Merry Christmas, NHS

So, after five months of negotiating the sometimes baffling currents of the Twittersphere, I finally created a tweet that is circulating well beyond my ‘edutwitter’ circle, responding to a thread in which tweeters who would have died without the care provided by the NHS share their stories. This led to some further contemplation of the situation in which I was placed 31 years ago, and how it might have worked out differently in a nation that was not served by a free-at-source, comprehensive health service.

In spring 1986, as a young mother with a two-year-old daughter, I was informed that rather than expecting one baby to arrive in the winter of that year, I would actually be giving birth to two. This was in the days where pre-natal scans were one-dimensional, fuzzy and indistinct, but the twins had arranged themselves for the occasion and appeared clearly on their first picture, like tiny soldiers standing side by side. As the pregnancy neared full term, I was scanned again and told that the babies were of ‘good size’. As it turned out they were both bigger than many singleton babies – 7lb 2oz and 7lb 12oz.

My first memory following the birth was hearing these weights being discussed by the delivery team; the next was that inexplicably, I was speeding into darkness, surrounded by flashes of light, until a loud voice shouted after me ‘what is happening to you?’ I was brought crashing down to earth by the realisation that someone was gently slapping my face. I then lay in a daze with no real awareness of time passing, dispassionately observing a flurry of activity around me. My next clear memory is looking up at a nurse, who was watching a drip and holding a bag of blood. She looked down, smiled and said ‘ah, you’re back with us now. Not to worry, you had a bit of a bleed, but we’ve sorted it all out now’.

I later found out later that the volume of the bleed was 3 litres- an amount that if not staunched and quickly replaced would have been extremely dangerous. At the time, given my speedy recovery and swift plunge into a life caring for three children under three, the incident retreated quickly into memory, and when asked if my twins needed special care when they were born I used to jokingly reply ‘no, but I did’.

However, in these days when our health service hangs by a thread, with public funding for the NHS expected to fall short of the projected need by between £25billion and £30billion by 2021 and with private health companies circling to step into the breach, I have been given cause to remember this pivotal moment in my life and contemplate how different things might have been.

For example, having twins in the US is an expensive business, due to their health care system operating through a complex maze of private insurance. In 2013, the costs for childbirth came in at around $21,000 per delivery for singletons, $105,000 for twins, and over $400,000 for triplets or more, and the package offered can vary considerably depending upon the type of medical coverage the mother is able to access.

In terms of looking back to the past in the UK, the UK maternal mortality remained steady at about five deaths per 1,000 deliveries from the mid-Victorian period until the 1950s, when it began to fall following the inauguration of the NHS. By 2014, the number of maternal deaths had fallen to 8.5 per 100,000.

While the concept of the NHS retreating into memory was unthinkable in 1986, 31 years later, concerns are increasingly raised about stealthy privatisation initiatives being undertaken by the UK’s current Conservative government. And so, it seems a good time to wish the NHS a Merry Christmas as it enters its seventieth year, and thank it for all the Christmases I have had with my three children from 1986 onwards, and for being here to spend Christmas 2017 with my three grandchildren.

We in the UK should never forget how lucky we are to have a health service that is free at source and available to all, because for those of us who have never known any different, our NHS can be rather like mum in the kitchen at Christmas – something we tend to take for granted, until she is no longer there.