{"id":11772,"date":"2020-09-04T12:26:46","date_gmt":"2020-09-04T12:26:46","guid":{"rendered":"https:\/\/sceptical.scot\/staging\/?p=11772"},"modified":"2026-04-18T19:34:31","modified_gmt":"2026-04-18T19:34:31","slug":"it-hurts-us-all-who-can-heal-scotlands-health-inequality","status":"publish","type":"post","link":"https:\/\/sceptical.scot\/staging\/2020\/09\/it-hurts-us-all-who-can-heal-scotlands-health-inequality\/","title":{"rendered":"It hurts us all: who can heal Scotland’s health inequality?"},"content":{"rendered":"\n

She is a small figure in black clothes etched on the white hospital bed. When no-one seems close enough to hear she murmurs a low groan. \u00a0<\/strong><\/p>\n

Marianne is in pain, I feel sure, but she makes a determined job of hiding it.<\/p>\n

\u201cI\u2019m feeling fine. I could go back to work right now, I could.\u201d she insists.\u00a0 The surgical team doesn\u2019t sound so sure.\u00a0 Marianne (not her real name) arrived in the ward in the early hours of the morning. She has a bulging hernia and she really should stay and wait in line for a space in theatre, they say.\u00a0 Her quiet reply echoes in my mind: \u201cI can\u2019t afford to stay, if you can\u2019t operate today I have to go home.\u201d<\/p>\n

From my bed diametrically opposite I feel my guts twang. Newly delivered from theatre, I try to imagine getting out of bed to go back to work with aching innards. It hurts to think of it.<\/p>\n

Fellow feeling.\u00a0 Like Boris Johnson I unexpectedly ended up in hospital, though I\u2019m in the Royal Infirmary Edinburgh, not St Thomas\u2019s London. Like Boris Johnson I leave with a debt of gratitude to a health service, which works all hours to tend whoever comes in with the supreme best of human ability. \u00a0There is a crucial difference. As UK Health Secretary Matt Hancock said in those far off days of April, the NHS cared for the Prime Minister, \u201cas they would have cared for anybody in this country.”<\/span><\/a> Yet Boris Johnson was deprived of something very special. Inevitably, he had no close contact with other patients, no chance to share in the give and take of ward life. To learn from the lives of others. \u00a0<\/span><\/p>\n

It goes without saying, even if he had been suffering from something other than Covid \u2013 an angry gallbladder, a perforated appendix, a ruptured hernia \u2013 the Prime Minister would never sit in public waiting rooms among other patients, shifting in pain on hard seats to find a comfortable position. He would never spend long hours of socially distanced space with people from many different walks of life. He missed a lot.<\/p>\n

Daily drama of health inequality<\/h2>\n

In my seven days of hospital care, before and after surgery, I get to do a lot of waiting, looking, listening and learning. It\u2019s a privileged front row seat, a ringside view of the daily drama of health inequality. On my first day in the surgical observation unit there\u2019s an older woman two seats in front of me who seems known and liked by many of the staff. She\u2019s quite ill, I think, but keeps asking if she can go home before the scan results are ready. She needs to relieve the young carer looking after her husband. He\u2019s got dementia, \u201cHe\u2019s doollally, I cannae leave that wee lassie with him all day.\u201d There\u2019s laughter in her voice. She\u2019s not complaining, just stating a fact. She has commitments at home that come before her own health.<\/p>\n

The young woman in the row next to mine, is impatient to get home to the kids so her husband can get to work. His boss isn\u2019t happy. She leaves before the scan results and I see her back again next morning, waiting to see the consultant.<\/p>\n

It takes three days before I\u2019m admitted to hospital, but I\u2019m grateful for the technical expertise and even more for the rigorous, kindly attention to detail in the outpatients department. The clear diagnosis of a badly inflamed gallbladder (how<\/i> did it become so angry, so quickly?) takes me to the hospital ward, a hefty dose of intravenous antibiotics and the weekend list of emergency operations. The RIE \u2013 like hospitals across Scotland and the rest of the UK \u2013 is in post-Covid catchup. There\u2019s just one emergency theatre operating at weekends and, rightly, those in greatest need are taken first.\u00a0 After the first day of pre-op fasting, the consultant surgeon comes to apologise. We\u2019ve missed today\u2019s slot, she says sympathetically. We\u2019ll try again tomorrow but she can\u2019t promise anything.\u00a0<\/p>\n

Like Marianne, I want to get home (if only for a night\u2019s sleep!) and at next morning\u2019s ward round I tentatively ask if that might be possible, if another day\u2019s fasting ends without surgery…? The surgeon looks me in the eye (masks emphasise eye to eye contact). She\u2019s sympathetic and completely straight. If I leave the hospital I will slip right off the priority list.\u00a0 It makes perfect sense. With good pain control and ice cubes to sip who am I to complain about lying in a comfortable bed watching the sun slip across the blue sky? I have lovely companions and unsought but compelling scenes from other people\u2019s lives.\u00a0<\/span><\/p>\n

Vivid and recurring images<\/h2>\n

Marianne lies on the bed by the window. A small, lonely figure in black, she stares into a middle distance.\u00a0\u00a0 Unlike previous occupants of that bed she avoids eye contact with the rest of us.\u00a0 Ward rounds bring good news for me and my friend in the next bed. We\u2019re healing well after successful surgery. We\u2019re getting home today.\u00a0 \u00a0Drifting in and out of sleep, I\u2019m aware of repeated trips to Marianne\u2019s bedside as nurses and doctors offer advice on seeking financial help, warning of the risk of going home untreated. Eventually a young man in green theatre scrubs somehow works a miracle. Before I\u2019m discharged I see Marianne, now wearing a hospital gown, being wheeled off to theatre. \u201cCome on chickadee,\u201d says a nurse patting her arm, \u201cwe\u2019re on our way.\u201d \u00a0\u00a0<\/p>\n

Four weeks later.<\/b> The anaesthetic has worn off but the images I brought home are vivid and recurring. <\/span>I hear the gravelly post-op voice of a woman wheeled into the ward in the middle of the night, just back from theatre, relieved of an infected ulcer. When the nurses leave her to sleep she lies awake repeating: \u201cYou stupid bitch, you stupid, stupid fucking cow.\u201d She\u2019s talking to herself.<\/p>\n

I think of the tense form of Marianne beside the window overlooking the vast hospital car park. \u00a0I have the luxury of slow recovery. Can she afford time to heal?<\/p>\n

Covid comes back into view. Oddly, in hospital it seemed quite far away. (Covid wards, a nurse had told me, were on the floor above and, at that time, there were only two patients being treated for the virus and none requiring intensive care.)\u00a0 In our ward we concentrated on the measurable business of getting into and out of theatre, out of bed and back home: temperatures, blood tests, bowel movements, drug trolleys, ward rounds, discharge. The intimate exchange of chance encounters, close bonds with people we\u2019ll likely never meet again. Covid rarely featured.\u00a0 Now I\u2019m troubled by niggling questions. What of all the people who can\u2019t take time to be ill, can\u2019t afford time to heal? What if they had Covid?<\/p>\n

\n

Covid-19 has exposed the great faults in British society. As\u00a0Build Back Fairer\u00a0<\/a>the Marmot Covid19 review reveals, the already existing gaps of inequality and poverty have grown in the last year with cruel impact on the health of people in the most deprived areas.\u00a0 NHS alert: code red for climate change<\/a><\/p>\n<\/blockquote>\n

Who can heal inequality?<\/h2>\n

The UK government is trialling a scheme to pay low-paid workers in coronavirus hotspots up to \u00a313 a day, \u00a3130 for ten days, if they have to self-isolate \u2013 and only if they can prove they are unable to work from home.\u00a0 Thirteen pounds a day. Who dreamed that up? And what about zero-hours workers with no holiday or sick pay forced to take time off work because they have other illnesses? \u00a0What about Marianne?<\/p>\n

I cannot read the Covid news without a growing sense of rage. I knew about inequality. Of course I did. As journalist and editor I read and write about people whose daily lives are very different to mine. I did not feel the difference in my guts before. The pandemic has exposed and compounded grotesque inequalities of our society but it did not cause them. There can be no recovery plan, no \u2018building back better\u2019 if politicians in Scotland and across the UK do not address inequality.<\/p>\n

From my hospital bed I saw no inequality of care. Just the looming inequality of outcome. I don\u2019t know where other women in my ward live but returning home I remember with new resonance the shocking fact that people in my part of North Edinburgh can expect to live 21 years longer<\/span><\/a> than someone living just a short car journey away, on my route to the infirmary.<\/span>\u00a0\u00a0 Our NHS \u2013 no matter how kind, committed, or skilled the medical teams, no matter how well funded \u2013 cannot by itself heal the diseases of poverty and deprivation. Solving the chronic afflictions of our time \u2013 poor housing, low paid jobs, no security, no sick pay, no hope \u2013 that\u2019s up to all of us: we citizens and those we elect to make our decisions. \u00a0What\u2019s our plan?<\/p>\n

Featured image: Building back better? Cranes over Edinburgh city centre. Fay Young\u00a0<\/p>\n

\u00a0Further reading<\/h4>\n

Poverty and coronavirus in Edinburgh: solutions in shared humanity. Zoe Ferguson for Sceptical Scot<\/a> \u00a0<\/p>\n

The Scotland effect: why life expectancy is lower north of the border: New Statesman<\/a>\u00a0<\/span><\/p>\n

Not OK, the shape of recovery to come: Fraser of Allander Institute<\/a>\u00a0<\/span><\/p>\n

How to build back better: cut the income gap: Richard Wilkinson The Guardian<\/a>\u00a0<\/span><\/p>\n

NHS alert code red for climate change: Sceptical Scot<\/a><\/p>\n

\u00a0<\/p>\n\n\n","protected":false},"excerpt":{"rendered":"

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