Article published on January 2, 2015.
What inspired you to write Picked Up, Patched Up & Sent Home?
Being an academic who works in community mental health, I’d read a few of the more academic books on what was happening to our NHS. Books like the excellent NHS SOS and NHS Plc. lay out the case very articulately. But they struck me as books that most everyday people wouldn’t read- they are quite detailed, dense and not entertaining in the conventional sense. It struck me there was space for a coffee table/toilet floor book to get the same message across. Something that people could pick up and put down, read short, hopefully funny accounts that gets across the same message that privatisation is going to destroy our national health service. That the picture of our NHS in some of the press isn’t really representative of most people’s experiences. And then I struck on what I thought was a masterplan. I was so pleased by my plan that I ran around telling everyone about it like a budget Lex Luthor. My plan was that the publisher would go for it because it had a built in audience (The NHS Support Federation, who get all profits and campaign against privatisation, would send a flyer out to their thousands of members), the NHS Support Federation would go for it because it would raise them much needed money, and it works for me as I get a book published that might help the cause a bit. The publishers liked the idea. The only feedback was that I needed to stop using the word ‘fuck’ so often (54 got ejected in the second draft) and stop being so mean to Eamon Holmes. My standards are pretty low so I took this as some measure of success.
How did you decide which of your NHS experiences to use in the book? Did you look for potential for comedy, or was it just looking to give a representative sample?
To be honest I just made a list of all the ones I could remember. I have a form of epilepsy called temporal lobe epilepsy that has savaged my long term memory so I didn’t really have the luxury of being selective. I just remembered the ones that I could and pretty much put them in if –
a. there was a way I could show how great some of the care I receive is and that I had previously just taken for granted and
b. could possibly be made entertaining.
Some of the encounters are pretty routine and did A. really well but not so much of the B so I thought outside the box a little for those. I’d try to link them to a broader context that I thought might be funny, for instance turning a routine appointment to get antibiotics into an adversarial chess game between me and the prescribing nurse or making a list of the Hypochondriac’s worst diseases. A few encounters didn’t quite make the cut but I can guarantee there won’t be a ‘Picked up..2’ as I literally can’t remember anything else.
Aside from getting locked in the gents and some embarrassment with a stethoscope, would you say your “NHS life” bears some resemblance to that of the average person?
Yes and No. I suspect that getting locked in a practice toilet and getting caught by a doctor trying on their stethoscope are possibly not things that everyone would do. Having a man loudly talk to me about foreskins in a crowded waiting room was just bad luck- wrong place at the wrong time. But most of the experiences in the book, like your children being born, getting antibiotics, having x-rays and riding in an ambulance are all pretty standard experiences. What is also standard from most people is that they are incredibly thankful to the NHS and have, on the whole, had a really good experience. We have the best health system in the World according to a recent Commonwealth Fund Report and spend less on it than every other G7 country. I honestly think most people, like me know how lucky they are.
Are there any other writers you looked to for inspiration when writing the book?
To be honest I’d feel a little too self-conscious to compare my writing to what other people write. I write humerous toilet floor books. Don’t get me wrong, I’m not decrying it as a form of writing that is without merit. I personally love that form of writing. I love doing it and I love reading it and such books probably give me personally as much pleasure as any other form. But to compare it to other writers would feel a bit like telling a friend that I painted my VW Golf red because Ferraris are red. If I was to try to aspire to a standard it would be to that of people who have that wonderful gift for recording the everyday in a funny, touching and unusual way, whether they are writers or not. The Bill Brysons and Michael Palins and Karl Pilkingtons of this world.
You’re standing for election for the National Health Action party next May. How’s that experience going for someone who isn’t a career politician?
It’s fascinating. I’ve never been involved in politics and not much in campaigning so it’s been a very steep learning curve with lots of public speeches, press stuff, local debates, some of which have gone well and some less so. Reading about local people talking about you both positively and negatively is quite an unusual experience but par for the course I suppose if you stick your head above the parapet. I feel a little like a meerkat at the moment who pops his head up from a hole in the ground and keeps popping it back down when something frightening comes along (like local politicians taking aim at me in the paper) but I’m slowly learning to keep my head up rather than keep ducking. The NHS is a political issue but it also cuts across party politics. It’s worth noting that 83% of conservative voters want a public NHS. I put myself up for all people in my constituency, regardless of whether they were previously blue, yellow, red, green or didn’t vote, to have someone to vote for if they didn’t want small groups of people making a lot of money out of our illnesses. I honestly don’t believe the decisions being taken in parliament reflect the will of most people out in our communities.
As you mention in the first chapter, Bevan’s original vision of a health service free at the point of need is pretty utopian when you think about it. Are we guilty of taking it for granted?
We probably are but then I think we have a right to take it for granted. The right to free healthcare and the right not to have your healthcare quality and needs decided by the financial needs of a small number of shareholders in private companies is something we have enshrined in our national culture. Bevan’s original vision was utopian but for the last 60 or so years we have seen that it is workable too. Even with our poor levels of funding compared to our neighbouring countries, we have still managed to keep a public NHS the best healthcare system in the world in that time. This is thanks to the dedication of our fantastic health professionals and support staff and thanks to the will and determination of our people. And it can continue. The most dangerous myth being perpetrated out there is that it is somehow unfundable and that we’re swimming against the tide here. All research shows this is patently wrong. When we start being serious about cracking down on the £100bn of annual tax avoidance by the companies who schmooze our mainstream political parties and when we remove the £5bn annual costs of an unnecessary competitive internal market in health, we will continue to stand above other countries in the way that we take care of people when they are at their most vulnerable.
Reading that back I think I might have been giving one speech too many in recent weeks but you get the gist.
The book is very funny, but there’s a deadly serious message in there. What do you see as both the best and the worst case scenarios for what the NHS look like in five or ten years? And what would need to happen for each to come about?
Worst case is the way we are currently heading. This is toward a fully privatisated health system based on insurance premiums. A small number of companies will make a killing out of the easiest healthcare work while the system as a whole will be fragmented, offer poor quality and persistently let people down in terms of coverage and quality of care. Local hospitals close down or are downgraded because they don’t make profit (this is already happening all over the country). And the increasing number of people who can’t afford health coverage (like the 50 million in the US who can’t afford it and like those before the war who couldn’t afford healthcare in the UK) will suffer in silence and die of preventable illnesses.
The best case is that we continue to make the tough political and tax decisions to fund a fully public NHS that has no costly and damaging internal market making local services bid against each other but that concentrates on good coverage, good healthcare and that treats everyone, no matter how much money they have. We’ve had it for 68 years and we can continue to have it. But we’re going to have to fight for it and we’re going to have to get out and vote for it.
About Carl Walker
Carl Walker is a lecturer in Psychology and a community mental health researcher from the University of Brighton. He has written a number of academic books on social inequalities and mental health and works with community groups on participatory mental health projects. He is involved locally and nationally in campaigning against the woeful privatisation of our wonderful NHS, a privatisation that is happening all over the country despite nobody voting for it. He is, rather nervously, standing for the National Health Action Party in the constituency of East Worthing and Shoreham in the upcoming general election. He writes toilet floor humour books and Picked Up, Patched up and sent home: Why I love the NHS represents a mixture of his pastime and campaigning. He lives in Worthing with his wife Ruth and their two children, Anna and Andrew and spends any free time he has cycling around the South Downs.
Picked Up, Patched Up and Sent Home, by Carl Walker