Nick Hornby

Nick Hornby

Dear NHS,

When I was in my early twenties, I ruptured my cruciate ligament playing football and I had to spend a couple of nights in one of your hospitals. I was worried about not being allowed to smoke for that long but this was the early 1980s and when I came round from the operation, more or less the first thing I saw was that there was an ashtray by my bed and that the other patients, all young men with football or motorbike injuries, were puffing away. You were probably a bit behind the curve at that point, but your thoughtfulness was certainly appreciated. I was looked after by a very pretty young nurse and, after I was discharged, I was cheeky enough to send her a postcard, care of the ward, asking her out for a drink. (Reader, I … Well, we went out a few times.) Probably every single one of us would like our relationship with you to be something like that: a minor injury, a couple of fags, discharge, a few dates with one of your nurses.

But of course, it doesn’t ever stop there. Life gets more complicated, more serious, scarier, and our connections to you become deeper and much more dependent. Ten years after my cruciate ligament injury, I became a father. My son Danny is severely autistic, it later turned out, but the autism came with a whole dizzying range of medical problems, many of them only obscurely linked to his condition. He was born in the Homerton Hospital in Hackney, but three months later he had an operation to repair a bilateral hernia at the Queen Elizabeth in Tower Hamlets. The granuloma on the back of his head was removed at Great Ormond Street when he was nine months old, and he was back there a few months later for an MRI scan for a pronounced left-sided weakness.

And then came the gut years, which have never gone away. He was a frequent visitor to the Royal Free – gut problems being a specialism of theirs – between the ages of seven and eleven, and he had surgery to insert an ACE tube when he was seventeen. In 2012, there was more surgery, to create an ileostomy, at the Royal London in Whitechapel. He was back there the following year for two lots of emergency surgery after complications. (The word ‘complication’ is rendered somewhat redundant by my son’s medical needs and problems. He is a permanent complication.) Since then, he’s been to A&E at the Whittington and admitted three times to UCLH. That’s seven London hospitals for one baby, child, young man, now grown man.

I am lucky enough to have money to spend on private treatment for my children and perhaps some people may wonder why I haven’t spent it. Why don’t we get him off the waiting list, leaving you, dear NHS, more time and resources to treat those who can’t afford it? Or – a question that might come from the particularly ignorant (or particularly fortunate) – why don’t we want the best for him?

This last question is easy to answer: the NHS is the best for him. This is not ideological or emotional commitment speaking; it’s a fact. My son’s problems and conditions have been acute, yes, but also taxing, puzzling and sometimes right at the edge of the range and reach of current medical knowledge. In Britain, at least, the only people likely to know are the staff at the big teaching hospitals. We couldn’t go anywhere else, because nowhere else would have been good enough. On occasions, there have been what seemed like entire roomfuls of brains thinking and talking about Danny. And we can forget this.

We all love you, NHS; we all think you are a great thing, that you have been underfunded, that, as I speak, you are being battered by wave after wave of desperately sick people, that when this is over we will want to thank you with more than applause. But we should also remember that the best and the brightest hearts and minds we have are all in your employ, and that is as important a reason to protect you as our sentimental feelings for you.

I shouldn’t give the impression that my son’s life has been blighted by illness. He is happy a good deal of the time and he now lives in a wonderful independent living facility, with carers he clearly loves. We take him – took him, will take him again – to the pub a couple of times a week and he goes out with one of the carers to do his shopping every day. Who funds these people who are looking after him now, brilliantly, while his parents can only follow his progress from a distance? You do, NHS. He would not be there, or maybe anywhere, without you.

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