A threadbare NHS

Austerity can be numbing; but we cannot allow that to lead to inaction over a lifeline service – our NHS.

Admittedly, I have become numb to the mainstream media’s vernacular associated with the NHS under 13 years of Conservative rule. Whether that’s cuts to the budget year on year, or a classic Daily Mail front page plastered with strike vitriol. But nothing took it more from abstract political ideology to a sobering reality than a recent event with my younger brother, Daniel. 

If we take it back to the post-war period, the NHS was created on the premise that healthcare should be universal and free at the point of use. Founded by Aneurin Bevan, who served as Minister for Health, under Clement Attlee’s Old Labour government. Bevan saw the NHS as the bedrock of civil society, famously claiming: ‘No society can legitimately call itself civil if a sick person is denied medical aid because of a lack of means.’ Fast forward 30 years when rampant neoliberalism gripped Britain under Thatcherism, and internal markets were introduced to increase ‘efficiency.’ While Thatcher practically privatised everything, she failed to completely sacrifice the NHS to the whims of the free-market. A synopsis of the Blairite and Brownite government gives for broadly similar reading, completely rebranding Labour under a form of ‘soft-Thatcherism’, with further engagement with private contractors and the continuation of NHS trusts which compete for patients to gain commissions. 

While Thatcherism and New Labour chipped and eroded the NHS from a publicly funded body to a quasi-marketised body, the public health policies of the Coalition under David Cameron and Geogre Osborne, I believe, are the root cause of today’s myriad issues. Spending was increasing at only 1.4% each year under the Coalition, compared with 5.5% under New Labour and, shockingly, 2.6% under the Thatcher and Major years. Between 2008/09 and 2018/19 the waiting list near doubled, from 2.2 million to 4.3 million, which was pinned on budget cuts and the ‘efficiency’ drive under Cameron. Efficiency is something that frequents NHS dialogues in Westminster, but plain and simply it meant, and continues to mean, outsourcing health services to private firms. Osborne set about a public sector pay freeze, which has been sustained under successive leaders and continues as I write. With figures showing that under 13 years of Tory rule, staff – from maternity assistants to nurses to doctors to midwives have lost between £30,000 and £48,000 in wages as a result of pay failing to match inflation. While pay has fallen in real-terms, staff shortages have grown year on year to a current shortage of 154,000 full-time staff. Knowing all of this prior to the incident, the reality behind the sickly lit double doors was still, nonetheless, sobering and deeply upsetting. 

My brother spent 5 days in ICU following vascular surgery, where he was supervised by two nurses on 12-hour rotations. Having had the chance to chat with both it was discernible that shifts beyond 17 and 18 hours were very much the norm. One of the nurses mentioned: “There are constant shortages, which often means we have to stay well beyond our paid hours. And we do it, we do it because we care; but it’s not sustainable.” The public cancer that is austerity is evident even in small forms: from pillow shortages, inadequate rooms for visitors staying overnight (which meant my parents spent most nights awake in a chair or catching a handful of hours of sleep between them), staff paying extortionate sums for school-esque dinners, to the ward along from ICU which was completely closed off as a result of reinforced autoclaved aerated concrete (RAAC) concerns. This all stems from the Coalitions continual cuts to devolved budgets. Despite working under a political establishment who through sheer dogma are able to sleep at night while 14% of nurses are resorting to food banks, and a right-wing press who demonise them for striking and putting patients at risk (apparently 13 years of austerity doesn’t come with a risk factor in healthcare), every single staff member went about duty unburdened, smiling despite tired eyes and going above and beyond at every port of call. Even when I thanked them for everything they are doing, both with my brother and more generally, they almost seemed to downplay the vital role they play in public life. “It’s just part of my job”, one of the nurses said.

In retrospect, the NHS staff at the Royal Infirmary in Edinburgh saved my brother’s life and my parents were able to leave the hospital with absolutely no debt. I left feeling ever thankful that such a health service exists here, but also very nihilistic, because what I had seen in what is a threadbare service. With Starmerism offering no resistance to privatisation, a stance that Bevan under Old Labour would find reprehensible, it is paramount that we fight for its survival. One quote struck a chord on leaving the hospital, and it continues to echo today, from Bevan himself: “the NHS will last as long as there are folk left with the faith to fight for it.”