Health of a nation
This clear-sighted yet emotionally charged hymn to the NHS is essential reading,
In a decade and a half of reviewing books for this newspaper, I have never once felt strongly that a new publication should be made compulsory reading; after all, if history has taught us anything it’s that, on the whole, people who tell others what they should or shouldn’t read are not to be trusted. That said, if it were up to me this clear-sighted yet emotionally charged hymn to the NHS by the Welsh poet Owen Sheers would be added to the curriculum in every high school from Land’s End to John O’groats with immediate effect.
Based on over 70 hours of interviews with NHS staff and patients at Nevill Hall Hospital in Abergavenny, To Provide All People cleverly weaves together the reallife stories of doctors, nurses, new mothers and road-accident casualties with the story of the health service itself, to create a astonishingly powerful argument for the importance of maintaining this hardwon public good in the spirit in which it was conceived. In an age in which the kind of all-embracing community spirit which flourished during the Second World War and in the years immediately after increasingly seems to have been replaced with the sort of vacuous, dead-eyed individualism encouraged by TV shows like The Apprentice, this book – a reminder of what we can achieve if we work together – is a valuable and necessary corrective.
The poem is divided into three sections – “Birth,” “Life” and “Death.” In “Birth,” Sheers mixes the experiences of midwives and parents in a maternity ward with the creation story of the NHS: how Labour’s Aneurin Bevan managed to get his grand scheme off the ground after the war in spite of stiff opposition from both the Tories and the nation’s doctors, in the form of the British Medical Association. Bevan appears in a series of direct quotations – carefully chosen extracts from speeches given in the House of Commons at various points during his career – but the other characters speak in a fluent form of free verse which both captures the natural rhythms of their speech and at the same time subtly poeticises what they say by occasionally setting up internal rhymes or by introducing dramatic pauses.
The second section, “Life,” begins with a telling quote from Bevan, taken from a speech he made on 25 June 1948, just a few days before the NHS was launched: “This Service must always be changing, growing and improving; it must always appear to be inadequate.” As Karen, a GP, subsequently makes clear however, these changes should ideally take place without undermining the core strength of the health service, namely that it is publicly owned and funded. Of the damaging legacy of Private Finance Initiatives, she observes: “The repayments, / you see – like a mortgage – are huge and at rates / sometimes as much as 70 per cent. / They put many hospitals in dire straits / forcing mergers, bed reductions, service closures. / The total bill for all projects, after capital worth, / stands at around 240 billion.
Now imagine, / what could the NHS do with that?” If those stanzas make To Provide
All People sound a little exposition heavy, there are more than enough heartbreakingly beautiful moments to compensate, and nowhere more so than in the final section, “Death.” On the maternity ward, Kerry the secretary talks movingly about the memorial garden she keeps for parents whose babies have died; Valeria, a nurse, characterises the NHS as “a vessel of sorts, / a vessel of all this love – in the relatives’ concern, their care, joy, and yes, their grief as well”; and, on the final page, terminally ill Alice reflects: “what I fear is this: / being one of the generations who, having inherited / this beautiful solution, will stop seeing its wonder, / until it becomes so diluted, well, it’s gone.”
Owen Sheers is at the Edinburgh International Book Festival today