Were I an American citizen, I would be dead. As a Scot who’s had her share of illness and surgery, I know that the massive costs of medical care in the Land of the Free would have ensured my early demise.
Today, despite ObamaCare, the average family in the US spends around 37 per cent of its income on healthcare. The American ambulance service makes more money than the entire American film industry. Given those statistics, I suspect most of us see the wisdom of keeping our health service.
The NHS will be seventy next year. Its present failings hit the headlines every day, while governments and the medical profession wrangle fruitlessly. Arguments rage about ring-fencing versus flexible spending, and rising costs outrunning investment. Progress amounts to claims from all sides that a big boy did it and ran away. The public is fickle, complaining about waiting times and bed blocking, but threatening civil ructions at the prospect of privatisation.
Sadly, prospect has become reality. Privatisation hides behind a cloak of ‘efficiency’, but its growing influence will soon reveal its dirty underwear. By then it will be too late for protest. As a country, we need to engage with the hierarchies now. Funding can be found – the paltry 8.5 per cent of GDP presently spent on health is shaming. Despite its deficiencies, the NHS remains in concept and practice the finest of Britain’s institutions: its life deserves to be saved.
A personal perception of NHS in Scotland
I’ve had advanced breast cancer since 2014, which has greatly heightened my perception of the NHS in Scotland. Like the little girl with the little curl, when it is good, it is very, very good – you know the rest. Since diagnosis I’ve had impeccable treatment and care, which has gifted me three more years of life. Earlier diagnosis, however, might have given me a more positive prognosis.
My condition is monitored by six-monthly scans, but the waiting times for the procedure and its results are lengthening. Waiting to know if the pernicious little travellers are now squatting in another bone or organ can fairly focus the mind. So those advocating early diagnosis and shorter waiting times get my vote.
I am nevertheless deeply grateful to the NHS for my ongoing care. I was given radiotherapy and a personalised treatment programme immediately after diagnosis; I have come to know and admire the people who care for me, and to recognise the challenges they face. Their job involves people who are emotional and afraid, yet they remain calm and positive; they work well with both mind and body.
Were you to join the groups of women waiting their turn in the oncology clinic, you’d hear laughter and hilarious exchanges about wigs and ‘Chemo Brain’; you wouldn’t see a silent gathering, brooding about what lies around the corner. And this is thanks to the people they’re waiting to see.
But I live in Glasgow, where I have access to a specialist breast cancer nurse and many other services: if my home were in rural Scotland, I’d face long journeys for support and specialist services. Third sector bodies are presently complementing NHS clinical services with a variety of social, practical and emotional services for cancer sufferers. They rely on public funding, however, and the smaller organisations struggle with outreach, particularly in the less populated areas. Patients must seek them out; if they could be referred to charity services upon diagnosis, this would raise awareness more than simply signposting and believing patients will attend.
Third sector support services can shoulder some of the NHS burden, and it seems anomalous that their vital contribution to the recovery process and to helping people self-manage their condition is often disregarded. With or without third sector support, in spite of all that’s being achieved, the NHS needs radical and expensive treatment. But that’s not going to happen until governments sort out their priorities and acknowledge that society’s well-being takes precedence over vote-winning strategies.
More maligned than lauded
While we wait, the NHS remains more maligned than lauded, ‘broken’ in the eyes of its detractors. To reset the balance, the ‘keepers’ among us must therefore do all that’s possible to tout its achievements. Since its inception, the NHS has saved countless millions of lives; it has grown and moved with the times, recognising the need for change in its treatments, management and approach to patients; it has carried out vital research; it has struggled on, despite the huge challenges of longevity brought about, ironically, by its own success.
The treatment of children is an example of radical change. I was four in 1945. My mother was in a sanitorium, my father in the Navy, and I was in the care of my grandparents. Severe measles had left me with an abscessed eardrum requiring minor surgery. Thinking a trip to hospital would be a treat, I wore my favourite red dress. On arrival, Gran’s request to stay was refused, and I was deprived of my teddy. An unsmiling nurse took me down in a lift – I remember the cold clashing of its doors – to a draughty corridor outside the theatre. She sat medown on top of a waste-bin, then left.
I remember my four-year-old’s fear, sitting shivering on the metal lid, dreading whatever lay behind the bright light in the doorway. Someone called me in, and under the white beam I saw two tall figures, their mouths covered like bandits’. There was no pre-med., no one held my hand or spoke. I was hoisted to the table, and wordlessly the chloroform mask was applied. I was sick over my red dress in the taxi going home.
A child’s experience of hospital today provides a delightful contrast. The NHS advises parents that ‘children can find going to hospital a daunting experience’. They caution that children should be told what to expect beforehand, and, above all, parents should ‘stay with their child for as long as possible’, extra beds being available. Wards are colourfully decorated, and full of toys, though children are encouraged to bring their own special cuddlies and comforters.
Dinosaurs are (almost) extinct
The needs of small people are prioritised: they are encouraged to play in the ward – no more sitting tucked up rigidly in beds with ‘hospital corners’. Consultants play the clown, happily losing their dignity if it raises a smile, and there is no premium on hugs.
Medicine has been humanised. The gulf between practitioner and patient has been bridged, and those surgeons of the very old school who saw themselves as lofty saviours of the great unwashed are mostly gone.
Back in the eighties, when I presented with a suspect lump, I asked the consultant if I had mastitis. With a look of withering contempt he put me straight: ‘Mastitis is a disease of cows.’ When I clyped to my GP he said, ‘The dinosaurs are dying out, but there’s a few left.’ Recently, I’ve encountered only one dinosaur, and he was shown the error of his ways by his own staff.
Who gets it right all the time? Who has to do the job of three and take the flak afterwards? Who, when the A&E is packed and drunks are bleeding over the reception desk, finds time to offer folks a cup of tea? They are magnificent people and we need more of them: more nurses, auxiliaries, doctors, ancillary workers, specialists and beds. Above all, we need to embrace and hold on tight to the thousands of fine, talented people who migrated to Scotland to keep our NHS alive.
Featured image: The Stethoscope by Alex Proimos CC BY-NC 2.0