Friday, 20 May 2016

People Power & A Child's Thwarted Rebellion. All For The Love Of Our NHS

“There’s no school tomorrow” announced my 8 year old the other day. Panic seized me like a python around my neck. Hyperventilating at the idea of arranging last minute childcare, I had a transient flash of lucidity. “There’s nothing about that in the school bulletin?” I said doubtfully, realising said bulletin had been languishing at the bottom of my child’s book bag for days. “It’s a strike,” he said casually, “we balloted for it today”. My heart sank like a brick as I braced myself for a call from the head master.

Some back story. My 8 year old was very cross when he discovered (in First News) that he’d missed the memo about the recent national children’s strike. He’s against academies, and tests of any kind of course, so he felt robbed of his day off school, I mean, day of protest.

With squinted eyes my disgruntled son sought to extract my motives for preventing him from going on strike. I explained that strike action is borne of a collective decision taken locally by a representative group or body having balloted its members. That was the conversation we had a couple of weeks ago.

Fast forward to this week and my child has put a notice on the school gates declaring tomorrow a day of strike action. For the NHS, no less. The “ballot” consisted of a petition to “Save our A&E” and, having gained several signatures from children and staff alike, the designated representative group (the Secret 7…which is more like the secret 17 because no-one who wants to join is excluded) voted in favour of strike action. To top it all, I was to blame.

Last week, I had been gathering baby booties from parents with small children at the school gates. The local Clinical Commissioning Group (CCG) were meeting last Tuesday in a fourth attempt to axe our A&E (the local health campaign group, of which I’m a member, thwarted three previous attempts). We knew the good men and women on the board who had previously voted against the (un)accountable officer (the boss), had come under intense pressure from above, so we didn’t expect a positive outcome this time.

We had submitted compelling evidence and had won the rational, clinical and intellectual argument. We needed a plan B now, to win hearts, as well as minds. Hence the baby booties. I arrived at the board meeting armed with 20 pairs of baby shoes and divvied them out amongst the public. The room was packed. My every move was watched by communications people whose job it was to spin the meeting to within an inch of its life. There were more PR people on the premises than there were doctors in the hospital.

I sat in the front row with my child’s first pair of moccasins. They were no bigger than the palm of my hand. I was there to speak up for him and the other children in this county who, had the A&E not existed, might not be alive today. Many of the booties came with a story of a child who had, at some point, fought for their life in the back of an ambulance. I realised I couldn’t share them all but I had to tell one.  Joshua’s mum had thrust his tiny shoes in my hand and said, “Put these in front of the chairman” and tell him my child’s story.

Doctors who become directors (CCG members are mostly clinicians) have conflicting interests. As doctors, their Hippocratic oath, Do no harm, takes precedence. As directors, corporate law dictates that finances and saving money trumps saving lives. The sterile boardroom arena, with spreadsheets and acronyms abound, is designed to keep the human element out of the decision making. I wanted to bring some humanity into the room, to remind doctors that the decisions they made would determine the fate of real children (as opposed to stats on a spreadsheet). Vulnerable human beings who depend on our generation to make the right decisions and leave them with a local health service that’s fit for purpose.

The public were reminded, “This is a meeting in public, not a public meeting”, which means we’re not allowed to speak unless or until the chairman says so. There’s the occasional display of low level civil disobedience, such as a local woman in her 80’s who regularly interrupts ever so politely with variations on the following, “I’m terribly sorry and I don’t mean to be rude…., followed inevitably by,….”but you’re talking total nonsense”, or “this is a farce”, thus the scene is set for theatre (heckling the baddies and clapping the goodies).

We waited patiently and then the public was granted 30 minutes to speak. Not nearly long enough for all the hands up but, that was our lot. The chair prevented the razor sharp, forensically informed chairwoman of the health campaign from speaking until the final moments.  But when she spoke, it was Hollywood gold. It was like being in a courtroom, listening to the closing arguments by an impassioned lawyer. Speaking as though her own life depended on it (it may well do), she set out a compelling case not to sign the death warrant of her client. In this case, the NHS. Nye Bevan would be proud. The rapturous applause turned to shouts of protest and slow clapping, when the chair malevolently announced he was drawing the public’s time to a close. Not only was he cutting our time short, he had allowed the (un) accountable officer to speak for 15 of our 30 minutes.

I stood up but the chair, seeing me armed with my BMDs (booties of mass destruction), tried to prevent me from speaking. Refusing to give me the mic I was forced to raise my voice to be heard as the meeting descended into chaos. This is Joshua’s story:

Joshua, age 2, had a severe fit a couple of weeks ago. He’s had a number of fits. Previously first responders came and waited with his distraught mother while an ambulance arrived. The wait is usually 15 minutes. On this occasion the ambulance took over 30 minutes during which time he stopped breathing. The first responder didn’t arrive.

First responders are increasingly not turning up, especially in critical cases. They’re local volunteers, trained in basic first aid only. They know ambulances are taking longer & longer to arrive & they didn’t sign up to holding people in their arms as they die.

In the ambulance Joshua turned blue and developed a rash. Paramedics changed route to allow them to get to the nearest A&E (having closed the children’s ward in our local hospital, children are now forced to travel almost twice the distance to get to another hospital). They made it clear that the best interests of the child was paramount & that meant getting to the nearest A&E as quickly as possible. Mothers at the school are terrified. If they shut our A&E, our children wouldn’t have that option and they could die.

Even healthy children are vulnerable to medical crises, such as anaphylactic allergic reactions, asthma, meningitis etc, where speed of access to A&E is of the essence. 

While I was speaking, people slowly emerged, like ghosts, from the public gallery and placed the baby booties on the table in front of the board. The solemnity and stillness of their movements was incredibly poignant. More so than I’d imagined when we’d planned it. I took my seat with the others and waited for the vote. To our astonishment, it was another victory and, even though we know the threat has not entirely disappeared, we savoured the moment. One of the board members approached me afterwards to say the blue fluffy booties I put in his hands made him think of his 2 year old. (I had reached out to him in particular because I thought he was one of the incredible doctors who treated my child in hospital).

The BBC had surreptitiously captured it all on a mobile phone and it was broadcast twice that evening. My son had seen it, which inspired his petition. Fortunately, by the time we got back to school, the rain had washed away any traces of the strike notice. The only evidence of a child’s thwarted rebellion clung to the tarmac, the blue ink bleeding a trail of destruction on a pulverised shred of white mulch paper. 

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