In the run-up to Brexit, the current government plans for an NHS bill in the next Queen’s Speech to supposedly "rein in" privatisation are not to be trusted. Furthermore, with the threat of a US trade deal, the future of Britain's health service hangs in the balance.
How did we get here? This is the question I set out to answer in Under the Knife, a 90-minute documentary that paints a chilling picture of an NHS being systematically dismantled and undermined. The film traces the marketisation of the health service – which began under Margaret Thatcher and has continued for more than 30 years – and the advancing wave of neoliberal thought that led to the crippling Private Finance Initiatives and other forms of privatisation.
The NHS is celebrated by politicians when it suits them, but many speak with forked tongues. As Michael Portillo, the former Conservative MP, admitted to Andrew Neil in 2013, the Tories lied about their plans for NHS reform in the 2010 election because "they didn't believe they would win...if they told you what they were going to do because people are so wedded to the NHS. It's like a national religion." Boris Johnson's new proposals should be seen in the light of Sir John Major's words on him and Michael Gove in 2016: "The NHS is about as safe with them as a pet hamster is in the presence of a hungry python."
More than 60 people were interviewed for Under the Knife, with a focus on frontline doctors, nurses and patients. We also hear from public figures, such as Gina Miller, the businesswoman and Brexit campaigner. She talks about her 30-year-old daughter, who has a mental age of six because she was starved of oxygen during birth due to a shortage of midwives. As the doctor and broadcaster Dr Phil Hammond puts it, responding to the former health secretary Jeremy Hunt's claim that a "jumbo jet-load" of patients die unnecessarily each week: "The NHS takes off with unsafe staffing levels, a hole in the fuselage and half a wing missing every day.”
I grew up in Johannesburg, South Africa, where access to healthcare was not equal. I was a medical journalist and witnessed how the severe inequality for black people under apartheid affected every facet of society.
My father was a doctor and worked in the largest state hospital in southern Africa. He always told me how wonderful the NHS was. When it began in 1948, it was revolutionary in providing free healthcare for everyone and became the gold standard for the world.
It was always my dream to work on Fleet Street. I arrived in London in 1987, got a job on a newspaper being launched by the Mirror Group (which got me a work permit), and subsequently worked as a sub-editor on several Fleet Street newspapers including The Guardian and The Daily Mirror. During this time, I trained as a psychotherapist and group analyst. I then worked in the NHS for more than 10 years.
I felt very proud and privileged to work in the NHS but was unsettled by what was happening. Yes, funding was an issue then as now, and the demographic has changed, but I witnessed endless reorganisations, cuts and closures. I experienced a culture of surveillance and targets, with staff working in constant uncertainty over what would happen next.
Under the Knife began as simple idea five years ago. Since then I have investigated tirelessly and become increasingly aware of the crisis in Britain’s healthcare system. Do we really want to go down the American route, which has bankrupted so many? Two years ago, I asked the Emmy award-winning film director Susan Steinberg to join me, and together with a small team we have made the idea a reality. I have devoted my time and personal money to make this project possible, as I think it is vital that we do everything we can to save this precious institution.
Crucially, the film gives hope to those fighting to preserve the NHS for future generations. It reminds younger viewers why the service was created, and what life was like when many people could not afford to go to doctors. “One of the strongest memories of my childhood is of the ambulance taking children to the fever hospital and they never came back,” says Polly McGrail, a retired academic who was brought up in the impoverished 1930s.
The film ends on an optimistic note, illustrating how communities, healthcare professionals and campaigners have fought to defend hospitals and services threatened with closure through the courts, in council chambers and on the streets.
To make the film, I formed the company Pam K Productions Ltd. I have now partnered with Keep Our NHS Public and The Daily Mirror to host a week-long, nationwide festival of free screenings. After a successful crowdfunding campaign and branch donations from UNITE, TUC and UNISON, we are taking the film into hospitals, universities – and to a cinema near you.
I believe this film is important. Everyone who wants to save the NHS should see it.
In the run-up to Brexit, Under the Knife will be screened in 55 locations including London, Manchester, Birmingham, Newcastle, Liverpool, and Brighton. Register here for a FREE ticket.