CHORAL MUSIC
Here's a thing.
How, exactly, would you say, does an idea begin?
Where does it all start?
In one woman's brain?
One man's heart?
Doesn't seem likely, does it?
I mean, all of us are fuelled by the thoughts of others,
by what we've read, gleaned or seen.
Take all this -
health care, medicine -
didn't just rise from nowhere, did it?
Someone, somewhere, I always think, back across the millennia,
must have been the first
to lay a hand on the wound of a stranger.
In a cave, maybe, ice at the mouth, a fire beside.
Or perhaps later, in a hut or a shelter.
Wherever, whenever it was,
someone must have been the first to offer comfort beyond their tribe.
Not because they had to or should,
but because they could.
Someone else again would have seen that, watched,
learnt how to do the same,
what stanched the blood, eased the pain.
And so it must have begun within us,
not so much an idea as an offering -
a caring chain of practice and knowledge.
A refusal, as a species, to just lie down and take it,
but rather, through attention, intelligence, care,
foster a belief in our agency in life,
our ability to pit our empathy and wit against
sickness, disease and death,
the trials of the body and the brain.
To say, when our health goes south, "No, not this."
To Provide All People,
a poem in the voice of the NHS, by Owen Sheers,
inspired by interviews with the patients and staff of the NHS.
Part One - Birth,
from that once imagining.
I was pregnant with our second,
when, at 28 weeks, one night I started to bleed.
There was pain, too. I didn't know what to do.
My husband was working away, so,
well, I'd never done it before,
but, for the very first time, I dialled 999.
And they came.
They were so calm, the ambulance men.
Talked me down, told me everything would be all right,
put me in the back,
then, with one holding my hand, drove off, at speed, into the night.
That night I found it frightening.
I mean, they were in danger, that's how it felt.
Both of them - their lives in the hands of a system,
strangers.
The midwife I'd first seen, she stayed with me.
She didn't have to.
I could see that she was busy, but she did.
Sat with me there, just holding my hand,
while I cried,
not knowing if the daughter inside me was alive or had died.
By the time I got there, it was morning.
I'd driven through the night and came in running.
At that point I was...scared, I guess,
for my wife and the life that she held.
It held so much, that one machine,
and we could feel it...
..the fate of our daughter, who, if she'd survived,
would one day love, imagine, dream and be.
Or wouldn't.
Because of course, that's what else was held in that screen,
as they lifted my gown and squeezed out the gel -
the possibility that all that future life,
hers and ours,
had already bled from out of me.
The NHS, it's there for when the pattern breaks, isn't it?
When the day we expect, the story we're living,
whoever you are,
takes a turn we didn't see coming.
Being a midwife, people often say, "You're lucky,
"you're at the other end of all that.
"You bring the turn everyone wants - new life in the room,
"two people arriving, three going out."
BABY CRIES Shhh...
And it's true, mostly we do.
And that's amazing.
It gets me every time, that creation of joy.
But birth,
well, sometimes I think that's a story
we expect to run too easy,
and it isn't always like that.
You'd be surprised how often it doesn't work out.
When that happens, though, there's still care to be given.
I'd say more, perhaps.
I'll cry with them,
give them a cwtch.
I mean, we're not robots, are we?
I knew before they turned the screen to us.
The midwife, it was written on her face.
And sure enough, when they did, she was there.
Our daughter.
BABY'S HEART BEATS
The white of her in all that fluid black,
her palm blooming briefly against the amniotic sac,
as if to say,
"Don't worry, Mam, I'm here, still here."
So was something else.
More black.
Pools of it throughout the placenta, like lakes on a map.
A bleed, that's what they called it after.
A haemorrhage, making the womb more ticking bomb than cosy home.
It all happened quickly after that.
30, 40 minutes later and they had us all in theatre.
"What is now proved was once only imagined."
A good line, that.
William Blake's, though, not me.
Fitting enough, I suppose, for all this.
Except, of course, it gives no sense, does it,
of how difficult it was
to birth such a happening from that once-imagining?
So, where to start, then, in telling that story?
The story of how, in the wake of a war,
we came as a country to care how we do.
How, 70 years ago, all this began.
Not the idea born fully formed in the mind of one man,
but, yes, its becoming tangible through his action.
Aneurin Bevan.
Born the sixth of ten, he was, in a two-up two-down.
Think of the soul of that town, Tredegar.
The spirit of his generation.
A culture of communal ambition,
in which power was a vehicle for ideas,
and ideas close cousins of action.
A desire to rise, not out of your class, but with it,
to make collective contribution a source of individual emancipation.
A belief in a civilised society,
in terms of wealth, health and beauty
for all and not just the few.
Ideas, conviction, vision -
they all need a soil in which to be sown.
And for Bevan, this was his.
And what fertile soil it was,
this hinterland of the young MP who, after years of opposition,
found himself, in the wake of a terrible war,
tasked by his Prime Minister
with both housing a bombed-out Britain
and creating, from the drained public purse,
a health service fit for the nation.
And if it hadn't been?
If the formative soil of the minister for health
at that time and place had been of a different constitution, then what?
SHE SCOFFS Well, if you ask me,
one's thing's for certain,
the shape and nature of all this
which we now consider so much a part of us...
..would have been very different.
And so would we.
I remember, as a child, in India,
my mother would ask us to pray for the women in labour.
If they needed a caesarean, you see, there was no facility.
Sometimes just to bleed could be fatal.
The hospital was hers, she set it up,
a nursing home for pregnant women in a place called Kinnigoli.
The first time she visited me, she was shocked.
"Is this really," she said, "the NHS?
"God! Look at the curtains!"
We'd heard so much, see, about the NHS, in India,
and there, well, private practice, it's very posh.
So, I had to explain to her,
"Yes, Mummy," I said, "It is.
"And yes, I know the building is old,
"but all this care you see -
"the latest machines, the drugs, the bloods, it's free,
"and that, not the curtains, is where you look for the beauty."
The election that brought Labour to power was an election like no other.
The public made their voices clear.
They said goodbye to Churchill, their greatest war leader ever,
and voted, instead, for change -
a new way of being.
After six years of fighting,
they wanted to see the national energy they'd witnessed
turned to the work of peace.
A welfare state, a new society.
Because of this
there was cross-party consensus
for the creation of a national health service.
From the off, there were two clear obstacles of opposition.
The first of these was the hospitals.
All previous plans for a national service
had them staying under current control.
But Nye, well, he wanted more than that,
a service owned by the public.
Excellence for everybody.
Only the state could achieve all that,
pay those bills.
So, there was, for Nye, only one solution -
nationalise the hospitals.
SHE CHUCKLES There was outcry.
From local authorities, doctors, politicians and press.
No-one had ever imagined a minister doing this.
The last thing I remember, though, was something I held, not heard.
A hand.
I still don't know whose.
But someone, a nurse, one of the team, had come to sit beside me.
A man, I think, from the texture of his palm.
I squeezed it tight, and in some way that helped.
A human anchor, a compassionate tether,
as I slipped away into a chemical night.
I've never felt, at once, such gratitude and dread.
Thankful my wife and daughter were there receiving the care,
the procedure they needed,
but fear, too, at what the outcome might be.
Then, suddenly, there was a midwife at the door.
"Come on," she said, "time to meet your daughter, Dad."
When I first saw her, she in a side room,
her chest rapid with her tiny lungs,
she seemed so small,
of no size at all to be at the centre of so many.
But there she was.
Alive.
"Can I pick her up?" I asked.
"Yes, of course," the doctors said,
one from Vietnam, I think the other Syria.
For a moment, we all just looked at her.
The most common of moments, regardless of nation.
Life brought into the room.
But then she started changing colour.
"She's going dusky," someone said,
and in seconds she was being rushed up the corridor,
the nurses running with her incubator.
Just minutes old and, once again, the system had her.
That second obstacle on the horizon before Bevan
was the doctors themselves.
The British Medical Association.
For 18 months, they locked horns with him.
Where Bevan saw reform, you see, they saw a darker fate,
a loss of medical freedom in a totalitarian state.
I mean, imagine that!
The doctors, being the sole reason
why the public, sisters, nurses
couldn't have their service.
In January of '48,
just six months before the Act's implementation date,
the BMA passed a motion of no confidence.
Bevan knew he had to find a way through.
His tactic was to appeal to the individual,
the doctors themselves,
not their association.
So, gambling on keeping to the day when the Act would come into effect,
Bevan gave a speech in February of '48,
in which he let fly at the BMA,
proving, one by one, their fears to be phantom,
before concluding...
..that this great Act should have so stormy a birth.
We all hoped it would have excited the medical profession...
..that despite our economic anxieties
we are all still able to do
the most civilised thing in the world...
..and put the welfare of the sick before every other consideration.
Together with minor concessions, Bevan's tactics worked.
And by that May, the BMA had advised the profession
to work with the service coming into being.
Somehow, he'd done it.
Against a weight of sceptical opposition,
including the Tories,
who voted 22 times against the Act.
In a couple of years,
he'd brought about a drastic shift in the country's cultural position.
Health care free at the point of delivery would,
in a matter of months, become a right...
..an expectation.
So much more than this,
than just a political victory.
No, all this...
..it was about more than that,
as Bevan himself said on the eve of the implementation of the Act.
"We now," he told the crowd, speaking at a rally in Manchester...
.."have the moral leadership of the world."
Moral again.
This was always, you see, for Bevan, about one thing.
Poverty and the shadow it brings,
and our ability as a species to work together,
if we want to,
to make that shadow just a little bit brighter.
"I believe it will lift the shadow from millions of homes.
"It will keep very many people alive who might otherwise be dead."
"It will relieve suffering.
"It will produce higher standards for the medical profession."
"It will be a great contribution towards
"the wellbeing of the common people of Great Britain."
So much new life in one room,
and sometimes hanging just by a thread.
Not just the babies, but the parents, the families,
all in our hands.
It is worth it, though.
I mean....sometimes, I think, in here, the place,
it's the best embodiment of the NHS.
These babies, they're from every background.
Well-to-do, Valleys, poor, well-off.
All got different lives ahead of them, too,
and, yeah, the playing fields will get unlevelled, all too soon.
By the age of three, for many, their life chances will be set,
and mostly by money.
But in here, see,
they all get the same care,
regardless of who they are.
And that...
..that really matters to me.
When I next saw her
she was in one of the cots in the special care unit.
There, at her head, oh...
..already on a label, with a cartoon of Alice in Wonderland,
was her name...
..Siriol.
Which is when it came clear.
Yes, the system had her,
but it was holding her, too, as an individual.
A person, newly through the looking glass
into this world of us.
And not only that,
but there she was,
at that moment,
along with my wife two floors below,
being stitched, the most precious things in my life.
And yet not once, despite that value,
had anyone mentioned money, payment.
And for that, too, I felt grateful.
Not because I wouldn't have paid it, of course I would.
But that's the point. Others couldn't.
And even if they could, it would be so easy to exploit, wouldn't it?
Health. Love.
But there, in the NHS, no-one does.
And THAT, I'd say, more than anything else, speaks well of us.
# Hold on to your heart
# It is all we are
# Till the breathing starts
# Hold on to your heart
# Hold on to your soul
# We are young and old
# Till life takes its toll
# Hold on to your soul
# They come one, they come all
# Brokenly beautiful
# Rise and fall Fearlessly wonderful
# All, all, all
# People
# All, all
# People. #
Yes, I do remember in fact, when the Act came into effect.
Or, at least, I remember when I first realised what that meant.
I must have been eight, nine, early Autumn, starting school,
when I walked into the dining room
to find the table empty, which was unusual.
Every quarter, you see, my father would use that table
to lay out his bills before sending them out.
It became a...
..a thing, I suppose.
Something my mother complained about.
Except then, in the autumn of '48, she didn't have to any more.
Because they were gone, weren't they?
Now, it would be a mistake of course to pretend it was all as simple
as that, that before July 5th, everyone paid and after they didn't.
My father was always saying
how patients still got treated for free before
via charities, the panel...
..or through doctors playing Robin Hood,
offering their services gratis to those who couldn't pay,
then charging those who could.
But at the same time, well, it can't be denied, can it?
That relationship between patient and doctor,
the country and health care, whether old or young, rich or poor,
infirm or able,
it altered overnight.
The best of medicine for everyone, no longer a luxury...
..but a right.
And taken off the table those bills,
that money,
and with them so much else.
Inequality, stress, avoidance, worry.
CHORAL MUSIC
Part Two - Life,
these chains of care.
As is so often the case, I inherited my interest from someone else.
A consultant who trained me. You hear of that again and again,
you're a young doctor trying things out then you meet a certain surgeon,
a specialist who somehow makes their subject light up, make sense.
For me, it was the brain,
the way Matthew spoke about it with such reverence.
So I hope I'm doing the same now, with my own students.
Passing on, down the chain.
What drew me was the culture and everyone bonded by this common goal.
I found it infectious, the mentality,
a shared desire to care.
Look at this, these places, they're the most equal, democratic
and diverse we've got,
and no-one after your money when you walk through the door.
Where else does that happen?
I don't know, we're always being told
that NHS could learn from industry
but I'd say it was the other way around.
The altruism of the staff, the loyalty.
If an industry could foster that, it would be one hell of a company!
I don't know, sometimes it feels like an island,
an island of care
marooned in a wider society that doesn't any more.
In some ways, it's primitive - medicine - it's raw,
and yeah, you can feel exposed, especially at night,
when you are on your own
and there are patients flooding through the door.
But at the same time, when you've got the whole hospital at your back,
on call, when the team come together on a resus,
or something similar,
well, there's nothing like it.
Having an immediate effect, that's what I like.
People present with a pain,
in their chest, their leg, their head,
and in the best cases you take it away,
and when you do, you see them come back to you.
I don't know, it's about wanting to serve, I suppose.
Put my shoulder to the wheel,
and in doing so, be part of the world that heals, not hurts.
I guide them through the process, the funeral, cremation -
all paid for by the health board, mind -
prepare the father for what he might be asked.
If he wants to carry the coffin, that kind of thing.
We offer the option of a cold cot too,
for when the mother isn't ready for the goodbyes just yet.
It's about gifting people time, isn't it?
And not just Mum and Dad either.
I mean, I've known nurses, midwives in here,
who, when a baby won't survive
and the mother would rather not see, or can't,
will take that foetus and just cwtch it in a corner
until its heart stops beating or the breaths stop coming,
so, for those few seconds, it can feel human warmth.
Thousands of moments of quiet care, and not extraordinary, either.
Because at its best that's what it is, isn't it?
The NHS.
Compassion being just the way things are.
Pain, you see, especially acute or chronic,
it folds you in until all you have is the present.
You ease it, and for the patient, time grows again.
Who they can be, what might they do.
Which is why it's so hard when you can't.
Ease it, I mean.
Often, especially if they're elderly,
we have to be their windows.
I mean, when you're ill, really ill, your world closes in.
So that's something else we can do beyond the general care.
Talk, listen.
For many, if they live alone, that's a treatment in itself.
So, yeah, we try to be an opening to their past,
their lives outside and, hopefully, to their lives after, too,
when they leave.
And, oh, when they do,
that's the best!
When a patient gets well...
..and then comes back.
SHE SOBS SILENTLY
Sorry...
I encourage my patients, when they're better,
to go back to critical care, say, "Hello."
Otherwise, you realise, the nurses there, they only ever see them ill
which is, I think, denying them the greatest pleasure.
Seeing that person, who for weeks maybe, they've cared for -
washed, treated, worried they'd lose -
now out of bed and back in their clothes, and their own life
once again. I mean, isn't that why we're all here,
to make that happen?
I run an emergency clinic, mostly for limb salvage,
but, um, I do this a lot as well, community visits.
Some of my patients, see, they can no longer leave the home, so, yeah,
I come to them.
The first visit is vital
to asses the risks, the needs,
and of course to start to make that bond.
Obviously that gets stronger with those you see every day.
The chronic, the diabetic.
One woman, we spent Christmas with her family.
And another man put us in his will because, well, for him,
that's what we'd become.
It's still a privilege, though, to go into someone's home,
or to be giving them care when they've got no-one else there.
And to be doing it too on the NHS.
I mean, most of my patients are poor.
In a paying system, well, a lot them would just never present.
When a heart arrests, it often doesn't stop
but what does happen is a fatal change in its rhythm.
The electrical charge that makes the muscle move
goes from a smooth, regular pattern to no pattern at all.
Chaotic.
This means the heart is no longer efficient,
and therefore no longer feeding blood to the brain.
And that can be it.
The difference between someone being here and not.
Electricity, and rhythm, our rhythm.
That's what starts us and can make us stop.
It leaves you thinking, of course it does, if them, why not me?
Or my children, my wife?
Which is why I always say to people, "Don't postpone."
Who knows what's round the corner?
Live for the here, each other.
Mental health.
I'd say we still separate it too much
from how we think and treat the physical.
Which is odd, because that's hardly how they exist, is it?
And the aims, the outcomes, they're the same - making people better,
saving lives, keeping them together as a person and with each other.
It's just, where a surgeon might work with a brain,
we try to do the same but working with a mind.
Because both, if they're ill, can kill you.
It's the risk, that's the most exhausting for me,
the judging of it, and the carrying it, too.
There was no trigger, really, just a band run of months.
My stepdad, well, we'd never got on
so as soon as he could he chucked me out of our home.
Then, a few weeks later, my best friend died.
I just felt empty, alone.
I turned to drink, and started self-harming, too,
as a way, I suppose, of trying to feel.
I didn't know, see, how to deal with it -
losing my friend.
I ended up on the streets, suicidal.
It was the police, in the end,
who put me in touch with the mental health teams.
I can't remember their names,
but I still see their faces when I go to dark places,
and in that way, I suppose they're still helping me now.
They made me see, too,
how when things go south, you've got to reach out.
But then that's why I'm so grateful, really.
Cos even if I'd known that before,
well, it only works, doesn't it,
if there's something there, someone to reach out for?
I'm humbled by the insights I've had into people's lives.
The stories they want to tell and the array of patients I've met.
I mean, mental illness doesn't care, does it...
..about class or social status?
It hits everybody.
My colleagues, too, they're extraordinary,
you throw them a name,
a name...could be from years ago
and they'll... They'll remember their histories, their cases.
But then, that's the most rewarding aspect -
being a part of patients' lives.
And why I entered this field.
Not just to find out what's wrong and how to heal them, but...
..also who they are.
If you do that,
it's not so much watching them get better
as watching them escape.
That's how I think of it.
They're enveloped by a condition, an...an...an...an alter-ego,
and with our help, the person inside, well, they...
..emerge from it.
It was about two or three days after we brought her home,
a month, I suppose, after she was born.
I couldn't sleep, was pinned to the bed all night
with anxiety, fear, terrible thoughts.
I knew, then, that something was wrong,
just when it was meant to all be so right.
# Hold on to your soul... #
I went to the GP and asked for help,
and within an hour the crisis team were here, in our home,
giving us care.
# Hold on to your soul
# They come one, they come all
# Brokenly beautiful
# Rise and fall Fearlessly wonderful
# All, all, all
# People
# All, all
# People. #
# Hold on to your hope
# When there's nowhere left to go
# When it's the end, you'll know... #
I worked in America for a bit, and was ill a few times while there.
And the first question they asked me was about insurance, how I'd pay.
When I came in here that day, I thought about that again.
How different it was,
when the triage nurse, before anything else, asked me first...
So, what's your name?
I slipped and broke my wrist, the radial bone.
When the doctor saw me, she explained
that rather than go for a plate or pins,
she and a colleague would manipulate the bone back in.
It was fascinating.
Like choreography, almost.
There was a trust, you could see,
born from them having seen the worst together, but also the best.
Eight days later, I came back to the fracture clinic.
I'd never seen so many broken bodies in my life!
And with every plaster holding not just a bone
but a story as well
of that moment when life took an unexpected turn
and a sudden pain brought them,
with all their different pasts and futures, here...
..to be put back together again.
Hm!
Working in it all those years, yes, it did make me,
well, a bit more socialist, I suppose,
which, let me stress, was never my natural position.
Still isn't.
But then, how could it not?
When you see the idea in practice, week in, week out,
it can't help but affect you.
To operate in the space of an hour or two, as I did once,
on a Lord then a rough sleeper.
To see that equality of care in front of you in the theatre,
it...imbues you with something.
And over time, I think, it made me see how the NHS,
it contributes, maybe, to more than just the health of the nation.
It's about social cohesion, isn't it?
A shared idea embodied in an entity
that enables our society to discover, and witness,
its humanity.
What would I say to Bevan?
Mostly, "Thank you," I guess.
And that he must be really proud of all the people he's helped.
Thank you.
But then, it was born of the people really, wasn't it?
But, yeah, thanks, because, at the end of the day, it's about life.
Congratulations! It's a great invention.
Because you know, you can really judge a country's civilisation
from how well the government cares for its people.
I'm sorry.
That's got me a bit tearful.
Thank you...
..I suppose.
And, probably, I'd want to ask him, too,
how should we hold on to the legacy?
I'd thank him for the balance.
Yeah, the balance it's put into society.
But I'd ask him, if he came back,
to appeal to the public about what they want.
I would kiss his hands!
Part Three - Death,
before you even saw.
This was back in August.
We had a young girl come in with cerebral palsy, a nasty sepsis.
Lovely girl, almost 20.
When I looked at her birthday,
I saw she was only a month younger than my eldest daughter.
Anyway, she'd never spoken, nor been mobile,
but she could communicate, in a way, with her Mam.
All this, you see, this is the kind of thing taken into consideration.
Because it was clear that she wouldn't make it...
..that the only treatment now was palliation.
And in the light of that, her mother and father asked
if they could take her home to die.
Well...well, we weren't too sure what to say.
It would mean a portable ventilator and a nurse, too,
to remove the tube there in the home.
But...it...
..it could be done.
So my manager, she said to me, "Will you be the one?
"The nurse who will accompany them?"
So, I did.
We took her home, helped the parents get her up to her bedroom...
..then they left and I got her dressed.
Into some pyjamas. Her own, y'know?
It was, if I'm honest, lovely,
to see her there surrounded by photos, in her own bedclothes,
her chair.
Everything that was part of her being her.
And when I was done,
I called the family back in and said,
"Look, I'm going to go downstairs and have a coffee, so,
"when you're ready, just let me know
"and I'll come and remove the ventilator tube."
Just the day before,
I'd had a conversation on the phone with a woman in some office.
"Do you feel qualified for this?"
she'd asked, "You'll be on your own, without your unit support.
"Anything goes wrong, you'll be held to account."
"I'm taking a girl back to her home to die," I said,
"with her family.
"What more support could I want?"
It's not to say I wasn't nervous, I was.
But, you know, in the end,
the happening of it was all the answer I needed.
After 15 minutes, they called me back in.
I removed the tube,
and some hours later she died.
And with her mam holding her hand, all the way through.
Not on a ward, mind, or on a hospital unit,
but there, where she belonged, in her daughter's bedroom.
It was like a gift, and, yes, I suppose it was.
But for me, things like this, it's in the DNA of the NHS.
To be able to give a gift like that,
to offer more, not less, to its patients,
who are, after all, the people who own it.
Cradle to grave - that was the concept.
And God knows I can vouch for that.
Within an hour, some days,
I'll go from being a stork one moment,
wheeling a newborn onto the ward,
to old Charon the next,
pushing a body, minutes later,
over the river and down to the morgue.
Because, well, we all have our seasons, don't we?
Our sand in the glass.
And not just people, either.
Plants, trees, animals, anything that lives.
Like ideas.
I don't know, sometimes you can't help wonder, can you,
given the direction of travel, if the sand in this glass isn't...
..well, running out?
How, though, exactly, might that happen?
How might an idea, once alive, come to die?
I'll tell you.
From inside.
Hollowed out, without you noticing, until it's a shell, no more.
Gone, before you even saw that it was going.
That's how.
Being so short-staffed, that's the hardest part.
And that's getting worse now, isn't it?
I mean, we've had amazing Spanish nurses here,
Portuguese, Romanian, Italian.
But now, with Brexit, they've either gone or are thinking of going.
For something this size, the NHS, it's surprisingly efficient.
One of the best.
But I'd say we could be better again,
if only we had the time, the space, to take it in hand.
But how can you
if you're always in that present moment of pain?
Yes, I am nervous,
like lots of my generation,
that we may be party, while we work in it,
to the service's dissolution.
Pay freezes, nurses losing their bursaries, cuts in social services.
I don't know, sometimes it seems it's like they want you to break.
It's sowing the seeds of doubt, isn't it?
And where will that lead?
I mean, this whole system was built on belief, shared purpose
and it's that which keeps it afloat.
You erode the idea, then people will think it's impossible,
we're asking too much. The whole bottomless pit argument,
when really it's not.
A world-class service needs a world-class budget,
simple as that.
Underfund it, then, yes, at times, you'll make the broken story true.
Winter pressures, outbreaks of flu.
But there's a difference, isn't there,
between breaking under pressure and the system being broken?
That pain I spoke about earlier?
The kind that folds you in,
locks you in the present moment only.
That, from what I've seen, is the kind of pain this system is in.
Look, I'm a GP.
I treat, diagnose, but if the NHS were my patient,
it would seem clear to me.
When costs are driven by profit incentive, not medical need,
well...then the companies brought in to heal...
..create, instead, a traumatic bleed.
The NHS is the people who embody the idea, so if you undermine them,
leave them disillusioned, disheartened, well, what then?
Sometimes I wish I could turn the whole thing off
and then back on again.
And not just to give us that time, but also as a way to prove it,
the preciousness of what we have,
through the grief we'd feel in losing it.
I've seen that happen with patients, relatives, so often.
The value of a person only truly felt when they're gone.
You start to really see what people mean to each other, who we are
and how our care can keep them together.
That's what I've come to learn.
That this huge machine, this system,
bigger than any other, is still...
..well, so human.
So, yeah, you get attached, of course you do.
Sometimes I'll even phone in when I'm off,
just to see how someone's doing... Alice, can you hear me?
..or, and this is the worst,
I'll lie in bed after a 12-hour shift,
still thinking about them.
"Did I change that drip, do such and such right?"
Because you're always so rushed, aren't you?
Sometimes after a really good day
I'll get home and, as I'm making my dinner, I'll look at hands,
not quite believing what, over the last few hours, they've done.
How many people they've washed, treated, comforted.
And what that might all mean, too,
to the people for whom those patients aren't patients at all,
but a mother, a brother,
a daughter, a son.
# All, all
# People. #
Am I scared?
Yes, a little.
But, you know, pain does a lot in dispelling a fear of death.
And also, for me...
..it's not so much a fear of what's next...
..as what I'll be leaving behind.
Lying here, having time to think, you see...
..it really does come clear, that it's...the chain
that's the meaning,
that matters.
Not so much the passing away, more the passing on.
My father, he used to say to me
that he and my mother chose to call me Alice
because of Wonderland
and the idea that the moment I was born, I was there.
Because to them, it was here -
life.
And of course they were right.
All capacity for wonder, and its opposite, ingratitude...
..expectation,
well, they all reside in us.
But this, the NHS...
To create such a monument to the communal,
yet able to care for the individual,
well, it's one of the most wondrous things we've ever done.
So, thinking about all that, the chain, what I fear is this...
SHE MOANS SOFTLY
..being one of the generations,
who, having inherited this beautiful solution...
..will stop seeing its wonder, until it's become so diluted
that, well, it's gone.
Yes, that's what I don't want.
To pass on an age of squander.
No.
My grandchildren and everyone else's,
they deserve something better.
I suppose, I don't know...
I suppose it's as simple, really,
as wanting to leave more light in your wake than shadow.
Real pain, in my experience, the kind that makes you cry,
is psychological.
Certainly, that's been true for me,
and I'd say, with regard to the NHS,
the pain that worries me the most.
Not its physical, that can be fixed,
but the psychological aspect, the philosophical even.
Once that's broken,
well, I mean,
I can tell you how to heal a fracture in a bone...
..but to a soul?
That's harder.
I suppose you could compare it, too, to what I once did -
surgery on the brain,
which is mostly about limiting damage.
The more you interfere and take away,
the greater the risk to function,
someone remaining who they are.
Well, the same could be said, you see,
of some of the reforms that have happened.
You take away too much of the original idea
and you alter the personality.
That's not to say changes shouldn't happen, of course they should.
The service should flex, adapt to the needs before it,
to be fair, as Bevan always said it should.
Christ, the whole thing came into being overnight,
and right after a war.
And then, just a year or two later,
when its very creation revealed such depths of health deprivation,
its running costs soared.
But we met that challenge, and rightly, too.
I mean, all that meant was that the health needs of a nation,
at last, were being met.
So, if we can do that then,
I'm sure, with the right political will,
we'll be able to do it again.
I certainly hope so, because, God knows,
I don't want my grandchildren
to be the generation who'll see those bills on the table again.
# Hold on to your heart
# It is all we are
# Till the breathing starts
# Hold on to your heart
# Hold on to your soul
# We are young and old
# Till life takes its toll
# Hold on to your soul
# They come one, they come all
# Brokenly beautiful
# Rise and fall Fearlessly wonderful
# All, all, all
# People
# All, all
# People
# Hold on to your hope
# When there's nowhere left to go
# When it's the end, you'll know
# Hold on to your hope
# They come one, they come all
# Brokenly beautiful
# Rise and fall Fearlessly wonderful
# All, all, all
# People... #
DISTANT BABY CRIES
# All, all
# People
# All, all
# People
# They come one, they come all
# Brokenly beautiful
# Rise and fall Fearlessly wonderful
# All, all, all
# All people. #
Here it comes, then, another dawn, another day.
And just think,
out there, all over the country...
..all those nurses, doctors,
midwives, paramedics,
living the idea, going out to care again.
All under the same three letters.
For now.
Because, well, as we know, ideas aren't days, are they?
We can't guarantee their return.
And I suppose, in the end, that's the question isn't it, really?
If, at some point,
the rhythm that keeps all this going were to alter,
come, for whatever reason, to a halt,
then do we, as a nation, fight to get it back again?
Do we, if the time comes,
resuscitate it or not?
# If it's going to hurt, let it hurt till the pain dies
# And if it's going to rain, let it rain till it runs dry
# And every time you lose is why
# You sit and watch the world go by
# Every second that you waste is a race to the finish line
# You gotta just provide # Give love if you wanna be loved
# You gotta just provide... #