Eleanor's Letter: Our knackered NHS & how politics and media aren't reflecting our concerns
Queenagers, the NHS, the ever thinner blue line and the election - what do you care about?
Dear Queenagers,
Greetings from the M1 where we are speeding to Manchester to drop off the little one at University; one of the legacies of being a journalist for so many years is being able to read and type in the car. Or it used to be! Let’s hope that’s still a skill I still have. I’ve been sewing my daughter’s waterproof coat – when was it that I stopped being able to see to thread needles? She has to do them for me. But I find mending surprisingly therapeutic.. bringing something back to life, giving it an extra lease of usefulness. All three kids in the back are on Vinted, shopping for ‘new’ second hand stuff. I love it that they take such pleasure in vintage – they don’t care about shops, preferring to winkle out the object of their desires for a few quid online. Good for the wallet, good for the planet, we Queenagers should take note.
This week the drum of impending elections has been unmistakeable. In London the Mayoral campaign is hotting up and in terms of mainstream news we are already in that ‘phony war’ period prior to a general election, even though we don’t yet know when it will be. Having lived inside the news cycle for so many years I am intrigued by what elements of it actually penetrate the civilian world. I used to read all the papers every day – including Sundays when I would wade through an endless pile, ripping out any article which sparked an idea. I’d end up like a bird in a nest of newsprint with a pile of rummaged gold (fodder for the next news cycle). Since I left newspapers four years ago I have given up buying them (I get the New York Times on my phone and the BBC). At first it was like going cold turkey; the sight of the mastheads was too painful, too much of a reminder of everything that was no longer my life. And if I am honest I had had my fill. Part of the reason my eyes are so knackered is 25 years of devouring tiny print in dim light or editing copy for 10 hour stretches. I’ve found it a liberation to let go of the intensity of that immersion in news – but I can still read its inner entrails. I am a civilian news punter with a professional nose. Which is why I want to write about the intersection between real life, news and politics today.
Politicians are always looking for the issues that will cut through. By that they mean the stuff which is bothering us all enough to make us go out and vote on it. What matters within Westminster – inside the Beltway, as they put it – eg whether or not Angela Rayner classified her residence as her primary or secondary abode (which is really all about the Tories trying to project their own sleaze onto Labour) most people don’t follow and don’t care about. I listen to the Westminster Hour on Radio4 and I marvel at the irrelevance of most of the chat to most of the population; most of it is politicians and political journalists dancing on the head of a pin. No wonder so many turn off! (If you want a blast of fresh air on politics then I highly recommend the Jess Philips, Ruth Davidson, Beth Rigby podcast Electoral Disfunction... refreshing to hear three Queenagers bringing their collective wisdom to politics).
But what I have noticed in the last few weeks is how some issues are becoming so acute that they are no longer just tales we read in the newspapers (or on our online apps or social media), but the stuff of actual conversation. What do I mean by that? Well – the other day at the pond I bumped into a friend who has been having trouble getting pregnant. She was happy that her IVF was starting the following day. Was it on the NHS I asked? She laughed as if the question was preposterous. “No I’d have to wait so long and it is such a lottery… “ I talked to my aunt. My cousin has been waiting for nearly three years for an operation on his back. He is the same age as me. Healthy, vigorous, has two young kids. He’s been living on incredibly strong pain killers while he waits for essential surgery on his discs. Any news on the operation? Again the same grim laugh. He’s on first name terms with his surgeon’s secretary – but the operation he so desperately needs keeps being delayed. Closer to home my little one has been sick for months. Endless visits to the GP have been fruitless. Finally I bit the bullet and paid for her to have the investigatory tests she needs. Wow it is eye-wateringly expensive. About £3000 in total. I am lucky that I can afford (just) to pay; I can’t think of anything else more important to spend money on than my children’s health. But the unfairness is palpable. Because I can pay she can get better - that option is not open to most!
I watched a report on the local news last week of a teacher who needed knee surgery and had been waiting two years; she’d had to give up her job because she was too immobile to be safe in the classroom. And in too much pain. There are 6.3 million people in Britain waiting for treatment (it was 4.4 million pre pandemic according to the British Medical Association). Everyone one of them is a person in agony, life impacted by something that could be fixed. The government keep bellyaching about the need to get over 50s back to work. I am sure that many of them are keen to be in employment, are frustrated to be sitting at home, unable to get on with their lives because they are waiting for treatment that never comes. It is a personal and national tragedy.
The truth is that the NHS is not sustainable in its current form – not with an ageing population with increasingly complex care needs and long-term conditions. This increasing demand is only going to increase calls for a brave radical conversation – we all know it – but I can’t think of a single politician who is articulating that. No votes in tackling such a holy cow.
I’m beginning to think that our communal belief in our supposedly beloved NHS is a kind of collective British madness. It is one of the biggest behemoths of an organisation on the planet, second only to the Chinese army. It doesn’t work. Treatment is rationed by wait. Those who can possibly pay, now do. Everyone else waits…that is not fair at all! And what is really depressing is that London is where the rest of the world’s wealthy comes to get treated; Central London is awash with private medical facilities: we visited one swanky one in the Shard. Another off Harley Street. Every floor boasted a different speciality. The customers are either well-heeled Brits on company medical insurance, or families like ours paying because we just about can and are worried – and rich foreigners. In both hospitals the signs everywhere were in English and Arabic… These places have a license to print money – the most basic test is £200, a consultant consultation starts at £325. We pay our taxes so that we can be treated ‘free’ by the NHS – but unless the illness is critical, or part of a trendy scheme (I keep being summoned to have my blood pressure taken) it is almost impossible to talk to a GP and even if you do it’s most likely you’ll get fobbed off, not referred for a test. This is not a criticism of the people who work within it, they are doing their best. But as an organisation it is just NOT fit for purpose; too many people, not enough capacity. Surely it’s time to switch to the kind of social insurance system they have in France and Germany? Where you pay a bit on use, which is subsidised, but the whole caboodle is not state run and inefficient. Breaking it up into smaller parts would help; all huge bureaucracies have huge wastage. I’ve always been a huge supporter of the NHS but it is just not functioning… and the public knows it.
But where are the politicians talking about NHS reform? Ha! Fat chance. They just all say they’ll stuff more cash into a useless system. And don’t even get me started on Social Care, which we all know is a disaster area, but no politician will even mention because there is currently no money and it will take vast amounts of cash to fix it. This is a Queenager issue because so many of us are either hitting health problems of our own, dealing and worrying about those in our families who are sick, or trying to organise care for ailing, elderly parents (20 per cent of women 50 plus are doing at least 10 hours a week in unpaid elder care). When the NHS malfunctions it is Queenagers who end up leaving their jobs to take time out to care… One Noon member said to me last week – “It’s like the politicians know they can’t fix this care issue or fund all the free work we are doing – it suits them for the care burden to fall on older women.” But given the gender pension gap is even bigger than the gender pay gap (women have 35% of men’s pensions at retirement according to the House of Commons library) it is imperative to keep Queenagers working until retirement age of 68 (likely to be more like 71 by the time I get there) so we don’t have a truly impecunious old age. But where are the politicians tackling or even talking about this conundrum? Don’t make me laugh…
It's not just health either. Have you tried to call the police recently? The thin blue line is thinner than ever.. a friend called the police to her house because a psychotic neighbour was threatening to kill her daughter’s boyfriend – it took them three hours to turn up. Similarly a call about anti-social behaviour, some really frightening homophobic abuse, was made by another Queenager three weeks ago and she is yet to hear anything back. These micro experiences all contribute to the macro picture of key services not working. This is the real news; the way the state shows up -or doesn’t - in all of our lives.
It is not surprising that Rishi Sunak’s government looks like it will face a historic defeat when they finally go to the polls – but the depressing thing is that even if they go, the economic situation is so dire that even a change in Westminster won’t achieve much.
Our world is facing huge shifts – demographic (a key part of this Queenager conversation), de-carbonisation (imperative, we’ve just had the 10th consecutive warmest month on record) and AI (if you want to know more about what that means for you join our event tomorrow, free for paid subscribers).
If as a country we are going to respond to them we need politicians who will engage… not who dance around issues that only concern them, or who are too scared to talk about the REAL news, the news which is affecting us all in our daily lives. The media are culpable too. When you are inside the bubble you get too obsessed by what all the other professionals are talking about -forgetting what actually matters to the public.
So I’d love to know what are the issues that are affecting you… what is the News that you care about? And what do you think should be done about it? Queenagers are a key demographic for the election. We matter. Let’s start putting our agenda on the map.
Lots of love
Eleanor
Ps if you are looking for a new binge watch, my top tip is This Town on BBC Iplayer – by the same people who made Peaky Blinders but set in Coventry and Birmingham in the 80s, the back drop of ska/two-tone, riots and the IRA. It is brilliantly shot and acted. I am loving it.
I've worked in the NHS on and off over the last 25 years and what's coming out of those diligently working in it all day every day, is quite different to what I've heard before. The despair, the fatalism, the sense of impending doom - it's different and I suspect, for the sick and the needy, quite dire on a level that even the average long-wait complainant and bed-in-a-corridor sufferrant has no idea about.
I agree though, Eleanor, not a peep is being uttered by politicians about the conversation topics, blue sky thinking and ideation that's needed to get us to a better place. I'm hearing about technical innovations in specific clinical specialisms, but nothing at all about the whole system that joins it all together...
Climate change is absolutely top of my list - Labour marginally better on this than the Conservatives and are at least listening to business about what CAN be done instead of what it is fashionable to fund right now.
Inequality - the levels of child poverty in this country are staggering and unacceptable. why aren’t Labour going back to Sure Start, lifting the benefit cap on >2 kids etc.
Schools and teaching - and if Labour think that putting VAT on private school fees is going to do more than touch the sides of the issues they are facing in the state system then they are badly advised. Much better to either properly abolish/nationalise private schools because there is a genuine ideological position that it is unfair that families can buy an advantage - or to raise income tax across the board if the need is to raise more money. Applying VAT seems to me to address neither issue adequately.
Water quality and a genuine conversation about renationalising the water companies (and the railways) instead of bailing out private companies
Social care as you say - which obviously also intersects with the NHS
And on, and on, and on. And that’s before you even touch libraries and the arts….