When the NHS was created in 1948, an information leaflet said “everyone – rich or poor, man, woman or child – can use it or any part of it”.
In my first year as a doctor I learned just how important that principle is. During that time, I went through an emotional rollercoaster. I remember one patient trying to break my arm on a Saturday afternoon because he thought we were holding him in hospital to kill him, and in that same shift I shared a hug with an old lady who just wanted some comfort. To be honest, I think that hug comforted me just as much, if not more, than it did her. Being a first-year doctor is incredibly hard, and equally rewarding; looking back on it now, there were two patients who showed me how important free healthcare is.
I worked in a small hospital in a former mining community – the kind of down-to-earth place where there’s often not much money to spare. Before the NHS, falling seriously ill there could have been a death sentence, because there just wasn’t any money to pay for doctors, nurses or hospital beds. These two patients were born into a place and time where getting sick would have been a terrifying and common occurrence.
I met the first patient, a woman, during a weekend shift. I can’t remember why I popped in to see her – maybe she needed some blood tests, maybe I wanted to start some antibiotics – but when I got there, she was sat in the chair next to her bed in a hospital gown with her handbag on her lap. When she saw me she started crying. I asked what was wrong. She wasn’t crying because she was ill. She wasn’t crying because she didn’t know where she was. She was crying because she knew exactly where she was, and she was scared.
She wasn’t scared of me, or the nurses, or of being in an unfamiliar place. She was scared because her handbag didn’t have her purse in it, and she thought that if she couldn’t pay we wouldn’t look after her. In her dementia, she appeared to have gone back to her childhood, to a time when everything had its cost, and she thought hospitals were expensive and she couldn’t afford the treatment she was having. I reassured her, told her she didn’t need any money because it was free, and that we would look after her no matter what happened. She stopped crying, but she didn’t look totally convinced. As I left, I wondered how it must have been to have that fear of falling ill when she was a child.
The second gentleman had come in with abdominal pain and needed an operation. I saw him when he came into hospital, and he told me he’d been brought in by ambulance and so didn’t have any of his things with him. I told him not to worry – we could provide what he needed until his family could get to hospital and bring him his own clothes and washbag. He told me with tears in his eyes that I didn’t understand. He hadn’t brought any of his things with him, so he wouldn’t be able to pay me for being his doctor. When I explained to him that it wouldn’t be necessary, the NHS would provide his care free of charge, he looked at me with a huge smile and said: “Really? Thank you, doctor.”
These were both ordinary people, with ordinary lives, who needed healthcare, and received it free of charge. No “Do you have your credit card details, sir?” or “and who’s your insurance provider, madam?”
We have the best healthcare system in the world, and because of that, I could tell both of these lovely people that they would be looked after, cared for, and had nothing to worry about. As I walked away from the second patient in a year who was worried about not being able to pay, I gave thanks to Nye Bevan for his vision and drive. He said the NHS would last “as long as there are folk left with the faith to fight for it”. Let us fight for our wonderful, equalising health service.
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