In Sickness and the National Health

Would anybody like to hazard a guess as to where and when this picture was taken?

I’m not absolutely sure, but I think it was about 1949, in or around Cossham Hospital, Kingswood, Bristol. I think the cute gamine on the far right with the silent-movie expression and a claw for a hand (I can’t think what else it is) is my mother, Zena B. Penrice, then a student nurse.

The point of exposing my deceased mater to ridicule is to ask you to think a little about the NHS we have now and the one we had in 1949. When this picture was taken the cobbled-together institution was probably about a year old, and people were having lots of fun. In the old charity hospitals, like this one, nurses and doctors (female and male respectively) would dress up at the drop of a hat and perform gang-show routines for the patients, whom they had often got to know well.

The reason they knew their patients so well is that they were brought in for long periods. There were very few treatments. Mostly people were put to bed and given a nice long rest, if they had something that could be cured, or allowed to die without undue doctoring if they didn’t. The nurses did nursing, with a lot of emphasis on cleaning, bedpan changing, and bedside manner. The doctors were God. Between the student nurses and God, came the Staff-nurses (step forward future Staff-Nurse Penrice), the Sisters and, most feared and respected, Matron.

Cossham Hospital, and places like it, did its best to give patients peace, stability and nursing care at a time when social problems – poverty, hunger, unemployment, domestic violence, etc – were as bad or worse than they are now. You might be going to die, or you might get better, but you could expect to be treated kindly. Then you’d go back to your hellish life on the Hillfields estate, where your drunk of a father would knock you about, but at least you’d had some respite. There were no trollies in corridors.

That, I would say, is the NHS of the mind that the British public feels deep affection for. Certainly there are plenty of politically motivated “I heart the NHS” movements, but finding people with real love for it, either among doctors or patients, is increasingly difficult. Middle class dinner parties (a tautology) are increasingly full of people saying “I love the NHS, but when it’s your own child/partner/parent you have to do the right thing, even if that means going private”. And who, really, can argue with that?

So what went wrong, and what can be done about it? Well, we could do without a lot of shroud-waving of the sort recently espoused by another organisation that constantly claims to be adored, the BBC. A week of non-news about old people in distress and discomfort, followed by a pious assertion that “everybody gets treated” doesn’t help anyone. Nor, really, does a call for a special NHS tax, although as a short-term measure it has something to commend it.

I come from an NHS family, and have been receiving treatment for 40 years for what they tell me is a lifelong, incurable, life-shortening condition that has to be controlled by powerful medication I should take every day until I am burnt at the local crem. I see a lovely CPN every month and we have a nice chat. He’ll probably be laid off soon.

I think I have a reasonable idea of how the service has changed and what might be going wrong. It is both simple and complicated, and its not just about the hospitals being overwhelmed by frail old people who should be culled, as the BBC reports inadvertently suggested.

I have more to say about this (of course I do) but that can wait. I may even get controversial.

 

 

 

 

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