Tuesday 16 July 2013

We need to have a chat about the NHS

Lately, I've noticed - indeed been on the receiving end - of a new phenomenon.

Suddenly, all over middle England, those drifting gently to the right of a fairly rightish centreground keep popping up on my timelines or in my inbox - or even all over my telly - to tell me patient care in the NHS is not all that it should be.

They message me with glee (which feels quite unseemly) to tell me "13,000 patients died at 14 failing health trusts under Labour" What do I say to that, eh? Eh? "Explain yourself Marsh" they gloat "What do you have to say about your precious NHS now?

Leaving aside the fact it's not true (Why would it be? I'm getting wholly accustomed to misleading stats from this government eagerly lapped up by the media")

Can someone tell me when I became Defender General of the NHS? I missed the memo.

Anyone who's read a single one of my NHS articles must surely know I am as critical of patient care, organisational waste and arrogant corporate cover-ups as I could be? What's more, my criticism has been public and unreserved, believe me, a dangerous stance to take. They surely know I've suffered all of them myself, not once, but many, many times?

But here's the thing. I've been writing about poor patient care for decades. I've been trying to uncover abuses and failures such as those so gleefully seized upon now for most of my life. As those at Mid Staffs and many other hospitals found out, no-one wanted to know. It was virtually impossible to expose poor patient care, let alone get anything done about it. It was hushed up, notes mysteriously disappeared, staff suffered sudden inexplicable memory loss.

How is it these partisans cared not a jot before? How is it I wrote to their very newspapers numerous times about exactly the failures they now adore, yet they were never interested.

Not, that is, until a Conservative government set about dismantling the NHS. Suddenly, in the Express (O'Flynn, you know who you are) Mail, and Telegraph the NHS is a "vast monolith", out of control, unable to meet patients needs due to it's vast public bloating.

The irony is, things have very much improved over the years, not worsened. There are close to a thousand NHS Trusts - Acute trusts, mental health trusts, foundation trusts - for 14 to be failing is tragic but perfectly likely. In every system there is the best, the worst and everything in between. Telling the families of those who experienced poor care or lost loved ones that the system is in fact remarkably functional won't help a jot. Using their pain to poke lefties like me with is bloody disgusting.

Despite all it's faults, I DO love the NHS, these point-scoring fools are right about that. Just swap with me one night when something bursts or ruptures and I am rushed screaming in a whirl of blue flashing lights to the nearest hospital. Swap as I am taken by gurney into A&E, swap as the highly trained staff recognise a genuine crisis and rush around me, intubating and injecting and setting up fluids. Swap with me as they calmly shout orders, acting as one, like a well oiled machine. Swap with me as they ease the dreadful pain and stabilise my heart. Swap with me as they rush me in a blur of sterile corridors towards an operating table and salvation. Swap as I thank any deity who may be listening that no-one is shoving a form in front of my dying face and asking about my "coverage" - worse still, refusing to save me if I have none"

Oh the NHS do acute better than anywhere. Make no mistake. Yes, I've sat in hospital beds so frustrated I wonder how I will make myself stay. I've suffered and witnessed atrocious care. All of those things can and must be addressed.

But they needed addressing 15 years ago too. They needed addressing under the Tories and they needed addressing under Labour. The self regulatory tradition of our NHS must be stamped on once and for all. Transparency must be flooded into every nook and cranny.

I've spent around a month a year in hospitals for most of my life. I've stayed across a string of Trusts, in-patient and out-patient, I've seen initiatives come and go, staffing slashed and staffing boosted. I've seen the very best and the very worst. Yet this new string of critics, with no more than a hip replacement and a dodgy knee between them, try to tell ME where the NHS fails and how that feels!!! The irony.

I love the NHS despite it's faults. I love the tireless dedication of an undervalued, underpaid staff who should have given up and rolled over years ago, but somehow never do, whatever the provocation from Westminster. I love knowing that no matter what I need to stay alive, I will get it. Possibly a little later than I'd like, possibly with a little tussling along the way, but I'll get it. I love that we regulate our medicines properly, unlike our drug-happy cousins in the US. I love that any drug or treatment will be available to me, based on need, regardless of cost. I love that I have a GP just down the road who knows me and sees us patients on the same day we call for an appointment.

I HATE the abuse and cruelty and utter helplessness of a bad nurse or poor doctor. Poor care has pushed me to the very brink of insanity. We have to do everything we can to make sure that no-one ever suffers again as I have, as many have, as those patients at those 14 trusts have.

But using the worst to imply there is no good is shameful. Actually shameful. Don't clog up my timelines with any more of your opportunistic, ignorant, uninformed nonsense, I shall simply direct you to this post. And remember I told you this.

Perhaps, in a few years, we WILL lose the NHS. Perhaps it will no longer be free at the point of care, no longer cover all regardless of ability to pay. Perhaps it will have fractured into a thousand private clinics.

And if you every find yourself on that gurney at 3am I promise you, unreservedly, you will wonder why on earth we gave up one of the best, most equitable achievements in our history. For your sake, I do hope you live to regret it.


  1. That argument from the right is insane troll logic. Cut the resources of the NHS till it squeaks, and then blame it when things start to go wrong as a result. It's the behaviour of an abuser.

    The fact remains that you still have to 'rotten cherry pick' to find the NHS horror stories. Nine times out of ten - probably much more - they will come through for you. Yes, you might wait around a bit. But this is serious stuff, this isn't the queue at Tesco. People shouldn't expect 'outstanding customer service', just health care, and maybe one day the saving of their life.

  2. those against the nhs ...have obviously money or health insurance to pay for treatment ...the irony is at the moment even with private treatment if there is an emergency you are rushed off to a nhs hospital .

  3. It is hard to love the NHS when 2 of the children born to you have died because of their failings - however I have to remember that the 2nd my Dani lived a lot longer because of the NHS; they transplanted her, they cured her cancer and we were grateful - she was grateful.

    We had the best of care for 22 years of her life - then we experienced the worse of care and what is more the knowledge that they did not care - half of what was considered important until we reached that hospital (that hospital which claims to be the best in the land - ney even in the universe) was abandoned as not necessary. Then they, in this centre of excellence, did not recognise symptoms of massive infection - so they ruined her heart and 4 years later she died waiting for heart surgery from another centre of excellence that forgot her.

    Please forgive that I do not like the NHS at the moment - but again this is tinged with the fact that they saved my remaining daughter from a gangrenous appendix this year - but even that was not without problems as it should have been done sooner - they sent her home from A&E, her GP 5 days later recognised the seriousness of her condition.

    I still believe in the project of the NHS - but it is overloaded with administration most of whom seem to be there to make paperwork disappear that is inconvenient.

    I worked in the NHS in the late 60's - I have been involved with the NHS as a patient and the mother of patients for most of my adult life and I have seen the management grow like topsy - it is no longer possible to work out who is in charge. Time to pare it down to the essentials and make the patient the sole focus of why it exists.

    Time for the NHS to have a culture of honesty - my son Edward died in 1976 from their mistakes he was 24 hours old - my daughter died in 2011 from the consequences of their mistakes - and all the relevant paperwork is missing - nothing in that respect has changed within the NHS in 35 years! that is an indictment of the sytem and of course the right wing see this as an opportunity to dismantle it all instead of changing what is wrong - complaints system needs to be independant and outside of the NHS and certainly outside of the trusts.

    Sorry this is a bit of a rant but I still find it difficult to believe how amazingly devious, lying and manipulative the administrators at two of the "best" hospitals. Prince Philip was saved at one of these - the same one that forgot about Dani required urgent heart valve replacements.

    1. When the Neo-Liberals took control of the country they carried out a controlled demolition of the NHS - which has at last brought us to the state it is in now. It was deliberate and probably one of the most evil things the Neo-Liberals have ever done in this country...

  4. Helga - It's not a rant, it's about as close to the reality of our NHS as it's possible to get. To judge the whole system without nuance or thought is shameful. But those of us with a right to judge it, tend to do so in a balanced and calm way. We who have every right to shout and scream and cry STILL want it to work and know that a private alternative will only mean that more suffer. Thanks for your comment xx

    1. Yes Sue, I am despite everything still a believer in the NHS - regardless of some of the terribly partisan things that I heard this afternoon coming from the House of Commons glad I had to stop ironing and go collect grandson from nursery. Time our elected representatives grew up and used their education for the good of all.

  5. your post was good, but "I love that any drug or treatment will be available to me, based on need, regardless of cost." kind of hurt.
    as a fat trans woman abused by the nhs gatekeepers and gender identity clinic policies, i know that's not always true. i know many other trans women and fat people denied care they need based on their weight ("just lose weight, you'll feel better" while a genuine issue gets worse)
    or getting sexually harassed by doctors because they're trans, and then denied all treatment when reporting it - being told they have to see a trans gatekeeper with a waiting list of years to have a growth removed.
    there are plenty of people who need treatments, and who are refused them based on discriminatory practices - the #TransDocFail hashtag highlighted that it's not just a few bad doctors, after all.
    the nhs is good but needs working on, and maybe you do get every treatment you need, but you make it sound like getting treatment you need (even if it requires waiting a bit) is inherent to the nhs when it currently isn't.

    1. Hi Kit,

      In fact it is. If your health providers are rationing care you are entitled to, then that is a part of the problems we need to address. Certainly there is a postcode lottery and there are MANY examples of people NOT getting the treatments they need and are entitled to. But that is NOT NHS practice it is poor practice and as with so many of the seemingly unending battles I've fought, it needs addressing. Good luck

    2. This comment has been removed by the author.

    3. (i really apologise if my comments are showing up multiple times, it may just be that they're not showing up on my screen - i left a couple of comments but upon refreshing the page only the first one was visible. so i deleted that, and am writing it up in one - the second part of which being written from memory.)

      i'd say it's inherent to the idea of the nhs, but not the actual nhs as it is today. transphobic gatekeeping practices are currently baked into policies, for example - policies that're stuck in standards of care documents from the 1970s. that's not an individual doctor's choice, it's what gics are told to work with.

      for instance, google "gender governance group" - these people are high up in the chain, and making policies that affect very wide areas. to say they are not a current inherent part of the nhs and the way it is run would be disingenuous.

      plenty of trans women have challenged these policies, but been told their doctors acted within guidelines. it's systemic. it's not limited to certain pcts or bad doctors - this is a widespread thing.

      to say it's not truly nhs feels like a no true scotsman argument to me. these are lived realities which cannot be explained away by isolated bad cases - nhs policies and guidelines direly need to be updated, so currently it IS nhs practice.

      the fact is that the nhs, per policy, refuses (or gives very large, emotionally painful hurdles first) to give necessary treatment to some minorities. we're talking often years - once you've passed the waiting list! - of total time spent humming and hahing over whether someone is Sure they're trans. "it's a big step, you know. take more time to think about it." all with the threat of being denied treatment if they are judged insufficiently serious about it. while your body continues to develop in a way you are likely at the very least uncomfortable with.

      someone we knew who used to work with policy creation said that they deliberately make the process as distressing as possible for trans people to root out people who are "just doing it for fun", despite no statistical evidence that there is enough risk to warrant that treatment.

    4. Hello Kit,

      My ex is a trans woman, and is currently waiting for the op. Her experiences of the NHS, once she plucked up courage to admit her issues, has been excellent. She has had the very best of support and carefully managed treatment, and easily got through the system to be put on the waiting list for the op, and things are moving quite fast now. There was never a hint of being denied treatment or discrimination. At every stage she has been treated with courtesy and respect by the people in the NHS that she has come into contact with, from GPs, to local gender clinic, to the HQ in London.

      So it is not all bad for trans people in navigating the NHS, to add a little balance to the argument.

      Kind regards


  6. Hi Sue. It really seems that right-wing thinking actually narrows a persons mind. I gave up on newspapers years ago. I am still open-minded about SOME politicians, namely the ones that don't want to hurt everyone who isn't like them. Conservatives and the NHS are not good bed-fellows, but the cynical way small problems are exploited as major failings is so childish and sickening. I will always have sympathies for people who have lost loved ones in any way in life and if there are short-comings in the NHS system, they should and MUST be corrected, but i don't for one minute believe that a conservative will have any more pity for someone if they die having paid for healthcare. No, all the right-wing talking morons care about is the profit made, whether the resulting performance of hospitals is better or worse. Indeed, conservatives will be happier knowing someone contributed to their piggy-banks before they died. So, we know the NHS isn't perfect, but it's more caring and compassionate and suited to the people of Great Britain than any private medical health corporations will EVER be.

  7. Hi Sue, you might have seen my comments recently on the fact that ME/CFS sufferers as a group are particularly, though not exclusively, mistreated by the NHS. Like you, I don't want to lose the NHS. At the same time, I'm only too aware that many who sing the praises of the NHS are perfectly willing to ignore the abuses at the hands of the NHS now, and it would appear, always will be. Basically there is never going to be a right time to say that for many patients, the NHS is neglectful and abusive, to the point of wrongful death and deterioration in health causation. So this is a difficult one. How DO we ensure the NHS is saved, but - likely more important to those mistreated and abused by the NHS - that mistreatment and abuse ceases? I have been extremely frustrated that various key supporters of the NHS have nothing to say about its abuses (not you Sue). I don't know what the answer is, though I think your article here is possibly a good first step.

  8. The NHS is doing the best it can and does some things magnificently but it struggles all the time with excessive administration and is being run in ways where it is about money and resources and systems rather than patients at the forefront.
    Politicians and administrators have forgotten that the NHS is about people and should always be about people.
    When they get that back as the proper focus then the NHS will still not be perfect but it will be going the right way.

  9. Sue, I think you are unfortunately sometimes a target for over-zealous fools, who see you as someone to lay their s**t on, simply because they know you are so proud and you care so much. It is despicable that they give you such stress when you are already have to deal with very hard times in your life. It just proves they have no moral integrity or respect for people. Please don't feel the need to do more than your share Sue, we all know you do more than enough to help disabled people and even people like me, who are not disabled, but want to support you 100%. Do not let their emails and stupid comments get you down, you are NOT responsible for their views. Thanks. X

  10. Awww, Martin, I really don't. I know some people find the cut and thrust of t'internet difficult, but luckily, I rarely get upset, I see each comment as a chance to change an opinion. Thanks for caring about me though :)

  11. We need to separate the notion of the NHS from the practices of particular doctors, nurses, teams or hospitals. The NHS is a funding model: it's that healthcare is funded out of taxation, unlike in the USA where it's funded out of private insurance contributions unless you're elderly, a veteran or in a lucky group of disabled people (I say lucky because not all disabled people get it). If they dismantle the NHS, it will not deal with the problems of bad care one bit - it will just make you pay for the services of the abusive or dismissive (but massively overpaid) doctor up front. The culture of disbelief and psychologising of chronic conditions are problems in the USA too, and the cover-up of ME in the 1980s started there.

    1. Matthew, thank you, exactly! I live in Ireland now and miss the NHS terribly, because whatever faults they have in the NHS also exist here in a system where you have to pay. I'm chronically ill and disabled, and have many friends all over the world with similar illnesses to mine, and from my own experiences and those of my friends, it's clear to me that the same problems exist in all healthcare systems, except one: the problem of not being able to afford it. My mum has only ever known the NHS, and she's convinced that you get better treatment if you pay for it. That may be the case sometimes, in terms of facilities and treatments available and length of appointments, but in terms of knowledge, bedside manner, prejudice, and refusal to take many types of medical issues seriously, it usually makes no difference whether the appointment is free or costs €220 (as my husband's last, completely useless and intensely aggravating rheumatologist appointment did). Anyone who thinks healthcare will improve once everyone has to pay for it or go without is completely delusional.

    2. I would disagree with some of your points in that the NHS as it is currently has ALREADY been shaped by neoliberal forces (since Thatcher, and under Labour too), to the point that it has become part of a two-tier system for many anyway, and the notion of patients as 'burdens on the state/NHS' is sewn into the fabric of the current NHS. The NHS as it currently stands is has allowed that two-tier system through the back door, as it were. But as I've been arguing elsewhere also, there needs to be a much more intelligent framing of the debate rather than knee-jerk reactions of lovely nurses and surgery that was successful - because, as we've already seen, these can EASILY be countermanded by horror stories. The use of ideology in the form of 'stories' about positive experience of the NHS, which effectively demonises those unlucky enough to have been mistreated by it, and alienates a great many people, who might then SUPPORT the Tory narrative because they have nowhere else, intellectually, to go! My ongoing problem is that many patients in the NHS, because of its set-up (and neoliberal forces) are ill-treated, whomever is in power. A useful strategy to support the principle of the NHS without panglossing it's flaws, and attacking the very people who are victims of how it's been operating as a neoliberal process since - well Thatcher I guess - would be to acknowledge its problems, without accepting the Tory narrative of how it should change. That would be a more effective argument then just relying on touchy-feely ideology of how the NHS sometimes does what it's supposed to do and there was a kind nurse once.

  12. I live in the United States, where health care costs are awfully high. I am so envious of your health care system. It's a guiding light to the world of how to be humane to your fellow woman and man.

  13. This comment has been removed by the author.

  14. the nhs is great but there are nurses and doctors within it who shouldn't be there at all and it's a very easy task to get rid of those that don't care

    pity that i no longer work as that was one of my specialist skills in Managing Different Personalities and in the correct placing of the employee and in the firing of those like mp's who just are winging it in life (IE not fit for anything but just talk and cause problems )

  15. To talk of mental health services in particular:

    I've known the worst of the NHS. There was a stunning lack of care displayed towards my brother just before he finally successfully managed to take his own life after having made numerous attempts which required hospitalisation. As a family we predicted it within a specified time frame, and my father also took his own life in light of what happened when we were ignored.

    But, I've known the best of the NHS. My own experience in mental health has been second to none. Even though there's little response the team just don't give up on me, especially when I say that caring for me isn't cost effective. I try, and they try, and I honestly believe I couldn't get better care providers if I paid to be private.

    Jeff said it's about people, and it is. At it's most basic, the NHS is people helping people. The right policies can make passion inspire improvement, but the wrong ones can also make the service cold and uncaring despite the best efforts of its workforce.

    I have a hollow fear that soon we'll hear the repeated refrain of how the NHS can't possibly continue in its current form. They'll avoid the word 'privatisation' but that's what it will be, and it will be much more drastic than making GPs responsible for budgets.

    If I had my way, private healthcare would be illegal, then we'd see how far those at the top are prepared to go to make sure the NHS has what it needs to function and to be the equal of any other system in the world. We'd get the right policies then. But I'm one of those dreamer people, I suppose.

    1. Whoa Pip, that's powerful comment. Could anything sum up better how you can love the NHS and hate it all at once? I'm so sorry for your losses.

  16. Thanks, Sue. I meant to leave the impression that I love the NHS, and that it's worth fighting for. It would be so easy to be negative, as most of the press seem to be today, but would it be helpful?

    If my Dad were still around, despite everything, I'm sure he'd think the NHS was worth it too.

  17. they getting ready to sell it off all this so called bad news softening the public off for a easy sell to the yanks

  18. It is so interesting i was searching for this topic from a long time. I read this article very carefully and now I got all my best information for writing blog on machine . I am so glad that i finally find blog resemblance to my topic. Thanks for this.