Why I have been depressed for the past nine years (and how to save the NHS)

It has been a difficult decade.

I remember the first vote that was lost, then the second, then the third and the intervening ups and downs all of which represented for me and millions of others a deterioration in what it is to be British and live in the UK.

Funny.

When asked, I always say, ‘Scottish. I am from Scotland.’

Last night on Question Time with multiple Scots seemingly obsessed with independence, I had never felt as British.

You see, with each defeat of Labour since 2010 I have seen the consequences, or rather, lived them. Not necessarily as starkly as millions of fellow citizens who have seen their living standards and experience of life deteriorate, but, in my work, in the slow, painful deterioration of the NHS.

I started my career as a consultant in 2007. Just before the crash. The next while wasn’t or at least didn’t seem too bad – I was busy working, planning, developing.

I met a colleague on Thursday who took me back to those days, sometimes referred to as the ‘Dr Oxxx years’, named for a cheery locum doctor who spent most of his time on-call (£ per hour), accumulating unmanageable numbers of patients.

Every subsequent year since then, I have seen the shrinkage of investment in health and social care; sometimes covered-up as ‘just social care’ with pseudo-protection for health budgets, but, in reality robbing from Peter to pay Paul, with hundreds of thousands of mostly older people trapped in a health/social care limbo, frequently living the last weeks and months of their lives in a state of suspended social/healthcare called ‘stepdown’ or ‘transfer or care’ or any other number of platitudes which result in a smaller and smaller budget to spend on improvement and evolution in the entire sector.

I remember after the last election, I carried the title of Alan Paton’s 1948* book around in my head for weeks, if not months, ‘Cry the Beloved Country’ – sure, I wasn’t living in Apartheid South Africa, but my sorrow for a nation, for those who would and have lost the most was as great.

Alongside another yesteryear reflection I was returned to the late 90’s when I began working as a doctor. During one of my postings, to an A&E department in North London – ‘long bed waits’ were the accepted norm – in those days it was usual for patients to spend a day or two waiting in A&E; we used to have a department full of hospital beds with people laying, sick, waiting for something to happen.

Don’t get me wrong, there was a tremendous camaraderie and yes, the hours were long, and I possess a bizarre nostalgia for those days (perhaps it was just that I was young), yet, I see it happening again.

A few weeks ago, I sat with a patient for over an hour waiting for a blue-light ambulance; I had diagnosed a stroke.

Much of my work is spent supporting older people in avoidance of unnecessary hospital admission. This I love and I see as one of my goals in life; yet, I also have to convince some people to go to hospital – so unhospitable have our temples to health and wellbeing become; whether through the waits I have mentioned or run-down, dust-ball wards, staffed by a skeleton crew of agency doctors, nurses and therapists.

Again, I do not wish to suggest that most of what happens in hospitals (and in social care) is not amazing; it is. Miracles take place on a daily basis. People care. Yet, the erosion of experience has become so extreme, there is so little fat left to trim that the next stop is surely something beyond the proverbial pound of flesh.

Now I see a threat to our system that risks wiping away decades of progress, allowing our National Health Service to fall into the bank-accounts of shareholders and hedge-fund managers; how many Teslas can you squeeze out of a hospital? How many zeros can you add to your multi-million stockpiles; I am sure some accounants have worked this out.

Why have I been depressed?

Well, I don’t want to belittle the word.

It has more meaning than the clinical one; yet, when you see society deteriorating, when there is so much potential for improvement, that is surely depressing; when you see vibrant doctors and nurses forced into early retirement because the work has become too much, that is bad; when you know that people have and will die because of cuts, what could be worse?

Austerity has been a blot on our country’s landscape that has led to poverty for millions and riches for a tiny number of others;

The measure of any society – and its risk of deterioration, fall or collapse is dictated by the divisions between rich and poor. You can plot it on a chart; the steeper the curve, the more likely are things to go wrong – think Rome, Carthage, France in 1789 or Russia in 1917.

The pressure cooker can only cope with so much before, pop.

How can we save the NHS?

I know that catchy, or pithy questions like this, designed to connect emotionally with the reader can be interpreted cynically. Yet, I wholeheartedly believe that on the 12^th of December we – that is you, me, everyone older that 18 in the UK, has the opportunity to vote for Labour and save the NHS.

I haven’t mentioned all the other policies and strategy plans with which I agree, whether the potential changes to taxation, vote on Europe or review of higher education fees; everything is up for grabs. This is our opportunity to undo some of the mess that has embarrassed us as a nation and damaged us as a people.

Many of the politicians representing us are imperfect. Yes, they are human. They possess shortcomings made big on TV, yet, there is imperfection on the one hand and self-serving, self-interest on the other.

I can’t face more of the misery.

The country cannot.

We need to reclaim our identity.

Vote.

Labour!

*This seemed an auspicious year.