The NHS saved my life. I was three weeks old and an operation in an NHS hospital in Glasgow kept me alive. From the moment I was old enough to notice the scars on my belly, my grandmother told me if she had been sick as a baby like me, she would have died because there was no money to afford an operation. Aunts, cousins and friends worked for in the NHS. I cannot begin to understand the bravery of our doctors, nurses, hospital support staff, cleaners and others.
But when finally we get through the coronavirus crisis we have to face some stark facts. Loving the NHS is not enough. The NHS is not the envy of the world. No other country has copied its model. Why? Well, when I praised our NHS to a German doctor, he said to me, somewhat puzzled: “why do you have a hospital beds crisis every winter? Germany has no such thing.” The answer is that Germany has 8.3 hospital beds per 1,000 people. The United Kingdom has 2.8. They have the beds. We have the crisis. Every year.
They have beds. We have the crisis.
Talk to any doctors, nurses or healthcare professionals and you will find out where the problems are. Our healthcare teams, in the phrase about First World War infantry, are Lions led by Donkeys. The NHS in England was “reformed” by Conservative health secretary Andrew Lansley in 2012. A friend who advised politicians said Lansley’s organisational chart looked like badly arranged spaghetti. Another NHS expert Roy Lilley says coronavirus has done more in three months to modernise the NHS bureaucracy than his three decades of arguing for change. A coronavirus tracker app! How very 21st century! But the problems remain.
Scotland, Northern Ireland and Wales have their own devolved systems. But England remains choked in the post-Lansley spaghetti dis-organisation. Then there’s money. Health inflation is higher than other inflation measures. Health spending hasn’t kept up. And above all, the patronising attitude that nurses are “angels” doesn’t pay the rent, unless you believe “angels” live on fresh air. Clapping on Thursday nights is a lovely gesture, but doesn’t pay the bills. We went into the pandemic 40,000 nurses short. Between the lack of protective gear and Brexit encouraging some EU 27 nurses to leave, expect the next tally to show even greater shortages of key staff.
“All in this together”
In 2009 during the financial crisis the then Opposition leader David Cameron told his party conference “we are all in this together.” He promised “if we pull together, come together, work together — we will get through this together.” But coronavirus shows some of us are more “in it” than others. The virus is not an equal-opportunity killer. In Britain’s poorest areas people are dying with coronavirus at twice the rate of people in the richest areas. People of colour, most notably among our health workers, are dying at a much greater rate than white people in the same jobs. The Office for National Statistics, Britain’s most trusted source of facts and figures, reported 55.1 deaths per 100,000 citizens in the 10 per cent most deprived areas England. The figures in the 10 per cent least deprived areas are 25 deaths in 100,000. Those from BAME (Black, Asian, Minority Ethnic) backgrounds are significantly over-represented in the mortality figures. Newham – a less well off area of London with a large BAME population – has reported 144.3 deaths per 100,000. Liverpool, Birmingham, Wolverhampton and Middlesborough also have a high death rate.
In February a report by Professor Sir Michael Marmot, one of Britain’s leading experts on health inequalities, said that for the first time in 100 years life expectancy in England had stalled over the past decade. Among English women living in the poorest communities life expectancy has declined since 2011. Marmot called it “shocking.” He said England had “lost a decade” in health care which – coincidentally – is the decade since we’ve been “all in it together” with Conservative led governments. The rich-poor life expectancy gap in Britain is a difference of 9.5 years for men and 7.7 years for women.
Love cannot be blind
I respect the people of the NHS more than I can say. But love cannot be blind when it comes to the way the NHS is run. As a rich country we can do better. We need a new social contract to rebuild the NHS so that it truly does become the envy of the world while being true to its core values, the values my grandmother shared. Whatever the bluster, the NHS is not safe with the Johnson government, especially after Brexit. That means you and I are not safe from coronavirus. Some say we cannot afford more money for the NHS. I believe we cannot afford to fail our health workers through lack of cash, facilities and protective equipment.