We can have Brexit or the NHS. We can't have both
Editor-at-large ALASTAIR CAMPBELL on why leaving the EU is so damaging to the health service
Another day, due to end with another anti-Brexit speech to another anti-Brexit meeting, but something truly upsetting happened en route to delay my arrival.
Given that one of my exhortations to the meeting when I made it was that those who were not already getting The New European every week should do so – a good quarter or so already were – the 200 people present already know this story, as I started my speech by sharing it with them.
This one was close to home, London NW3, one of the epicentres of Remainism, and my partner Fiona came too. I was feeling pretty tired and wired because I had spent much of the day talking about mental illness for a documentary. So Brexit might, just this once I hoped, provide a little light relief.
It was not to be. As we walked the last 50 yards to the school where the meeting was being held, across the road we spotted a young man, clearly distressed, barefoot and bare-chested, half-walking, half-running, looking around constantly in a wild panic, clutching clothes and shoes.
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Having once experienced a psychotic episode myself, I was pretty clear that was what was happening to him. He ran across the road towards us, and when he got close enough, stopping to 'hide' behind a lamp-post, I asked him if there was anything we could do to help. He was salivating, shivering, had black rings around his wild eyes, a small amount of blood on his top lip, and he was gesticulating frantically in all directions, his head constantly turning this way and that as he responded to whatever imagined sounds, visions, people and things were chasing him.
We asked if he could remember a phone number of a friend or family member we might call. Numbers came out in a torrent. I asked if he minded if we called for an ambulance. More gesticulating. I dialed 999. It is not something I have done very often, but when I have, the response and subsequent action have been fast. This time, I quickly discovered 999 is a hotline to a Health Service in trouble.
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What felt like an age of taped messages passed before finally a human voice came on. I explained the circumstances, emphasised the urgency, and was then taken through what I assume to be a standard questionnaire. It was not easy, simultaneously dealing with a stack of questions about someone I had only just met, who was not communicating rationally, whilst trying to keep that person close enough to ensure he didn't run away or, my real fear, charge into the road and get hit by a car or bus.
After all the questions came instructions as to what to do if he turned violent, or vomited, and so forth. I do understand that they have to ask certain questions, not least to make sure ambulance time is not being wasted, but this did seem to go on a lot longer than it needed to. But then came the moment when I realised I may as well hang up.
'Stay with him, and we will try to get an ambulance to you in two hours.'
'Yes. We are having a lot of demand right now.'
Fiona went into the meeting, where the audience was waiting, to explain my delay. She found a doctor who came out to help, by which point the young man had taken fright and was running away. The doctor ran after him but she ended up being hit with his shoe, and he sped off again. She called the police, not to report the assault but because in her experience they respond more quickly to incidents like this than ambulances, and she shared our genuine concerns for his welfare.
Of course life goes on. We went into the school, I was introduced, and made my speech, promising them I would focus on what they wanted me to talk about – Brexit, and in particular how to stop it – but I started by telling them the story of what had just happened and why, in my view, it WAS related to Brexit.
Days earlier, I had sat in the studio of Robert Peston's Sunday morning programme and watched as he interviewed Health Secretary Jeremy Hunt who said that for him, and for Theresa May, mental health was a 'priority'.
But is it? In the NHS Constitution there is now a commitment to parity between physical and mental health. Good. So that is the law then. But we don't have it, do we? I have tried to work out what the physical health equivalent would be of what this young well-spoken man was going through. The best I can do is a car crash at 100mph when you forgot to wear your seat belt. His mind was in bits in a way your body might be in bits if it went through the windscreen. Yet we couldn't even get an ambulance in the few minutes we had him vaguely willing to trust us, and heaven knows where he ended up.
Look up 'priority' in the Oxford English Dictionary, and you read it means 'the fact or condition of being regarded or treated as more important than others.' Well, that sure as hell isn't mental health, not within the NHS, let alone within the government as a whole.
There is only one thing that is taking priority according to the dictionary definition and that is Brexit. It is taking up the greatest time and energy of senior ministers and of the government machine. It is throwing up the biggest problems. It is creating the greatest chaos. It is consuming the bulk of the government's bandwidth.
When May explained after becoming Prime Minister that mental health was a 'personal priority', she made a pledge that within four years, no child or young person would have to go outside their own region to find a psychiatric bed it they needed one. No more terrible stories of children from Plymouth being treated in Birmingham, or children from Newcastle ending up in Manchester.
So good news, yes, the pledge she made? Well, hold on a minute. That means it is going to take a whole bloody Olympiad to do that, while in just two years she reckons she is going to deliver Brexit, the most complicated challenge any government has faced since the Second World War. Please stop saying mental health is a priority if that is the extent of the ambition, especially at a time when child and adolescent mental health services are going backwards not forwards.
It is normally well understood that the two absolute top priorities for government are the economy and security. I am sure May would go along with that. Yet both of these are taking second place to, and being damaged by, the bigger priority of delivering Brexit. The Bank of England interest rate rise is but the latest of many economic indicators and actions which fly in the face of the Brextremists' claim that there is no economic downside to Brexit.
A weaker economy means weaker security. The new defence secretary has hopefully now been properly briefed on the state of our defences, and how the Brexit fall in the value of the pound is weakening them, hitting defence procurement in ways that are leaving generals and admirals frankly in a state of disbelief at how quickly our defences appear to be fading – a symbol, if any more were needed, of a nation in decline.
What was it Dean Acheson said about Britain losing an empire but not yet finding a role? Right now, what with Brexit and Sexpestit, it feels like the role is to give other countries something to laugh at or feel sorry for, depending on their mood or nature.
Yet on we plough towards the Brexit cliff edge. I don't like using the language of mental illness in the political debate, but it is madness, an act of national self-harm, when the only real priority this government has – Brexit – is doing such damage to the things they say are priorities, whether that is the economy, defence, peace in Ireland, our standing in the world, health, education, combating child poverty, helping the 'Just About Managing' – remember them? – or the fight against crime. On all of those, the indicators are going in the wrong direction. Is Brexit helping or hindering on each on them? We know, and they know, the answer. Yet on we go.
In the Q&A, another doctor spoke: Charles House, medical director at University College Hospital. He wanted to know why the NHS was not figuring more in the debate.
No, not the £350m Big Lie on the big red bus, but the money that Dr House knew was being drained from healthcare because of current and future economic damage caused by Brexit. He was armed with the latest borrowing predictions. He had examples of various areas of healthcare facing major cuts, most recently reports in the media that day about cutbacks in IVF.
He felt the NHS was 'the silver bullet' the anti-Brexit campaign needed, 'because it is becoming clearer and clearer that we can have Brexit or the NHS but we can't have both'. Heed those words. Polling published here last week showing growing concern that Brexit may be damaging the NHS suggests the public sense he is right.
It is not just about money, of course. There is staffing. The day we met, the Nursing and Midwifery Council reported a 67% rise in the number of EU nurses and midwives leaving the register compared with the same period the year before. Dr House said there had been a 96% drop in EU nursing applicants – there is a nursing recruitment crisis in mental health by the way – in the 12 months following the referendum. Recently I spoke for the Time to Change mental health campaign at Kingston Hospital, Surrey, where 13% of the medical staff are from the EU. They're not all going home, but some are.
Of course – and here is another reason why Labour needs to change its stance on this – the hard right tail currently wagging the government dog on Brexit policy has no fears about damage to the NHS. It fits very well with their vision of a low tax, low regulation, low public spending small State economy where the NHS can be run down and opened up to wholesale Americanisation.
The morning after our NW3 Remoan-in, my 999 experience still front of mind, I noted in the press widespread reporting of a doubling over two years in the number of patients waiting more than an hour to be transferred from an ambulance when they finally get one to an A&E ward. In London, the number had trebled; in other parts of the country, quadrupled. With the flu season, and the Christmas booze season, shortly upon us, the winter crisis which Labour investment stopped is back as part of the NHS annual cycle. Brexit, be in no doubt, is helping to drive it. Remember that the next time you're listening to a tape recording telling you to hold until your 999 call can be answered.
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