Without the NHS I would not be writing this today. They have saved my life on three occasions, and provided other care and treatment on more times than I can remember. The NHS is also responsible for one of the proudest days of my life. This happened fifteen years ago when I started working for it. I have seen many changes over those amazing fifteen years; some of which have been good, many more than have not been, and some that have been absolutely outrageous.
The current funding crisis – and it is an underfunding issue as opposed to an overspending one – coupled with the junior doctor’s dispute, has led me consider the kind of health provision that I want.
I want a National Health Service that is publicly run. I don’t want Virgin Care, BUPA, or G4S. One that is free at the point of delivery; that is paid for by National Insurance contributions, that can be topped up by people willing and able to pay more. I want an NHS that is funded fully by the government of the day, regardless of the colour of their ties, that is the priority ahead of all government departments, and that doesn’t require charity to supplement areas of deficit.
I want an NHS that is free from archaic, arbitrary, and unrealistic tick-box targets that are used to weaponise healthcare, to play party political games, and to demonise health workers for political leverage. One that is free from political and media spin, and from spurious claims of it being an ‘unsustainable’ relic. There is nothing more important than the health of the nation. By definition, it cannot be unsustainable. Endless global war, conquests and white elephant vanity projects are unsustainable; not the NHS that I want to see.
I want an NHS free from the tentacles of private health companies that, as sure as night follows day, place the creation of wealth for their shareholders above the care of their patients. One that isn’t a cash-cow for the private sector to milk, that isn’t for them to cherry pick profitable areas that they then cast aside when the money dries up. I want an NHS that is emancipated from the shackles of damaging PFI deals that have left it with an estate of inadequately built facilities and decades of crippling debt; the repayments of which eat up most of any increase in annual funding.
I want an NHS free from US-style insurance companies that regularly move heaven and earth to avoid paying for their subscribers medical expenses. Nor do I want to be a ‘subscriber’. I want an NHS that isn’t subservient to parasitic big-pharma that make billions off the backs of human misery and suffering and who try to protect profitable monopolies by gerrymandering and blocking generic medicines. One that recognises that big-pharma needs it just as much as it needs big-pharma. There should be a rebalancing of the relationship and of pricing.
I want an NHS that values its workers, that treats and pays them properly, that doesn’t breach the terms of their contracts when it suits them, that doesn’t demote people to save money and that doesn’t allow clinical areas to run with dangerous levels of staffing. One that doesn’t expect workers to provide hundreds of hours of unpaid overtime every year, but one that gives people permanent contracts, that trains sufficient numbers of staff, that provides trainee health professionals with bursaries, that promotes a healthy work-life balance, that doesn’t treat workers and trade unions fighting for improvements as spoilers and as people who don’t care about patients or their care. I want an NHS that values people, training, skills, and experience.
I want an NHS free from senior management control-freakery and bullying cultures. One that is open and honest, that encourages staff and patient concerns, that protects whistle-blowers. One that has sufficient beds, that isn’t a post code lottery, that gives mental health services the parity of esteem it has desperately required for so long, that treats older people with respect and dignity, and not as bed blockers. I want an NHS that doesn’t close A&E departments, maternity units, and mental health facilities by stealth by cooking the books, and in the face of huge local opposition. I want an NHS that is democratised, that gives people a genuine say in how it is run; from top to bottom.
I want the NHS that facilitated my arrival into this world, that vaccinated me, that measured and weighed me, that tested my hearing and my eyesight, that looked after my teeth, that removed my appendix, that saved my life, that diagnosed me, that treated me, that has put my mind at rest, that provided compassionate and person-centred care for my loved-ones in the last days of their lives. I want the NHS that has been there whenever I or the people I hold dearest, have needed it.
I want an NHS that is a safety net, from the cradle to the grave. I want an NHS that means you don’t have to worry about becoming ill, or worry about how you will be able to afford care and treatment. One that is publicly owned, publicly, ran, and publicly accountable. One that is dynamic, proactive, forward thinking, evidence based and research focused. I want the NHS to do away with the notion that private sector involvement is necessary, as progress and innovation can only happen when profit is available. Most health professionals are not motivated by such base considerations, and I wholeheartedly do not accept the premise.
I want an NHS that is the envy of the world, that its workers proudly fight for, that its patients proudly fight for, and that I will fight for until the one I know and love facilitates my leaving of this world, as surely as it did my arrival, and removes my patient ID wristband from my cold, dead hand.
“The NHS will last as long as there are folk left with the faith to fight for it.”
– Aneurin Bevan, on the NHS.