“Gizza job – I can do that!”
UB40 – One in Ten:
The environment is always the key, it triggers a response which triggers another, like the flapping of a butterfly’s wings in a quantum world, just a small change can produce climactic results.
Take the industrial revolution for instance; one of the crucial factors that is often forgotten, is the improvement in roads that came with the introduction of Tarmacadam.
The road system network had been laid down in Roman times, but by the 18th century many were in a state of ill repair, with certain sections being nothing more than glorified ditches, and what’s more, the turnpike trusts meant you had to pay for the privilege of using them.
Then, British engineering ingenuity in the 19th century saw the introduction of “Macadam” roads which were both stronger and more durable and weather resistant than the existing ones, allowing heavier loads and speedier transportation.
They were however, still prone to rutting and generating dust, not ideal for the derrière or the lungs.
These debilitating problems were overcome in the early 1900s, by a Mr Edgar Hooley, following a serendipitous walk along the outskirts of Denby in Derbyshire.
He noticed a smooth stretch of road outside an ironworks factory. Upon investigation he discovered that a barrel of tar had fallen onto the road and then been covered up with waste slag from a nearby furnace. This unintentional resurfacing had solidified the road, and meant there was no further rutting or dust.
The addition of coal tar to macadam roads led to the invention of “tarmac” and paved the way for the introduction of the motor car, and then the aeroplane, as well as giving rise to the: “Boys from the Blackstuff”
Alan Bleasdale’s powerful drama followed the lives of 5 unemployed men from Liverpool, who used to work on the roads, tarmacing.
It movingly and humorously, captured the mood of the nation in the 1980s.
Driven to the depths of despair by rising unemployment and lack of social support, the working classes, and men in particular, were left on the scrap heap, whilst monetarist economics was used as a weapon to control inflation, drive down wages and destroy the unions.
At the same time, privatisation, banking and big business in general, were allowed free reign, to spread with little control or regulation.
That was Thatcher’s Britain, a macroeconomic philosophy that had far reaching effects on a microcosm of British society and ultimately people’s lives
Boys From The Blackstuff was named among the 40 greatest shows in a Radio Times list, and won much critical acclaim, including, a BAFTA in 1983.
It was typical of the 80s that those who ran the game, the people that could do something about the inflammatory environment; the unsafe grounds, the violent society and the general climate of hate and racism, looked away for as long as the cash registers kept ringing.
But those who attended a match during the period, knew something was drastically wrong.
Today, those of us who work in the medical profession, instinctively know something isn’t right.
As a GP, I’ve always imagined myself working down the pit on the coal face of primary care, and I’m old enough to remember the miners discontent and the emergence of monetarism and the “Loadsamoney” mentality that so dominated the decade and it feels eerily similar down the “pits” of the NHS right now.
With the threat of strikes and the politicising of wage demands and thinly veiled government threats to change working conditions and pay, there is a growing unease amongst all NHS shopfloor workers.
The ‘P’ word on everybody’s lips is not Prevention, but, Privatisation, another throwback to the 80s, which helped to widen social inequalities and adversely affect people’s health.
Demand (for healthcare) far exceeds supply and the predictions are this will continue ad infinitum, until we all go broke and big private institutions come to our rescue.
The supply and demand equation means doctors and GP’s in particular, are getting too expensive to both employ and train, and the government and big business’s preferred option is to replace them with; nurse practitioners, pharmacists, paramedics, physicians assistants and ultimately I guess, artificial intelligence (Babylon Health) in an effort to sort out the supply side of the problem.
Indeed, I think I may be heading for a change of job, hence the interest in the tarmacing!
Whereas, any fool in the asylum can see the real gains, at least in terms of people’s health and sanity, are to be made on the demand side.
By keeping people healthy, fit and active, willing and able to do a productive day’s work, and not stressed out and depressed, you give the individual a purpose in life, a reason to get out of bed and start living again, not just existing in the system as another national insurance number or, another “statistical reminder in a world that doesn’t care.”
In fact, I am reminded of a scene from the Boys from the Blackstuff, in which the working class hero Yosser “gizza job” Hughes, with his mental health in terminal decline, through the shame of unemployment, the lack of social support and finally the threat of losing his children, goes to confession looking for help, and tells the priest he is desperate. The priest, trying to comfort Yosser, tells him: “Call me Dan, – Dan”; to which Yosser replies: “I’m desperate Dan.”
Now, I suppose if it wasn’t so important, I could raise a rye smile, at the lack of resources devoted to health promotion, the rigid adherence to drug funded guidelines, the paralysis from analysis of the Quality outcomes Framework, the criminal cost of certain medications, the formation of an internal market, which just creates competition where it isn’t needed, and the blame/claim culture, which does nothing to ease workload pressures and is just another aspect of big business (insurance and law) metastasising to places it doesn’t belong.
But, instead I live in hope.
In this poignant scene, George Malone, one of the Boys from the Blackstuff, is dying from cancer and he goes back to a place from his childhood, overlooking the Liverpool docks and, in a moving and memorable final soliloquy he says:
“I can’t believe there is no hope.”
George’s Last Ride:
The spirit of George, gives me a faith and a hope that the medical profession can overcome this bleak midwinter crisis, that sees so many loved ones who never come home.
When the enemy’s within (the system), you have to start looking outside for answers. You have to start building new roads, resurfacing and strengthening existing ones, and make the journey back to health a smooth and swift one.
Because, when the ruts and cracks start appearing and everything around you is turning to dust, who ya’ gonna call?
The Boys from the Blackstuff!