National Health Service at 70 - My two penneth.

On the 70th anniversary of the National Health Service, a personal input from the Founder of Highcroft Writing.

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I love the NHS. I love the NHS like I love my home town. It’s far from perfect, but it’s heart is generally in the right place and even on the bad days, when it seems like its stuck together with 70-year-old sticky tape and bandages, I’m proud of it. It’s the old saying, ‘I can call my family whatever the hell I want, because they’re my family… but don’t you even think about calling my family…” That’s how I feel about the NHS.

It has let me down, in quality and in experience, but it has always been there in my lifetime and the prospect of losing it is frankly terrifying.

I was born on the NHS. My mum did all the hard work, obviously, but she had some help from the NHS. I had broken bones treated by the NHS. I had childhood illnesses on the NHS. I had a brief stay in hospital, with suspected concussion, on the NHS. I have had medication subsidised by the NHS. I have had inoculations on the NHS. I have had regular smear tests on the NHS. I have had breast examinations on the NHS. I am still having breast examinations on the NHS. I had infertility checks on the NHS. I gave birth on the NHS. I did all the hard work, obviously, but I had some help from the NHS. I had monthly midwifery appointments on the NHS. I had multiple baby scans on the NHS, more than I would have ideally wanted but all very much appreciated. I had health visitor appointments on the NHS. I won’t go in to the support that has been there for my child or for my wider family over the years, that is their personal information, but suffice to say that I am truly grateful for the NHS.

Plenty of these experiences have been far from ideal. Not every midwife got a thank you. Some, quite frankly, got evil glares and guttural swearing under my breath. Some paediatricians should absolutely rethink their choice of specialism. Some General Practitioners (GPs) need to retire or re-train if reading the NHS website can give you better and more up to date advice, and don’t get me started on the week I had to sleep on a plastic chair next to the hospital bed of my grandmother because they did not seem capable of keeping her safely in the ward. In all these cases I can moan about the service because the service was there.

Yes, I have been paying taxes in to the NHS whilst working, starting all those many years ago, and I could absolutely have been paying in to a private healthcare arrangement instead, but that does not sit with me. I believe in public services. I believe that the things we need as a society, like medical services, fire services and the police etc., can not be run as a business. A business is there to make money. A business is there to deliver a service that is most cost effective for them. A business can decide which cases are too much hassle and too expensive to deal with and to walk away from those deals. An insurance company can argue the contract loopholes to turn away the desperate and needy. I don’t want to put my money in to an arrangement that turns away the desperate and the needy. I do not want to live in the kind of society where you must watch a house burn because the owners weren’t up to date on their fire protection payments. I do not want to live in a society where a parent cannot get lifesaving medication for its child because they lost a job and the medical insurance that went with it.

This is not about other people and their life choices. This is about everyone and the choices we make as a society. You can so easily become that hard-working individual who paid in to an insurance plan for years, who suddenly finds themselves hit by hard times and now an unacceptable proposition to an insurance company. You’re alone. No one will test for, or treat, your cancer. No one will supply the medication that is giving you a quality of life – or keeping you alive.

It’s only my opinion, but I believe that when it’s run as a business it’s run by the wrong ‘bottom line’. In healthcare, the real bottom line should be if it’s the right thing for that person. If you find yourself unemployed, for whatever reason, you don’t suddenly find yourself no longer human and susceptible to the frailties of the human body and mind. In those times, I believe that we need to pick up the slack. We need to be there for each other. Undoubtedly there are people milking a creaking system, the ‘bad apples’ getting free medical services on someone else’s hard-earned taxes, but I don’t believe that’s a good enough reason to pick apart a system born from the right intentions. Pick out the apples, work on the individual trees, just don’t bulldoze the orchard.

I have worked in the public sector, not the NHS, and I have worked in the private sector. I understand the complaints that the public sector has had in the past. The old, ‘they get paid too much’, ‘get too good a pension’, ‘don’t really work as hard as people in the private sector’ and ‘waste public funds’. There are many sides to every situation. Yes, I have seen people in the public sector ‘play the game’ to do the smallest amount of work for the biggest reward - being carried by their hard working and dedicated colleagues. I’ve seen that in the private sector too. The bit here for me, is the hard working and dedicated colleagues. I’ve found that teams in the public sector become more of a team, more of a work family. They do it for the ‘good’. That’s not to say there isn’t camaraderie in the private sector and that people suddenly lose their morals and ideals. I don’t decry that. I’m talking about the nurse who stays on after the shift has ended, to sit with the dying man in his last few hours. The police officer who stays on after their shift to hold the hand of someone trapped in a car until the fire service arrives, and the colleague who swops the next shift, even though it causes them childcare issues, because they know their counterpart, ‘just can’t right now’. The fire officers who are currently battling away heroically on Saddleworth and Winter Hill. Those that walked in to the burning Grenfell Tower. That’s not for the public-sector pension.

The other argument for privatisation that is often raised, is that sometimes the process is harder, more bureaucratic, in the Public Sector. To ‘do something’ about those individuals who are seen to not be working fair, to get access to things, to make purchases - all these processes are seen to be over-engineered. Undoubtedly things will fall foul of an overengineered system, but I’m an advocate of working on the process, not ripping the whole thing out. I can’t see that a transparent process with checks, is always a bad thing. There’s a due process that is followed, to make sure that actions are fair. An employee is given the chance to explain if there are issues, given the chance to improve and, importantly, peers may be allocated to an investigation to be sure that it’s not one employee trying to oust another with rumours and unfair criticism - simply because they don’t like them, or they ‘don’t fit’ with the culture of a team. It’s about being fair and being seen to be fair. Large purchases may require panels, to assess whether money is being spent legally and wisely. They won’t always get things right. Panels are made up of humans too. If a fat-cat benefits from public money? Work against the fat cat, work with the system.

The NHS does not need privatising or removing – in my opinion.

The NHS needs support. The NHS needs ongoing programmes of improvement. The NHS desperately needs financing. The NHS, and the people who work within it, without doubt needs championing.

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