In 1985 Yorkshire Television made ‘The Halifax
Laundry Blues’, a news documentary about plans to shut a National Health Service
(NHS) laundry. 1 The Conservative
government, as part of plans to reorganise the service, was looking to put laundry services
out for tender, allowing private companies to pitch for contracts to perform the work.
Although existing in-house services were also permitted to bid, the government’s
clear preference for outside contractors often meant that success was unlikely. The
Planned Obsolescence of Medical Humanitarian Missions: An Interview with
Tony Redmond, Professor and Practitioner of International Emergency Medicine and
Co-founder of HCRI and UK-Med
difficulty is the answer;
I am sure some people do, but it is really difficult, whereas if you can move more
freely between humanitarian and general medical practice, I think you would also
more readily apply in humanitarian settings the technological innovations that are
TRM: That is what UK-Med tries to do, right, taking people working for
the NHS who are trained in care as we deliver it in this part of the world and take
Writing about Personal Experiences of Humanitarianism
the sceptics in the UK’s National Health Service (NHS) the value this work brings back to the NHS. Even if you do not share my motives there is an element of enlightened self-interest for us at home when we return with what we’ve learned overseas in these large-scale medical humanitarian crises.
GO: I cover some aspects of this in the preface to the book because it was really what the publisher wanted to see. I acknowledge all the criticisms of humanitarianism and I was not intending to mount a defence or rebuttal. Rather, I was seeking to offer some nuance in
The National Health Service (NHS) officially ‘opened’ across Britain in 1948. It replaced a patchy system of charity and local providers, and made healthcare free at the point of use. Over the subsequent decades, the NHS was vested with cultural meaning, and even love. By 1992, the former Chancellor of the Exchequer Nigel Lawson declared that the service was ‘the closest thing the English have to a religion’. Yet in 2016, a physician publishing in the British Medical Journal asked whether the service was, in fact, a ‘national religion or national football’, referring to the complex politics of healthcare. Placards, posters, and prescriptions radically illuminates the multiple meanings of the NHS, in public life and culture, over its seventy years of life. The book charts how this institution has been ignored, worshipped, challenged, and seen as under threat throughout its history. It analyses changing cultural representations and patterns of public behaviour that have emerged, and the politics and everyday life of health. By looking at the NHS through the lenses of labour, activism, consumerism, space, and representation, this collection showcases the depth and potential of cultural history. This approach can explain how and why the NHS has become the defining institution of contemporary Britain.
Healthcare aims to be patient-centred but a large gap remains between the fine words and the reality. Care often feels designed for the convenience of the organisations that deliver it, and not enough around patients and their families, or even around the frontline staff who provide it. Why does this happen? What does it feel like? What can be done about it? This book stimulates reflection on these questions by listening closely to those at the frontline. It provides accounts from patients, carers and healthcare professionals who are patients about what it’s like when services get it right, and wrong, from birth up to the end of life. Quite simply, we want to draw upon the power of storytelling – which is increasingly valued as a tool for learning – to help policymakers and practitioners to understand how to deliver better care. We also hope to enlighten the general reader about how they might go about navigating “the system” while it remains imperfect. There is a growing literature of first-person accounts from patients and from healthcare professionals. This book differs by providing a collection of narratives of experiences of the NHS in England to paint a rich and varied picture. Alongside these narratives we provide some international context, and an overview of the history of moves towards a more patient-centred approach to care. We present the theory and practice of storytelling in the context of healthcare. We also seek to help the reader to draw out the practical learning from the individual accounts.
His grin is a sudden breath of air.
History is humble round these parts
but once its storied engines start
the others follow, thick and fast.
In here, the future is a calm propeller,
the lift-off to a second chance,
a gentle runway
from the past. 1
‘Wings’ by Beth Calverley was produced
as part of a commission by ‘NHS at 70’ in collaboration with the Arts
Beyond its seventieth year, Britons are repeatedly
told in culture, politics, and media that the National Health Service (NHS) is loved and
important, yet under threat. 1 What does it
mean when we say that we ‘love’ the NHS? How do different public groups
ascribe meaning to this service? When do feelings about the NHS, such as love or fear, turn
to action, such as protest or changing patterns of usage? Understanding these questions
helps us to think through a cultural history of the NHS, bound up with
Commas are such useful nuancing devices. The careful
positioning of a comma between ‘I’m afraid’ and ‘there’s
no NHS’ changes the intent from a very English expression of disappointment into a
personal statement of fear. Both seem appropriate when we consider the history and current
state of the English National Health Service.
Technically, the ‘NHS’ is on shaky ground as a legal entity.
The institution created in 1948 was the ‘National Health Service’. That was
the title of the 1946 Act of
to feel that something important is missing from
these accounts when it comes to colour, feeling, and meaning. There are different routes
available if we want to address this. One is to turn to the social history of experience, an
approach taken by Saunders, Crane, and Whitecross in this book. Another, and that which
forms the focus of this chapter, is to examine how the welfare state, and here in particular
the National Health Service (NHS), was represented.
If we look sideways to the story of the ‘warfare state’ we
This chapter looks at the emergence of the National
Health Service (NHS) on the British high street in 1948. It explores people’s access
to prescription medicines delivered in shops, as opposed to the health treatments and
consultations available from surgeries, hospitals, or other familiar
‘institutions’ of the NHS. Specifically, the chapter asks: what cultural shift
– evidenced by the millions of patients trailing from general practitioners’
(GPs’) surgeries to chemists’ shops for their free medicines