dust-jacket. A real treasure!
My parents brought me up on tales of the Means Test and life before the welfare state.
My political education started early and I understood from a young age that political choices determine the nature of the society in which we live. It’s interesting to look back at the ups and downs of our NHS matched against the political orientation of the government of the day.
My recent experience of our NHS has been of the very best. I’ve gone from a referral by my GP for an ultra-sound scan to completing my first three-week cycle of chemotherapy in just eleven weeks.
As I explained in Don’t Leave It Too Late, I was feeling perfectly healthy on May 5th and had a cancer diagnosis by June 19th. In addition to the ultra-sound scan I’ve had X-rays; a CT scan; a PET scan; an ambulance journey between hospitals; talks with five different consultants; a colonoscopy and an endoscopy; several hours in A&E; and countless blood tests. That was all within 33 days and I’ve spent the last three weeks having my first cycle of chemotherapy. In addition to the Prickly Bottom, I’ve had eight chemotherapy tablets at home each day for fourteen days followed by seven rest days to allow my body time to recover and prepare for the next cycle.
I don’t know what the outcome of the treatment will be as the primary cancer has spread to other parts of my body. But this I do know:
the treatment I’ve received from our NHS has been exemplary
and nothing more could have been done to expedite my diagnosis and get me into treatment as quickly as possible.
And along the way I’ve met the most fantastic people. Whatever their role and responsibilities, I’ve experienced nothing but the highest professionalism, kindness and consideration from the doctors, nurses, technicians and support services staff that I’ve encountered in our NHS.
Our NHS is amazing and it’s because of the wonderful staff who give it their all.
Of course, the strain our NHS is under is clearly visible. I’ve experienced trolley queues in A&E; delays to appointments; and worryingly long waiting times for appointments for scans. The reason my progress through the system has been so rapid is because I’ve been offered last minute cancellations for scans and consultations when other patients were unable to attend and I was able to change my plans and take whatever appointment was offered.
I’ve also observed patients waiting too long for attention from staff while the same staff are rushed off their feet trying to attend to everyone’s needs. And an agency nurse taking charge of a ward for the night shift having never been on the ward before. And the bed system blocked because a specialist bed needed cleaning and there was a lack of staff to undertake the work. Consequently two patients couldn’t be moved into other beds and I was admitted to mine at midnight.
I’m not complaining. I’m very grateful to have been diagnosed and moved into treatment so rapidly. But the effect of insufficient staff and insufficient capacity for the increasing demand is there for all to see. And it’s not as if the increasing elderly population has occurred as a surprise. My generation wasn’t labelled the baby-boomers for nothing!
And then there’s the creeping privatisation;
I knew that many functions of our NHS have been out-sourced and privatised but I hadn’t realised the extent until my recent hospital visits. Here’s just one example:
One of the consultants referred me for a PET scan. Positron emission tomography (PET) scans are used to produce detailed three-dimensional images of the inside of the body. The scan uses radio-active tracers in a special dye which is injected into a vein and absorbed into the body. The resulting images show if there are any cancer cells and where in the body they’re lurking.
In January 2015, a company called Alliance Medical won a ten-year NHS contract to provide PET scanning services across 30 locations in England. You can read Alliance Medical’s announcement of their new contract here. The contract NHS England gave to Alliance Medical wasn’t universally appreciated as this report in The Stoke Sentinel demonstrates.
I duly turned up for my PET scan which was undertaken in an Alliance Medical unit situated within our large regional hospital. Subsequently I googled Alliance Medical and discovered some additional information to that outlined above. On the Companies House website, Alliance Medical’s Annual Report and Financial Statement for 2016 show that the company is doing very nicely. On page 3 the report says that “The improved business performance during the year is as a result of the PET contract won by the Company at the end of 2015.” The company profit for the year amounted to £42.7 million and dividends were paid amounting to £105.5 million. In November 2016 Alliance Medical was sold to Life UK Healthcare for a reported $727 million.
We’ve gone a long way down the privatisation road since the Thatcher government introduced the contracting out of cleaning, laundry and catering services. Public money for private profit has always seemed wrong to me but my recent experiences have made me realise it’s gone way further than I ever imagined.
the asset stripping;
Do you know about the Naylor Report which the present government accepted prior to the recent General Election. That’s the report which advocates selling off to developers land owned by our NHS which is supposedly surplus to requirements. Valued between £1.8 and £2.7 billion the Naylor Report devotes a whole chapter to how our NHS could be encouraged and incentivised to flog off the estate because apparently there is reluctance in many areas to join in the sale of the century.
Are you familiar with the NHS Sustainability and Transformation Plan for your area? Do you remember voting for it? No, me neither! But whatever your local health authority is planning for your area is in its STP ( if you can find it and make any sense of it!)
I’m not the only sceptic.
“It is a con trick designed to turn public property into private wealth,” says Calderdale and Kirklees 999Call for the NHS.
And meanwhile the big corporates like Capita are queuing up to lend a helping hand.
The King’s Fund, together with the Health Foundation, have reported that the NHS surplus estate, which is immediately saleable, could be worth as much as £700 million. Department of Health data suggests more than 900 football pitches-worth of land owned by the NHS could also be surplus to requirements; the Surplus Land programme will seek to mobilise disposal and ensure capital receipts are realised for the health economy.
There is clearly a need and an opportunity to reduce the existing estate, to release capacity for additional housing and complementary care facilities, but it needs to be done without adversely impacting services or patients.
Read more of Capita’s advice for unlocking the potential of the NHS estate.
With the disastrous sell-off of the Royal Mail at an estimated £1 billion less than it was worth, how can we be assured that proposals to sell our NHS land (even if they are justified) will be for its true value?
You might like to check out the We Own It website and join their campaign to halt the privatisation of NHS Professionals, the in-house employment agency which saves our NHS millions of pounds each year.
and the ludicrous friends and family test.
Whoever was the idiot who thought up the friends and family test? I first came across it about a year ago when our GP’s surgery was going through an inspection. The practice nurse gave us an A5 postcard with the question “How likely are you to recommend our service to friends and family if they needed similar care or treatment?” The answer was a ranking from “extremely likely” to “extremely unlikely”. We filled the form in and added a comment thinking this was part of the inspection process as the nurse said it would be helpful to the surgery if the survey was completed.
Fair enough; not a very good way to construct a survey with a self-selecting set of respondents and such a subjective criteria but the sort of thing you expect from an inspection regime.
Except that the friends and family test isn’t just used during an inspection. Subsequently I’ve noticed the cards are available all the time at the GP’s surgery with a request to complete them on every visit. I’ve just looked up my current GP’s surgery and there is one – yes, one – rating. And the surgery we were attending during their inspection, despite their efforts to promote the survey, has 8 ratings.
However, it doesn’t stop there because hospital departments also use the survey and pursue responses with much greater diligence than the surgeries. In addition to the A5 card I’ve seen patients preparing for discharge from the ward presented with an iPad and asked to complete the survey on-line. Great! You’re about to go home after major surgery and you get that to contend with. The worst example was the telephone call I received the day after I’d met the consultant and received my cancer diagnosis. I recognised the telephone code and first numbers as a call from the hospital. My heart leapt! They’ve made a mistake I thought and are ringing to tell me it’s all been a bad dream. No, it was an automated message asking me to complete the friends and family survey. I slammed the phone down with some choice words only to hear the phone ringing again with the same request for an answer to the survey question. Tactless and insensitive, or what? An administrator hands out the A5 card in the chemotherapy unit. Would you recommend our service to your family and friends? Yes, of course I would if they needed it. You’re doing a great job. But right at this minute, I just want to go home.
This is not the way to collect information about the effectiveness of our NHS. This really is bureaucracy gone mad. The survey can’t possibly provide accurate or useful data. It’s just a tick box exercise that generates some numbers that can only be worthless. It’s a cheap and crude tool that does no good to anyone important i.e the patients or the staff. I don’t blame the admin staff: they’re only doing the work they’ve been given by management. But management at the highest level should re-think this one and in my opinion, scrap it.
I’m grateful to my dad and both my sets of grandparents for voting Labour in 1945 to get our NHS started.
(My mum wasn’t old enough to vote in 1945 as she wasn’t twenty one, the voting age at the time. But if she’d been able she would have voted for Labour’s NHS too.)
Huffington Post published a good blogpost on July 5th with five mind-blowing facts about our NHS. I’m sure there are some aspects of our NHS that past generations wouldn’t recognise. But the core principle that our NHS is a public, not-for-profit service free to all when needed remains the same to this day. And hopefully enough people in NHS campaigning and support groups, the Labour Party and the voting public will keep up the pressure on the government to keep it that way.
A belated Happy 69th Birthday to our NHS and I hope I’m still here next year to celebrate the 70th anniversary. Meanwhile here’s a clip from the 2012 Olympics tribute to our wonderful NHS.
Thanks for reading my blog today.
And thanks for the blog comments, Twitter messages and emails offering me support and encouragement. I had my blood tests this morning and am expecting to start my second cycle of chemotherapy tomorrow. So, when you’re eating lunch I’ll probably be getting another prickly bottom!