Take it from an American, says Ashley Lane. If the Conservatives continue to dismantle the NHS, millions will end up in healthcare poverty
When I was ten days old, something staggeringly rare happened to my mother: she became quadriplegic (unable to move her arms and legs) overnight. Doctors found an AVM (arteriovenous malformation) in her spinal cord; she had basically had a stroke in her spine. The cause of AVM is unknown, but there was some suggestion that the symptoms had been brought on by the trauma of giving birth.
After surgery and treatment, Mum regained movement in her arms but is still paralysed from under her arms down. As a result, she found it increasingly difficult to work. Eventually she was forced to leave her career, which because we lived in America meant losing the health benefits that came with her job. This left her alone to navigate immensely complex, and expensive, healthcare alternatives.
Sometimes the doctors she needed to see were covered by her Health Maintenance Organization (HMO). When they were not, and this was not an uncommon occurrence, she was faced with paying out of pocket. Specialised and essential services like physiotherapy, which ran at about $150 per session, were not part of the plan. Not to mention the $6,000 or more co-pay for larger supplies, like wheelchairs, or hospital stays that can cost as much as $2,800 – both, once again, out of pocket. Prescriptions, covered by the Medicare programme, were equally as hit and miss. Some would cost $1.75. Others, $60. Even as a child I understood the toll this constant battle took on her, both financially and emotionally.
My mother is fortunate, though. She has had, and continues to have, the incredible support of my family – and as a result avoided destitution. Unfortunately, not everyone in America is as lucky. According to a shocking 2016 Census report, more than 11.2 million Americans are in poverty because of out-of-pocket medical bills. That situation is only going to get worse as the Trump administration begins to overturn Obamacare.
When I eventually moved to England in 2008, I was astonished to find the kind of medical safety net that the NHS offered people like my mother. The same medications for which she would be charged upwards of $50 back at home were roughly £7 in the UK, or free if she were to qualify. Likewise, her sessions with the physiotherapist and trips to A&E after an accident or an illness wouldn’t have cost her a dime (or indeed a penny).
Nearly ten years later the same organisation is almost unrecognisable thanks to gradual financial cuts made by the Government in what looks like a bid to drive the country towards a privatised health system. Though being admitted to A&E remains free for now and prescriptions are still a set price (now £8.60), there is a shortage of staff, resulting in longer wait times for appointments, and what the Royal College of Nursing told the BBC was a “woeful lack of training” among nurses.
“Nurses should be [paid] a salary from the first day of their training and they should have a clear career structure with fair renumeration,” Lydia Walton, a nurse practitioner from North Lincolnshire tells me. “Nurses are the core of the NHS and their strength should be maintained and harvested.”
To cover the shortfall, NHS trusts bring in agency workers, at a cost of billions. “These agencies are making vast amounts of money. Really, the biggest challenge for the NHS is to radically get rid of its internal market and stop contracting services from providers who are interested in profit,” says Walton.
And things are getting worse. It’s been revealed that NHS spending, per person, for the 2018-19 fiscal year would decrease by 0.6 per cent in real terms. That will mean even fewer trained staff. It’s a recipe for disaster, especially for people like my mum, since the social care system (which administers the Personal Independence Payment that determines whether a person qualifies for a wheelchair or modified vehicle, among other things) is also underfunded.
When Theresa May announced in April that she would hold a snap election, many viewed this as a vote about Brexit. But this election should be equally about the NHS. The system is under clear threat and there’s nowhere near enough coverage of the issues. For voters, it’s a prime opportunity to push out the people behind the pernicious decisions that could eventually drive the UK healthcare system into privatisation.
As an American, I’ve found watching the dismantling of Obamacare deeply painful. Now that I’m married to a Brit, I feel horrified to see the UK sleepwalking towards a similar privatised system, with all the inequality that entails. Just think about what it must have been like for my mother to be unable to hold her newborn baby. Now think about having to deal with that AND finding the money for a raft of unexpected medical bills.
The Conservatives can’t be allowed to privatise British healthcare, or situations like hers (and worse) will become a reality here too.
Ashley Lane is a freelance journalist, formerly of The National newspaper in the UAE