I am going back to a piece I wrote last week about the NHS. During the depths of the recent COVID-19 pandemic, soon to return to a Nightingale Hospital near you, we stood and applauded our NHS heroes on a weekly basis. And quite right, too. It was a real life story of frontline public sectors going above and beyond their expected duties to save lives and make people better. There was an element within that, encouraged by cynical and populist politicians, that the NHS was perfect thanks to all that extra money invested in it by Conservative governments since 2010. The problem is that this wasn’t and still isn’t true.
That the NHS is a great emergency service is true, beyond reasonable doubt. If you have a life-threatening condition, or one that requires urgent attention, the odds are you won’t die from it. Because of the longer waiting lists, caused by both government underspending and the effects of COVID-19, the sufferer might suffer a bit longer than they otherwise might, but they aren’t a death sentence. For medical issues that are causing immense physical and indeed mental pain – come to my house and you can hear about both – then you’ve got to wait.
Take me – please. To my astonishment, I’ve been given access to therapy for my depression in a matter of weeks. It’s ‘only’ for six weeks and it’s going to take place via Zoom, but it’s something. I do not expect a miracle cure in six weeks but therapy has sometimes worked for me. But here’s the rub: mental health provision where I live (South Gloucestershire) is provided by NHS ‘partners’, which is to say run-for-profit private companies. The company that called me after my NHS referral told me that if I wanted further therapy after my six weeks, then I would need to pay them for it. Now, I could probably afford to pay a private provider, but I have a real problem with this. My experience is that I need a relatively clear head for therapy to work. If I am anxious that I am paying out money which would make a substantial hole in my limited finances, could it not make it less likely that said therapy be of value? In other words, I pay out hundreds of pounds, which might be better saved for a rainy day, and get more ill when I am apparently supposed to be getting better. However, I’m not ungrateful. I’ll take what I can get. But there’s more and worse.
MY GP has referred me for an ADHD assessment. In recent years, various people, including therapists and other assorted well-meaning folk, have suggested that I may have had undiagnosed ADHD all my life. To me, this could explain everything. My woeful performances at school, a lifelong struggle at work and a myriad of problems in my personal life. Initial tests indicated a strong likelihood that I had this condition and I took the information to my GP who made a referral to a specialist. Within a week, I got the unwelcome news that the NHS were no longer accepting new referrals (due to COVID-19 being the usual excuse for everything in the NHS these days) and my referral was on hold. Then, listening to a show on the radio, yesterday I received a massive shock. The waiting list for ADHD referrals was at least two years. Two years and I’m even on it. I’m not going to kid you: I’m gutted.
The interviewee on the radio said that because of the lengthy NHS waiting lists, she went private and got the diagnosis which confirmed what she always suspected. She now feels liberated. Life is better. Good for her. I bear her no ill will. I am just very jealous of two things. First, that she could afford to go private and second being able to live with the possibility of having an assessment which then came up with a negative diagnosis. Paying what would for me by not a small fortune but a large one for effectively nothing would, I feel, drive my depression to new low levels. My view – and I know this is likely to be controversial in a country which has just elected, by a landslide vote, a political party that in its heart of hearts does not support the existence of the NHS – is that after the best part of 46 years worked and paid taxes, I should neither have to wait for longer, perhaps much longer, than two years just for a diagnosis or have to pay for it myself. The thought that I might not live long enough for an assessment is not lost on me and nor is the far more negative thought I might not want to.
Mental health: the Cinderella service, provided thinly, as an afterthought and spun by lying politicians as being regarded as important as physical health. Spoiler alert: is isn’t regarded as important. A patchwork service exists at the bottom end, as well as a limited crisis service at the top end. But in the middle? Almost nothing. In other words, there is a direct parallel between physical and mental health after all. If you’re in a bad way in the here and now, the NHS will patch you up. If they think you can wait, to save them a few bob, then they’ll make you wait.
The weekly clap for carers was nice when it lasted, but things are crap for carers now, as well as the people they serve so selflessly and often for so little reward. The NHS probably won’t let you die because of underfunding but it might make you suffer.
