Poetical Essay On The Existing State Of Things

The summer news drought has been cancelled. Right back in the middle of the 19th Century, Fleet Street labelled the month of August ‘the Silly Season’ (‘Cucumber Time’ to my European readers). This year we have a vibrant Technicolor news freak out instead. Every time you think that Mr Trump has reached his offensive peak, he comes up with something that breaks into new territory of obnoxiousness. Members of the Parliamentary Labour Party have been just as inventive in coming up with blood curdling un-comradely accusations against each other and the Labour Party’s ordinary membership (today 100,000 new members were characterised by Iraq War apologist Tom Watson as a hoard of Trotskyite entryists and their dupes). This is sporting of them, as it gives Mrs May some breathing space to conceal the gaping rifts in the Tory Party.

There is also some proper news out there. The crisis in the NHS is real. For example,  St Helens Clinical Commissioning Group has announced that it is ‘considering’ suspension of all ‘non-essential’ hospital referrals for four months during the winter to cope with a financial deficit and in order to maintain core emergency services. Meanwhile, United Lincolnshire Hospitals Trusts is ‘considering’ closing their A&E some of the time, because they cannot recruit medical staff. Not even at agency locum rates of pay.

Like global warming, the UK’s crisis in healthcare is not an unstoppable natural phenomenon. It is man-made and it can be man-unmade. It is not a consequence of selfish baby boomers like me living longer than our grandparents did. It has arisen from a variety of government policies over the last 20 years. In many cases, it was known from the outset that the strongest impact of those policies would be felt about now.

In 1991, the Chancellor of the Exchequer, Norman Lamont, said “Rising unemployment and the recession have been the price that we have had to pay to get inflation down. That price is well worth paying”. For children born in the 1980s and 1990s, it was inevitable that the attendant rise in inequality would have an impact on their adult health and social well-being. Now that they have significant health and social problems, austerity has removed the infrastructure to help them.

A lot of the current problems of the English health service track back to Alan Milburn’s tenure as Secretary of State for Health from 1999 to 2003. More than anyone, he promoted the Private Finance Initative as a method of paying for today’s capital developments tomorrow (which inevitably has become today). He distanced Government from financial decisions by inventing Foundation Trusts. It was Milburn who started the dismantling of British postgraduate medical training.

The fact is that the nation has some key choices. Firstly, taxes need to rise, especially for the wealthiest. Health care for all can be paid for, and the most equitable and efficient way of doing this is from general taxation. The alternative is that the people with most illness, who are generally also the poorest, will get least treatment. I have seen this in other parts of the world, and it is unbearable. Who could live comfortably in a country where people routinely died of treatable diseases? Secondly, governments need to stop wasting money on reorganisations of the health service and on badly procured capital projects. Thirdly, the UK Government needs to understand that it has created a recruitment and retention problem that will only be solved when they start considering the quality of life of doctors, nurses and other health professionals. There is no level of remuneration that will recruit people to jobs that are impossible to reconcile with domestic commitments. They need to stop trying to bully junior doctors. It is surely an error of Napoleonic magnitude to open up a second front against senior doctors.

Action on just these three points would probably resolve the crisis. Unfortunately, Mrs May is no more likely to heed my advice than Mr Cameron before her. Nonetheless, the health service will not collapse. Health services never do, not even in war zones. Instead, they just become more and more limited in what they can do. Commitment and professionalism continue to flourish despite the rise of Fordism in health care (see previous blogs), and hospitals continue to function until the last nursing assistant is gone. We do not have to stand by and watch a process of continuous deterioration in NHS. It remains this country’s key civilising innovation of the last hundred years, and it should not be allowed to die of starvation. We need to kick up a fuss.

As for the rest of the news, a lost Percy Bysshe Shelley poem has been found. It’s a political rant written when he was 18, entitled Poetical Essay On The Existing State Of Things’. Even at that tender age, he did commentary so much more stylishly than the likes of me. Shelley was a man of the Enlightenment, and the poem ends with an optimistic expectation of the triumph of reason:

“Then, then shall things, which now confusedly hurled,

Seem Chaos, be resolved to order’s sway,

And errors night be turned to virtue’s day.”

I strongly feel that it is important to remain hopeful in difficult times, but some things really test my resolve. Listening to Radio 4 this morning, I was taken aback to hear alternative comedy legend and fellow Kidbrooke Park Junior Mixed and Roan School alumnus Arthur Smith defending the remake of Are You Being Served? He is a member of the cast. Truly, is nothing sacred?