More than just a number

I’m genuinely saddened not to be at work at this time. I would have loved to celebrate with my colleagues.

The NHS was ten years old when I was born, so although out of nappies it was still very young. Five thousand people a year still died of Diptheria in 1958 - this was the year they started vaccinating for it, along with polio.

I was what the victorians would have called a sickly child. I had a difficult-to-diagnose medical condition for several years before a new x-ray technique identified the problem and I had major surgery at the age of seven, which left me with a long post surgical stay in hospital of six weeks. My grandfather had a hernia repair at the same time and was hospitalised for two weeks (and was given guinness to drink in bed) - something which is now done as day surgery. Length of hospital stay is often viewed as an indicator of success, although sometimes there is an argument made that people are discharged too quickly. But the culture of that time was definitely what we would now quaintly call one of “bedrest” and nurses had much more wide ranging (and frankly demeaning) roles. One nurse I worked with as late as the mid 1980s said that she had to clean the windows on the wards as well as provide care when first qualified.

I was also a frequent A&E attender (being accident prone) but we didn’t have a car and I can remember, on one occasion, my father applying a tourniquet and running with me  in his arms across local fields to the nearest cottage hospital. At least three of the hospitals I attended in South London have now all gone, and it is difficult to mourn them. They were grim and outdated as was my local GP surgery (in a Victorian House with a broken gas fire and cracked linoleum). I’m convinced that they just made people sicker.

It was possibly because I was a “frequent flyer” with the NHS that I developed an interest in working in it. I also got to know a lot about it through my father who was a  trade unionist at national level; in those days of labour organisation involvement in public services representatives of the major unions sat on the NHS’s National Board and influenced decision making.

I graduated from University in 1980 with a degree in social administration, having done my dissertation on Industrial Democracy in the NHS. I was rejected for the National NHS Management Training Scheme (or its forerunner) at the time and interestingly the rather overweight manager that interviewed me chain smoked throughout the hour we were together, which is a remarkable thing to look back on. It would not be until some years later that the NHS realised that it had to model and support good behaviour in its workforce as well as expect it of people that used it. So I went instead to work at the Maudsley as a nursing assistant, which was a remarkable experience in a disadvantaged but vibrant South London community. Half the auxiliaries were, like me, graduates (although usually in psychology) and the other half were mainly West Indians who lived locally and knew the realities of poor mental health, stigma and inequality.

Looking back on this period, three of the great steps forward for the NHS have (in my view) been its emphasis on healthy lifestyles, a more holistic approach to mental health, and its emphasis on dealing with inequality. Technological progress was always inevitable, although it tended then (and still does) to put the emphasis on cure rather than prevention.
Over the years that followed I worked in advocacy, commissioned mental health and learning disability services, managed paediatric teams, and eventually went into NHS corporate management. It has been a 37 year career which has been rich, rewarding, very demanding, at times frustrating, and always very steep on learning. I have had jobs where I have worked some very long hours and dealt with some very strange issues*. I have been frequently injured on psychiatric wards, gone through several significant re-organisations, overseen major IT projects, worked with some excellent colleagues of all ages, and even sat in police headquarters at 6am on the morning of the 2012 Olympics as the Director responsible for co-ordinating the Surrey NHS’s support to the games. But I have, I hope, always retained the belief that I and the vast majority of NHS staff (whether in the community or on the wards, in the back offices, or in technical functions) have the patient’s interests as the foremost concern. At the end of the day we are all users of the NHS, including those that work in it. I was kept alive by it, had three children with it, and saw my mother cared for it through her years of dementia and old age; and now as I am about to turn sixty I am reliant on it to support me with my own long term condition and mental health issues. It is a remarkable institution, and if like me you had parents who grew up in the pre-war years and didn’t have it, you will know that it doesn’t just bring practical benefits it is also a wider force for good. Seventy is a good age but we should always be optimistic and hope that the best is yet to come; if it is, it will be because the NHS and the public have a shared vision for it and because we have broken down as many of the barriers to its success as we can and use it wisely. It belongs to all of us and we all have a responsibility for its stewardship.

As for the politicians, take them with a pinch of salt. The £20bn "birthday present" just goes some way to putting back the funding the NHS has been starved of in the austerity years, an act about as ethical as nicking your kids pocket money to pay for their christmas presents. Don’t be fooled. Demand more.

Happy Birthday NHS. You’re the best thing that ever happened to this country.



* There was a time when a social worker rang me to say that one of my patients had a gun with a silver bullet in it, and did I have any suggestions as to its use? On another occasion I received an on call message one weekend to say that a box of radioactive substance had been found in a residential road in Surrey and could I advise on the health implications?