Goodbye NHS – we miss you now you’re gone

The NHS will last as long as there are folk left with the faith to fight for it - Nye BevanWould I lose my job to save the NHS? Yes, in a heartbeat. In a fraction of a heartbeat. Even in this shitty economy with the shitty attacks on the unemployed. If that was all it took to save the NHS I would be typing my notice now.

Would I lose my job in a futile gesture of distress that will be ignored by a minority government with no mandate for what they are doing? Well, no. And it is eating me up. Which is why I am typing this at half past four in the morning.

Today the NHS is 65 years old.

Earlier this year the Tory government and their Lib Dem partners killed it.

In April, the coalition government passed legislation which means that NHS service provision must be put out to tender and so hefty percentage of every pound spent on healthcare in this country must go into the pockets of the likes of Richard Branson and the MPs with financial interests in UK healthcare companies. They were kids voting for Christmas. They passed this legislation despite the fact it was not in their manifesto and they have no mandate to do so. The media were silent while they did it; the good guys found the story too complicated to tell, the frightened guys were silent because they were cowed by the Leveson inquiry, and the venal guys were lined up side by side with the MPs and their friends in the healthcare companies.

The NHS was imperfect, especially after so many years being undermined by New Labour. But it is no where near as imperfect as the smear stories masquerading as news items these last five years would have you believe. The smear stories are propaganda designed to let us assume that it’s not worth saving.

The thing is, if you ask the question “what do we do about the NHS?” the answer must not be “sell it off to the lowest bidder”. We are already seeing that profit-taking companies fail to provide an improved service, that they actually provide worse services, and that they force people who work in the most emotionally demanding jobs in the world to work in perpetual crisis mode. This is not only bleeding patients for profit, it is bullying staff for profit too.

Today those who care to fight for free healthcare for all are marching for the NHS. But I can’t be with them because I have a presentation to give on Monday, and I lost three days this week to migraine, and I am not prepared to lose my job in a futile gesture.

I’ve marched three times in recent years, each time against the Labour government, once for peace, and twice to protest their ignorant destruction of rural life. I did not feel as hopeless then as I do now. But what I learned is that a government driven by dogma will ignore a million peaceful people in the streets. And revolutions since the start of time show that raging mobs produce governments no better than the ones they overthrow.

Democracy is broken. I don’t know if it ever really worked but here it is broken. MPs milk the system for expenses and sell their votes and influence to whoever will pay them. The whores I’ve known have all been infinitely more honest.

What frightens me is that there is no place in the world and no time in the world that I can think of where freedom has been sustained. I think of all those acts of British rebellion from Wat Tyler, to the Levellers, to the Luddites, to the Rebakkah Rioters, to the Jarrow Marchers, to the General Strike of 1929, to the Miners in the 1980s, to the million of us who marched for peace in 2001, and know that all the government have to do is say “la la la, we can’t hear you”. The only way to overturn an established order, it seems, is over their dead bodies, and that’s no solution.

I have come to suspect that the stirling example and unprecedented experiment in justice and social democracy of Europe in the last 65 years was only possible after the shock of a world war, and a war in which fascism was defeated by the collective actions of coalition governments. By, in fact, the will of the people.

The late 1940s were, I suspect, the only moment in history when the NHS could be established, when enough people were used to acting in consort for the greater good of their fellow men and women. At every time before and since we have been fractured into little silos of selfishness and self-interest.

And today I will go to work to keep my job, because I no longer believe that peaceful protest works. And when the election comes round, I shall cast my vote because, like a beleaguered spouse, I keep faith with democracy though I no longer trust it.

And now I shall take some triptanes (which cost me nothing) and some asprin (which cost me 35p) and go back to bed because crying gives me migraines, and migraines are the reason I can’t go to London in the first place.

PS – apologies for spelling mistakes and typos.  This piece is posted as written, which is something I never do these days.

3 responses to “Goodbye NHS – we miss you now you’re gone

  1. I hope the head is better, Ben. Everything you say about the NHS has some truth in it and dodging migraines in the middle of the night shows your dedication. You have the right temperament to make a good junior doctor, traipsing around the wards in darkness. I don’t think you have the Whole Story right however.

    Let me tell you about yesterday. In the morning I had the pleasure of talking with a senior doctor in NHS England (The Commissioning Board). He told me how they had rewritten the Health and Social Care Act to bring in requirements over and above those envisaged by the Tories (something I had suspected, when I read the Act). The statutory duty to tackle health inequalities was allowed to pass into law and is now informing plans across the country. NHS England recognise that too much political interference in healthcare planning is not helpful and they are trying to distance themselves from government to a degree, which is difficult to do, as you will understand.

    In the afternoon, I attended our CCG Governing Body meeting in public. We approved changes to our Risk Register that included making provision for the risk that national policies might get in the way of local priorities.

    In spite of some cynicism among us older folks, who feel we have seen it all before, there is a huge amount of energy and real dedication to getting the best for our patients. I don’t think the system is quite as good as it could be, or should be. In particular, I think a lot of the mechanisms for change are so involved that they often hinder rather than facilitate change. There are actually quite a few things that I would like to see improved. Some of these will happen, with a lot of work; some cannot happen for reasons of financial or political constraint.

    Nonetheless, I do feel that the NHS in England is in very much better shape than you make out. And I really do wish you some good night’s sleep without headaches.

    • I find this hugely encouraging. Really encouraging. What I am affeard of is the power passing to the non medical owners of the services. And it people finding it has happened when it is Too Late. There is no unnuanced truth about a single person, let alone the health service of a medium sized country. It is hugely encouraging to know practitioners are fixing the NHS. I certainly don’t trust any politicians with it. Oy vey but I am worn out and cynical these days. It’s good to see something to be hopeful about.

  2. The government seems to be doing a marvellous job of cutting, smearing and generally damaging some of the insitutions which we should be most proud of – the public library service as well as the NHS, and I’m sure there are others. I haven’t marched, but I have signed petitions, written to my MP (and received maddening responses) and so on.

    However, I spend a large part of my working life with people who work for, once worked for or hope to work for the NHS. I don’t know a single health student who hopes for a non-NHS job when they graduate (though some will inevitably end up in one), and I find that quite heartening. Even more heartening is the absolute determination of people in the health sector to ensure that patients (or whatever the government says we should call patients today) receive the best possible care. Nurses don’t need to be taught Compassion – from where I stand, they have bucketloads of it. I could not do their job, and I admire them immensely. I truly hope that the NHS will survive this attack, and continue to do its bloody good job for a long time to come.

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