A Love Letter to the NHS (And What We Need To Do To Save It)

***This is a guest post by Andrew Godfrey-Meers, a PhD student writing about comics, disability and performance at the University of Dundee. Find him on Twitter here. All NHS demo photography c/o Andrew Godfrey-Meers. ***

A Love Letter to the NHS

The NHS & Me

It may seem inane to say this, given that most of us were born into it, but I owe my life to the NHS.

I am one of the approximately 9,000 people in the UK who was born with Cystic Fibrosis, a degenerative illness of the lungs and pancreas. This is an illness that requires daily management, for which there is no cure and has an average lifespan of 40 (I have a 50% chance of making it past that age). At the age of 31 I have the NHS to thank for my longevity and the fact that I am lucky enough to live a relatively ‘normal’ life.

The NHS has been there for me on many occasions: from putting me on a nebulised antibiotic that dramatically improved my lung function in my early teens, to treating me when I terrified my housemates in university by coughing up large quantities of blood, even coming through for me when I got drunk and jumped through a window like an idiot when I was 16 and severed an artery.

I certainly do not think that the NHS is perfect, and I’ll readily admit that I have had some of my worst as well as my best care through this institution. However, I know all too well what an alternative system would look like for me and approximately 13 million other people with disabilities in the UK, not to mention those who are well but who would not be able to afford private healthcare in the future. Using the US system as a yardstick, I would be classed as having a pre-existing condition, and thus be uninsurable, making the average cost of my healthcare $15,000 per year.

Although I am lucky enough to live in Scotland where prescriptions are free, I know from past experience that a months worth of medicine in other parts of the UK could cost me anywhere between £80 and £160. I can’t even get travel insurance that is catered specifically for my illness without paying through the nose.

A Love Letter to the NHS

The NHS Crisis & the Government’s Role

Whilst other parties have certainly had their role to play in the ongoing NHS crisis – both with New Labour’s influx of PFI contracts (itself a policy taken from John Major) and their expansion of privatisation, and then the Lib Dems complicity in the signing of the disastrous Health & Social Care Act in 2012 – the past seven years of Conservative rule have brought the NHS closer to the brink than it has ever been.

Over the past seven years the NHS has been deliberately cut, underfunded, and sold off to private interests in order to undermine it and make the idea of a private insurance-based system seem more palatable to the general public. Before the Conservatives first came into power in 2010 the NHS was in surplus with a record 70% patient satisfaction rating, but in just over two years it was in deficit, and today has had a total 10% drop in patient satisfaction.

NHS Financial Position

This perhaps surprising minimal drop in satisfaction is largely due to the tireless dedication of staff. To quote an interviewee on Channel 4’s recent documentary series Confessions of a Junior Doctor: “The NHS is run on goodwill. Without it, it would collapse.”

The relative silence by the Tories on the changes taking place, especially in their manifestos, has been deliberate. As Michael Portillo himself said: ‘they didn’t believe people would vote for them if they told them what they were going to do.’ (1) Most tellingly the Health & Social Care Act of 2012 had changes in it that, according to former Health Secretary David Nicholson, were so big ‘you could see [them] from space,’ (2) but for the sake of brevity I’ll limit this post to just two:

  • Firstly, the introduction of a clause that effectively absolved the Health Secretary of all responsibility for the population’s health, which goes a long way to explain how Jeremy Hunt is as shit as he is and still in the job.
  • Secondly was the commissioning of services to ‘any qualified provider’ (3) which lead to an influx of contracts being won by the likes of Care UK, Serco, Circle Health, United Health, and Virgin Care, even when internal bids were much cheaper. For an overview of the numbers, click here.

Coupled with the above are the euphemistically named ‘Sustainability & Transformation Plans (STPs)’ which basically mean £20 billion in cuts and 19 hospital closures by 2021 – when this is considered alongside the Tories apparent £10 billion in funding for the NHS so far and a further £8 billion manifesto promise, well, it doesn’t really add up to much.

There are countess other messes that the Conservatives have made when it comes to the NHS; the Junior Doctors strike, the poor treatment of whistleblowers, the removal of the student bursary and the measly 1% pay rise that has left nurses needing to use food banks or quitting the service to work in supermarkets because that work is better paid. This last one has a particular personal resonance for me as the majority of my care comes from specialist teams of nurses, or ward nurses, rather than doctors – so I for one fully support the decision by the Royal Collage of Nursing to strike over their pay this summer.

A Love Letter to the NHS

So What Exactly is the Problem With Having Private Companies in the NHS?

Well, a prime example would be that this flawed system has lead to farcical situations such as Virgin Care suing the NHS recently because it lost out on a contract to run children’s services in Surrey. Additionally, many of these private companies are based offshore, so don’t pay tax in the UK, this means that they do not contribute to the overall economic health of the NHS. Their profits are syphoned back into the companies themselves not used for the public good.

There’s also the fact that private companies are allowed to operate using the NHS logo, often meaning that patients aren’t aware they are being treated by a private company, so when these companies underperform (which they frequently do) it’s the NHS that gets the bad press. Also, there have been increasing instances of electively private patients being prioritised in NHS hospitals for operations, which amongst the increased rationing and cancelation taking place at the moment, is deeply unfair.

I do not object to people making the choice to go private for their healthcare, I object to it no longer being a choice. I reserve my right to be suspicious of a private company’s motivation when it comes to matters of health, where profit should not be an incentive over people’s lives.

A Love Letter to the NHS

Conflicts of Interest

There are incredible conflicts of interest in Tory health care policy and once you look for them, they are – as Nicholson so eloquently put it – so big you can see them from space. It has been pointed out that Jeremy Hunt co-authored a book called Direct Democracy that contained a chapter calling for the de-nationilisation of the NHS. I would point to the involvement of Tory MP Oliver Letwin as being much more indicative of what is happening in the NHS right now.

Letwin was one of the lesser known architects of the Health & Social Care Act and has been with the conservatives since Thatcher. His book, Privatising the World, lays out his theory of privatisation – including ways in which to make sure the public accept it. It is reported that during a meeting in 2005 he remarked that ‘the NHS will not exist’ (4) within five years of Conservative rule, and alongside Tory MP John Redwood he wrote the twenty-page pamphlet ‘Britain’s Biggest Enterprise: ideas for radical reform of the NHS.’ Numerous recommendations from this pamphlet found their way into the Health & Social Care Act, but perhaps the most telling quote from this pamphlet is the one that echoes Portillo’s earlier sentiments of incremental change and secrecy:

‘But need there be just one leap? Might it not, rather, be possible to work slowly from the present system towards a national insurance scheme?’

The list of MPs (mostly Conservative, but also a handful of Labour & Lib Dem) with links to private health care companies is a sight to behold. Even Simon Stevens, head of the NHS, is not squeaky clean; he is former advisor for Tony Blair’s health care reforms and has been employed at various high levels by the private healthcare company United Health before getting the top NHS job.

Vote NHS

What Can I Do?

As in life, there will be a broad spectrum of political views held by workers within the NHS. There will be some people in the NHS that may believe in privatisation, or wish to benefit financially from it; however the loudest voices within the NHS have been the ones that believe in its core message of healthcare regardless of means, and these voices have been warning us about what is happening for quite some time.

I for one am more inclined to believe these voices than the empty rhetoric of the so-called Tory ‘party of the NHS’ whose record would suggest that they are anything but.

I would urge you to listen to these voices, and the voices of people with disabilities who have suffered needlessly under the Tories.

I would urge you to believe in these voices, and to support them, with your voice and with your vote.

I would urge you to read the Labour Party Manifesto if you live in England and Wales, which puts reversal of PFI’s, removal of private companies, increased funding, pay increases for nurses and the return of the student nursing bursary at the heart of its policy.

I agree with Theresa May on one thing: this is the most important election of our lifetime, but not for the reason she wants us to believe.

The NHS saved my life and many others, now it’s time for us to return the favour.

A few organisations, people, and articles that are worth checking out/following on Twitter &/or Facebook:


(1) https://www.youtube.com/watch?v=StUFD6FTXe4

(2) https://chpi.org.uk/wp-content/uploads/2014/01/The-architecture-of-power-in-the-NHS-Scott-Greer-Jan-2014.pdf

(3) https://www.ft.com/content/5d4f52cc-2c42-11e7-bc4b-5528796fe35c

(4) http://www.independent.co.uk/life-style/health-and-families/health-news/letwin-nhs-will-not-exist-under-tories-731278.html

***This is a guest post by Andrew Godfrey-Meers, a PhD student writing about comics, disability and performance at the University of Dundee. Find him on Twitter here. All NHS demo photography c/o Andrew Godfrey-Meers. ***

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