Sixty nine years ago, give or take a week or so, I was delivered into this world. My mother gave birth to me in what was then known as “the huts”, a collection of prefabricated buildings that stood alongside the main Doncaster Royal Infirmary hospital building. The National Health Service was almost exactly 40 months old. I was, to all intents & purposes, a child born into a Brave New World. No doubt my parents were extremely grateful, although I have no idea what the alternatives may have been if the NHS hadn’t been formed. In 1948 a UK population of around 50 million was served by 80,000 doctors & nurses, today, in a country where no one has any idea just how many people there are living here, legally and illegally, (estimates range from 64 million to 70+million) the number of doctors and nurses has risen to 332,000. In 1948 there was one medical professional for every 625 people in the UK, today, if we accept the upper numbers of population, there is one medical professional for every 211 people.
My first real memory of the NHS, sometime in the mid 1950’s I suppose, is the waiting room of the surgery in my home village of Rossington. The GP was called Grafdyke and I clearly recall sat waiting to see him, I can’t remember for what, in a wood lined hut, attached to a larger building. It must have been winter and the room was heated by an oil stove set behind a wire mesh guard. As a child we queued in this same waiting room to be vaccinated against the common diseases of the day. In later years other doctors joined the practice. I remember one called Marshall, who was called out to visit my mother one night. My old mum was a heavy smoker with bronchial problems, Dr. Marshall warned her, in no uncertain terms, that to continue to smoke her 40 Park Drive a day was to condemn herself to an early grave. He must have got through to her. She never smoked again, that may well have been the last time the NHS had a positive effect on her life, but, then again, I may be wrong. Some years prior to this I remember meeting my mother in the street, this was in the days when dentistry was an integral part of the service and not a contracted out hodgepodge, as it now is. She was holding a blood soaked rag to her mouth & she could hardly speak. She hadn’t a tooth in her head and, within a couple of weeks, she had dentures. Maybe all her teeth were rotten and the NHS was doing her a favour, again, we’ll never know. It must have been around this time that I developed a somewhat irrational fear of dentists, which it took me many years to overcome.
Time moved on and my adenoids were cauterised, which wasn’t the most pleasurable of experiences, although it did stem the frequent nose bleeds I’d suffered throughout my childhood. The NHS simply was. It existed, we used it and I’d never known a time when it wasn’t a thing. When needles hurt, or doctors were brusque, I, along with many others I suspect, simply accepted that this was how it worked. We weren’t poor, but we were “working class” and in the 50’s and 60’s we tended, in the main, to accept our lot in life. It was probably the early 1980’s, when my maternal grandmother died, that I had my first inkling of something not being quite right in our “envy of the world” health service. She’d been diagnosed with dementia and was in the Doncaster Royal, a place that will get mentioned quite a lot in this article. I’m not saying that she was allowed to die by design, but she was allowed, unchecked, to eat a couple of pounds of green grapes and she literally shat herself to death on the ward. My mother and aunt made noises, but they were fobbed off (or placated) and that’s as far as it went.
Some Interesting statistics about The NHS
The NHS budget, in 1948, was £11.4 billion in today’s terms, the population was circa 50 million, national spend per head was around £250
The NHS budget, in 2019 was £153 billion, the population (although no one really knows) was around 65 million, national spend, per head was around £2350
The NHS, in 1948, had circa 80,000 clinical (doctors and nurses) full time staff, one for every 625 people in the UK
The NHS, in 2019, had circa 332,000 clinical full time staff, one for every 220 people in the UK
The NHS, in 1948, had circa 480,000 hospital beds available, one bed for every 105 people
The NHS, in 2019, had circa 141,000 beds available, one bed for every 460 people
The NHS is one of the worlds largest direct employers with circa 1,270,000 full time staff
The current NHS wage bill accounts for around 45% of the total budget or iro £48 billion
It’s difficult to find the exact figures of the number of people employed in non clinical roles, but it’s in the region of 650,000, the number of clinical staff, including nursing assistants, midwifes, medically qualified managers, physios and other therapists is around 620,000. If these numbers are correct (I admit the difficulty of collating them, due to devolved responsibility) then the cost of non clinical staff, to the NHS and ultimately the taxpayer, currently comes in at around £25-26 billion. Included in this will be countless diversity officers, inclusion officers, art keepers, procurement administrators and their managers, senior managers and directors. My guess is that at least 50% of this money is spent for nothing and could be far better employed.
In 1988 my second child was born, again in Doncaster Royal Infirmary, a junior doctor oversaw the birth. I rushed home from London to be there, I was working on a fire repair in the Brinks Mat building at the time, but that’s another story. The junior doctor was completely out of his depth and he panicked at a critical moment, putting my wife through agony. A nurse and midwife took over, after the stitching up was completed my concerns for the well being of my wife were expertly placated. I wish I’d have known then what I know now. The trauma, although we now don’t discuss it, still haunts my wife to this day.
I used to be a blood donor, never minded doing it and always felt that I was “giving something back”. Early in 1995 I received a letter from The Blood Transfusion Service asking me to cease donating, as the antibodies for Hepatitis-C had been discovered in my blood. Hep-C is a nasty disease and the catching of it is, in many cases, associated with the injecting of drugs. There is a theory that it can also be sexually transmitted. I accepted the diagnosis given my past history and when, in 1996, I was offered the opportunity to take part in a drug trial I (somewhat naively) accepted. I won’t go into the machinations of the two weeks I spent in a private hospital in North London, suffice to say there were four small groups of people on the trial, chosen after arrival. A control group on placebo, one group on Ribavirin, one group on Interferon and the final group, the one I was chosen for, on both Ribavirin and Interferon. The long term side effects, unknown at the time of this trial (allegedly) include insomnia, irrational irritability (low temper threshold), tiredness and depression. I took both drugs for 6 months, they changed my life beyond recognition. I became withdrawn where once I’d been open and outgoing, I became short tempered and ferociously argumentative where previously I’d had a reputation as a calming influence, I sank into pits of black depression followed by periods of heavy drinking and sadly, for a short time, returned to using stimulants & depressants. I also lost my hair. I was lucky to retain my marriage and my family.
I lived like this, laying awake at nights or wandering around the village where I lived for 18 months or so. The words of The Beautiful South song “I’ll Sail This Ship Alone” were constantly in my head, like a form of weird tinnitus. I was making regular visits to the phlebotomy department of The Royal Free, at my own expense, for tests to see if the antibodies were still present in my blood, which they were, although to what extent it’s now hard to say.
I started to feel poorly over the end of the Christmas break 1997, always with the thought in my mind that Hep-C can be a killer. I returned to work on the 5th of January 1998 in agony, after being awake all night with stomach pains. By 10am I was feeling quite poorly and went to see the owner of the business where I worked, to tell him I wasn’t well. He took one look at me & told me to go home, I was literally grey. I went to bed and slept, Mrs.C woke me at lunchtime, took one look at me and phoned the doctor. He duly arrived, gave me a cursory examination, ignored the pain and told me I had flu! He was called out again, some hours later. I was by now immobile with pain, sweating profusely and feeling really very ill. An ambulance was called and I was “blue lighted” to Colchester General.
Some more interesting facts about the NHS;
Clinical negligence claims currently run at around 11,000 a year.
At this moment in time there are £83 billion of claims outstanding against the NHS
The NHS has outstanding legal fees (costs of negligence litigation) of £43billion
The NHS budget (lest you forget) is iro £153 billion (153-83-43=27)
I was left in the main corridor of the hospital, naked except for a gown and a thin sheet, I was almost delirious by now but there was little prospect of my being seen. I remember it was extremely cold & there was a cardboard vomit tray on my chest. Was I close to death? I honestly couldn’t say, but I did know something was very wrong with me. Comically, the main door of the hospital entrance fell off its runners and an icy wind, which blew straight towards me, was the only thing keeping me conscious. I don’t know how many medical staff ignored me as they went about their work. I reached out and grabbed a young doctor and as forcefully as I could, told him of my plight. I had private medical insurance through my job and insisted that I be moved, as soon as possible, to The Oaks (more of which later) Private Hospital. I must have got through to him, a private ambulance was arranged and I was moved across town to a single room in the said establishment.
The consultation that I’d been unable to get at the general hospital happened within an hour of my arrival at The Oaks. A surgeon, (funnily enough the same guy who’d carried out my vasectomy and continued with the operation even though the anesthetic had only partly taken hold) gave me a thorough physical examination, got me medication to stabilise my condition, a big dose of pethidine for the pain and told me that he’d remove my appendix the next day. Although I was close to having full blown peritonitis he was pretty sure another 8 hours or so wouldn’t see me off. I watched “Once Were Warriors” before descending into a drug induced sleep.
Long story short here, my appendix was removed, my colour returned and, once I could manage to get to the toilet unaided and urinate without passing any blood, I was allowed home. Within days I felt physically like a new man. The mental issues were still with me, though as yet I hadn’t fully attributed them to the drug cocktail I’d been taking for the Hep-C diagnosis. I returned to work and in due course to The Royal Free for blood tests. No antibodies twice in a row. I started to do some research and was astounded by what I discovered and subsequently had confirmed. Our blood produces antibodies to fight viruses and the like. I’d been diagnosed with Hep-C when, in all likelihood as my appendix had started to weep, causing a mild form of peritonitis, my body was fighting this problem. I’ve never had a symptom of Hep-C, subsequent blood tests have revealed nothing abnormal and, given my age, I’m in reasonably rude health. Neither The Royal Free, the senior medical team who encouraged me to take the “cure” or anyone else at the NHS ever accepted I’d been wrongly diagnosed, nor acknowledged the possibility of it. I know different though. I’ve never had the hint of an apology, maybe I should have sued them.
Some time in either 1997 or 1998 my father was having problems with his back passage, the original diagnosis was that he had an ingrowing hair near his anus which was causing an irritation. By the time he was properly diagnosed with bowel cancer it was too late to do anything and the cancer was deemed terminal. We watched a man who’d been an accomplished swimmer and half decent amateur football in his youth turn into a husk. I sat up with him on Boxing Night 2000. He’d lost the power of speech and was now a shell of himself. I’m guessing it was the pain that kept him awake, but every time I awoke from dozing he was looking directly at me, imploring me, or so I thought, to put a pillow over his face and end it for him. I tell myself now that I seriously considered doing it, but that’s just hindsight. We returned to Essex, he lived just outside Barnsley, only to be called back on 2nd January. I arrived in time, along with my sister, to sit with him as he shuffled off his mortal coil. His end of life care, at least for those couple of days, couldn’t have been better. I didn’t know then that I’d lose both my parents, both to cancer, within 7 months of each other.
I could go on, avoiding the NHS where humanly possible has become almost a way of life. Cynical doesn’t quite cut it. In late 2000 my mother became increasingly worried about a pain in her abdomen, her GP had been treating her for water retention for some time, but she suspected there was a bigger problem and she was right. She entered Doncaster Royal Infirmary on a Wednesday morning in June 2001 and went straight to the ICU. She had a tumor in her abdomen, the size of a small grapefruit, which had gone undetected for many months. It’d take me several paragraphs to list fully the lies, half truths and deflections we were subjected to, as a family, over the next couple of days. The NHS gave up on her, although they didn’t tell us this. She died on the Saturday, in a dirty unlit room, vomiting up her insides as my sister and I sat with her. She was clearly in agony, although she was unable to speak. Her pain management system had failed, no one with authority was available to replace it (it was the weekend) and nurses were weeping in the corridor, distraught at their inability to help. We complained, I wanted to go to the papers, the hospital management went into full obfuscation mode, claiming that we had been kept fully informed and my mothers death and missed diagnosis were unfortunate, but understandable occurrences, they even claimed that we had collectively imagined a meeting with a doctor. My sister talked me out of making a fuss, she said the pain and the exposure would be too much. I think we should have sued them.
I was working in the Middle East in 2007 and my wife went into The Oaks Colchester for a surgical procedure. The NHS surgeon, obviously in a hurry to juggle both his NHS & private patients, stitched up the incision on her abdomen but neglected to do the same internally. If my daughter hadn’t have arrived in the recovery room, just as the monitor registered that my wife’s blood pressure was dangerously low, as she was bleeding out internally, my wife would probably have died. As it was she had to be rushed back into surgery and have the original procedure almost repeated. Her recovery was long and slow, plans for our moving to the Middle Est were abandoned as she needed me at home and our lives took another strange turn, not for the first time courtesy of OUR NHS. Maybe we should have sued them.
Over the last thirteen years or so we’ve all learned to take any diagnosis and/or treatment with a hefty pinch of salt. Diet, exercise and mindfulness (he says, ironically) are important steps to ensuring the NHS is kept, at least in our house, at a good arms length. I have no doubt that, in a very many cases, the NHS does wonderful work but there has to be a recognition, at least in part, that it is run, staffed and managed by ordinary people;
The NHS is staffed & run by people like you & me. Many of them will have great empathy, see what they do as a calling & take the challenge head on. Some will be lazy & feckless. Some will be glory hunters. Some are in it for what they can get for themselves. Deifying it is wrong.
— Brian “Intrepid Populist” Firth. Englishman in🤡🌍 (@Crosscolin88) November 12, 2020
At the end of May, while working in the garden, I injured my shoulder, it was pretty obvious that I’d either trapped a nerve, badly strained a muscle, or, worst case, done both. One of the several GP’s at my practice saw me and managed to manipulate the knotted shoulder muscle somewhat, which alleviated the pain enough so that, with the help of 100mgs of Codeine, I was able to get some sleep. We all know our own bodies to some extent. It was clear to me that the damage was quite serious and debilitating. The pain was excruciating. In quite short order I received a call from the Musculoskeletal Clinic and, over the next couple of weeks, was given an exercise regime to follow. I asked several times about having a scan to try to identify just how severe the damage was but was denied this, on the advice of a surgeon (or so I was told). Almost 6 months down the road and, although the pain is less acute and the movement is returning to my arm, I still have limited motor function in the ring finger of my right hand, the little finger is next to useless and my palm and lower forearm are numb. Any lengthy activity requiring use of my right arm (even typing) tightens up my shoulder, brings on pain and increases the ever present tingling in my right hand and forearm. In exasperation I called my GP practice. The result? Even though I made it quite clear that this was not a new problem and asked that she refer to my notes and put me back in touch with someone who knew my case, she simply created a new referral. Two letters arrived which were exactly the same as each other, I called to make an appointment (scheduled for 09/12/2020) and explained the situation. It didn’t matter that I had an ongoing problem, we had to go back to square one, still no face to face, still no scan. If they send me an exercise video I think I might scream.
On the 13th of October we visited a relatives house to have a drink in celebration of a birthday. It was the second time this year that we’d been in their house. By the 18th of October the six of us who had been sat around the table and one other person who’d been present but not involved (doing a Corbyn) had all tested positive for Covid-19. We all suffered an illness of some kind, with varying symptoms and varying levels of impact. The younger ones were hardly poorly at all, although the 3 over 60’s all suffered headache, coughing and a level of tiredness. Ironically, I slept better, for a week or so, than I have for many a year. I took lay advice, along with Vit-D3, Vit-C, Zinc & Paracetamol, all of which I’m continuing to take (don’t @ me), I also drank a couple of pints a day of a mixture of lemon squash, bottled still water and tonic water (for the quinine, again no @’s). After a week of not feeling very well I decided to undertake a small experiment and rang my GP practice. The receptionist wasn’t too keen, but I insisted on a call back, the conversation with the GP was very illuminating. In essence the NHS on the ground, as it were, is committed to protecting itself from Covid-19 at all costs, no face to face, no advice on medication or supplements that might help (or hinder) the recovery process, no prescribed medication, nothing. If you need help, I was told, you must refer to the 111 helpline or the Covid-19 government website (how very “New World Order”). If the algorithms detect that you’re dying an ambulance will be despatched, otherwise, take the paracetamol, keep up with the fluids and hope for the best.
I don’t believe the NHS is anywhere near as good as it thinks it is. It wasn’t great before Blair and his cronies got hold of it and it isn’t great now. Turning it into an quasi-religious cult, by calling ALL its staff heroes, applauding it in the street, banging pans and painting rainbows everywhere does far more harm than good. Both the organisation itself and a goodly majority (thankfully not all) of its employees now believe the myth, created and promulgated by the bought and paid for media, that it is inviolate and beyond any criticism. Try putting some of the facts about it on twitter if you want to test the theory.
In the 72 years since the formation of the NHS ;
The number of clinically qualified staff has increased by around 400%
The cost to the nation per head of population has risen by 900%
The number of hospital beds has reduced by 75%
The NHS is a behemoth. It’s unwieldy, it’s extremely top heavy with management, it’s far too interested in things it shouldn’t be interested in and it’s profligate in the extreme (because the money it spends isn’t seen as real). Friends of its higher ups and of politicians make millions from it yet no one in power blinks an eye. Governments of all stripes award contracts to companies based on who they are owned by, not what service or product they can provide. Maybe my family & I have been unlucky, but I don’t think so. Maybe some of the claims of negligence and bad practice are spurious and driven by personal greed, but we’re talking about billions of pounds here.
I think it’s lost its way. It’s lost touch with its core values. Many of its staff have become political activists, a bad thing when it should be the one national institution that is fully committed to being non-political. At the same time all politicians use it as a football to prove they are the party of the NHS, yet nothing ever really changes. Blair and Brown virtually bankrupted the whole thing with PFI, yet they’re seen as its saviours by many. I have no doubt that many of the staff are dedicated and selfless, but we’ve all seen the Tic Tok video’s. 17 million paid sick days a year are taken. Tens of thousands of NHS staff are currently either isolating having tested positive or having been in direct contact with Covid-19 sufferers. The government wants us to “protect” the NHS but the cost of doing so, in terms of those missing appointments and routine procedures is beyond calculable. In 1948 the population of this country needed better health care, how is it possible that 72 years on we are now having to avoid using the service to protect it from itself? Furthermore, how is it possible that, for all it gets right, it gets so much wrong? I don’t know, I wish I did, but unless it gets radically reformed (something I very much doubt will happen) it will continue to be a financial black hole and, for all the good it does, it will continue, as all such institutions will, to shrug off its failings by pointing to its successes. Cold comfort for the very many people it lets down.
At today’s prices the original build cost of the PFI scheme, to the NHS, was £11.4 billion
The current level of debt is expected, very shortly, to rise to £79 billion
Total PFI debt to the nation, for various infrastructure projects, including the “Building Schools For The Future” programme (another Blair/Brown/Mandleson sweetener for their dodgy pals) currently stands at around £300 billion for projects with an initial cost of £55 billion
This is a personal view, I’ve heard many stories of great outcomes, lives saved, diseases mastered, congenital defects reduced, massive traumas survived and heartwarming stories of many staff who have gone above and beyond the call of basic duty to make a difference. The NHS, IMHO, is the ultimate “Curates Egg”, burdened with massive debt, to such an extent that, whatever comes next, it will never be able to deliver the services we all deserve without the aforementioned massive reforms and cancelling of the outstanding and growing debt mountain.
PS. If my numbers aren’t 100% accurate it isn’t for want of trying.
© Colin Cross 2020
The Goodnight Vienna Audio file