THE NHS : OUR GOLDEN CALF

I do not say this lightly, but it is my honest belief that both my parents died unnecessarily because of the NHS, because of its inherent flaws and weaknesses. Both my parents died in their sixties, my dad in August 2012 and my mum just a few weeks ago on the 12th April 2020, the day after my 46th birthday. Whilst my dad was dying the 2012 Olympics were on, including the celebration of the NHS that figured prominently in the opening ceremony. At that time the NHS was paraded as the best and most worthy achievement of our culture. It was a quintessentially British achievement, indeed a marker of British identity. We presented an image of ourselves to the world, and the NHS figured prominently in that as a point of pride. It was a symbol of decency and compassion. It’s mere existence made us a more moral nation than others.

During the coronavirus pandemic, we have seen a second peak of respect for the NHS, and for the second time, whilst this national celebration of all that the NHS is and does grips the nation, I have lost another beloved parent. Today, questioning the NHS in any way, let alone looking for a different or better model of healthcare, has become a taboo. In certain circles now in the UK, questioning the NHS is akin to admitting that you are some form of heartless psychopath who would prefer to see the poor and the vulnerable dying in the streets. It would certainly be the end of any significant political career to dare to challenge the universal love and respect the NHS has acquired, just as in previous centuries no serious leader could have rejected the Church and its teachings. To point out the flaws of the NHS, today, is an act of heresy and sacrilege, contradicting the only universal religion followed by every creed and culture now inhabiting these isles.

If you think I am exaggerating, you should look into current reactions and experiences more deeply. You do not need to refer back to the way that a bidding war of NHS pledges now dominates British elections. You do not need to reference the way the Labour Party always claim that this hugely expensive enterprise is on the edge of collapse and requires more money, or the way that recent Conservative governments have offered it special protection from austerity or vast injections of additional funds just as profligate as those proposed by leftist parties. All your evidence can come from the last few months and still make a compelling case.

Take for example the government's own original slogan in response to this pandemic, prominently featured on lecterns and backgrounds and repeated through large chunks of the daily briefings. ‘Stay Home.Protect the NHS. Save Lives’. This is the central slogan of the British, Conservative government response to coronavirus. Note the order of the three priorities presented here. Our first duty is social distancing. We must halt the spread of the virus by staying at home. Our second duty is to protect the NHS. We must limit the strains placed upon it, and ensure that the whole edifice does not collapse. We must not run out of beds or wards, or exhaust the patience and capacity of NHS staff, or overwhelm an apparently fragile system that cannot actually cope with any serious pandemic. Saving lives comes third in the list. It would be churlish and unfair to call it an afterthought, so I won’t. But it is clearly less significant than ‘protecting the NHS’.

Think about what this means. At one and the same time we are told that the NHS is the envy of the world, the best health service in the world, so marvellous that any voice raised in doubt regarding its capabilities must be a selfish voice, an evil voice, an uncaring voice.....AND that the NHS is on the point of collapse, that it is 24 or 48 hours from extinction, that we must save it, that it needs protection, that it cannot cope. How are these two thoughts actually compatible? If it was the incredibly brilliant, smoothly oiled, efficiently functioning service we are told, would it not be safe from collapse, resistant to sudden disaster, and calmly assured in the face of pandemic? Why would we need to treat it as if it were the patient we were most worried about, as if it’s potential demise and frailty in the face of threat was more important than the lives of the patients it is treating? It cannot simultaneously be the envy of the world and a frail septuagenarian that requires special protection. It cannot simultaneously be the perfect saviour and the most vulnerable victim.

It is in treatment and detection of cancer that the flaws of the NHS have been evident for some time, especially to families like mine who have suffered terrible loss because of these flaws. Our cancer detection and survival rates are amongst the worst in the developed world. That is a fact. I was prompted to research it after finding that my father’s cancer went undiagnosed and misdiagnosed for over a year. It has only been confirmed by my experience with my mother. My father was told that his cancer symptoms were the result of depression and alcoholism, despite him forgoing all alcohol as soon as he was instructed to do so. My mother was told that her persistent cough and repeated back pains were the result of acid reflux. Both of them were finally correctly diagnosed only a matter of short weeks before their deaths. Like many other families, we were robbed of the time that would have been vital in order to save them. We barely had time to say goodbye.

Now realise that during this pandemic cancer treatments for thousands of patients have been delayed and cancelled. Vital operations have been postponed. The same sorry failure to diagnose early and with accuracy no doubt continues, but added to that is a deliberate choice to keep these patients away from hospital. Now this could well be a perfectly sensible calculation given the risks of them contracting coronavirus in an already vulnerable state. But wouldn’t a truly world class system, a system that others envy and of which we can truly be proud, accommodate both? Could we not try to keep cancer patients promptly treated and alive, as well as coronavirus patients? What kind of perfect system is it that makes us choose between the two?

These are the kinds of question we are not supposed to ask, and the kinds of questions I must ask in order to respect the memory of my parents, and that of tens of thousands who die unnecessarily every year in NHS care. I watched my mother dying very recently, so this is an emotional topic for me. All the same, I instinctively distrust reactions to healthcare that are founded solely in emotion, and especially in a sort of quasi religious emotion. The blind worship of the NHS as a whole we see today worries me, because a worshipped institution is an unquestioned institution. It is a system that can make more mistakes, because nobody questions it. All the rainbows and the rhetoric, all the talk of heroes and angels, can disguise and excuse a host of problems. These are problems that end lives.

I can fully understand people respecting and admiring individual nurses and doctors and healthcare professionals. But these are human beings, not a system, not an institution. My parents both received some care that was remarkably good, and some that was remarkably bad. I think I could have had more years with both of them from a better healthcare system than we currently possess. I don’t want others to suffer in the same way because the NHS is beyond all criticism. That’s why I look forward to the day when the painted rainbows and the synchronised clapping finally end. Only when those things are set aside can we actually improve this creaking behemoth.

Bartholomew Chiaroscuro is a nom de guerre