Detail of John Snow's famous map showing the cholera outbreak centred on the Broad Street pump.
Between 1831 and 1854, tens of thousands of English people died of cholera. British anaesthetist John Snow suspected the mass epidemic to be a water-borne disease caused by sewage being dumped in cesspools near town wells.
But Snow struggled to convince the authorities to take action. The medical establishment were so wedded to their theory that disease was caused by breathing ‘vapours’ or ‘miasma’ that they ignored the extensive evidence implicating one pump in particular.
So Snow took the law into his own hands. One night, according to legend, he went out and chained the pump up himself. With this foray into epidemiological vandalism he not only stopped the cholera but ushered in a new era of medicine.
Today we have our own medical epidemic that is crying out for a modern John Snow. Recent research on the metal health implications of austerity showed that austerity, and the bedroom tax in particular, is causing depression and anxiety triggered by fear over bills or being forced to move house.
And last month a CQC review showed that England’s mental health crisis care system is now ‘unsafe and unfair’, with patients reporting problems with care that would be unthinkable in physical health emergencies. Only 14% of people got the care they need with clear problems with bed availability and crisis teams.
GPs surgeries, already dealing with malnutrition and debt related stress, are now at risk of being overwhelmed.
The modern equivalent of the miasma theorists look at this crumbling system and see inefficiencies, poor organisation and a desperate need for outsourcing.
Were John Snow alive today he would deal with it quite differently.
Today - the day before the upcoming emergency austerity budget (£12bn cuts, including the £1,700 a year that the Institute for Fiscal Studies say will be taken from the tax credits of 3.7m families) - he would walk through the gates of Downing Street (managing not to call anyone a pleb on the way) and put a huge chain around the front door of 11 Downing Street. He would close down the pump that is pushing people and their mental health services to crisis point.
I appreciate that the institutions of modern democratic states cannot effectively be stopped simply by chaining a man inside his house. In the case of Osborne it's a lovely thought but it's quite unlikely that the response of David Cameron to his paymasters in the City would be 'Sorry chaps, some bugger's chained the G-Man inside his house so it looks like we'll have to put the budget off'.
Let's suppose for a strange moment the chain did actually work. The chancellor’s first panicked thoughts might be as to what will happen when his family ran out of food. How would they make their meagre supply last until they received help. All of a sudden the grandeur of the chancellor's abode would start to look like so many other households struggling through austerity in Britain. As the days wore on the chancellor and his wife might have to think about skipping a meal so that the kids could get fed. Or cutting the sizes of the portions that the kids get when times are really tough. After a while this would undoubtedly play on his mental state, it would start to make him feel low, guilty, desperate and worthless and just at the point that he could really benefit from support for his deteriorating mental health he'd have no access to services because he was, of course, chained in his house.
And then the chancellor could truly say that he'd arrived in austerity Britain.
What does the phrase ‘emergency budget’ really mean? Since the election there has been no actual external or internal crisis. One can only assume that the phrase ‘emergency budget’ should be read not as 'budget for an emergency' (since there is none) but rather 'budget causing an emergency'.
In other words, it is an 'iatrogenic budget'. Iatrogenesis is a medical term which means 'a state caused by the treatment of a condition'. More ‘austerity’ is prescribed for the country's ills but as anyone working in mental health today can see, it will continue to cause untold misery.
Which brings us back to John Snow.
The government’s imposition of wholly manufactured iatrogenic suffering shows that this country has never had a greater need for doctors to put the metaphorical chain on the chancellor's door. To stand together, speak out and expose the deliberate degradation of the lives of mental health service users, their families and the sources of state funded care which can make the difference between desperate people making it through the night or not.
And so over to the British Medical Association. Are you are you going to follow the miasma theory of austerity or join those medics already fighting and finally put the chain on this austerity farce?