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Author: Roy Noble, Bevan Commissioner


The other evening, in our house, we broke the ‘stay at home’ isolation directive during this coronavirus pandemic. At eight o ‘clock we stepped outside our front door to join in the nation-wide ‘clapping for carers’ applause, in support of NHS staff. Oh yes, as neighbours, we were all in self-isolation, but yet, we were together, social distancing, in a group and part of a massive crowd stretching to every corner of our country.

Occasions such as this night make the mind meander, reflect and ponder… isolation, yet in a crowd. I turned over a relatively recent page from my memory. Lying in a bed in Ward 7 of Prince Charles Hospital in Merthyr Tydfil eighteen months ago, at about eight o’clock of an evening, I became aware of a low pitched hum. It proved to be the window blinds automatically easing down, to close.

Now, I would venture to suggest that the lights of Merthyr Tydfil were never going to challenge Las Vegas, but I needed to see them. They were my link with the outside world. In the hours that followed, darkness was joined by a new relative – isolation – even though I was in company, with other patients and the ever attentive support of the night shift staff.

Oddly, that feeling of being cut-off from the world, had happened before, twice, both in a medical landscape. In 1962, South Wales was hit by a small-pox epidemic.

International sports events were called off and life became threatened and insecure, even for students like myself, who felt, naturally, invincible. I ended up in the sick-bay, having been felled by the small-pox vaccine jab. It was a quarantine corner that, gradually, became crowded.

A few years earlier, in my embryonic early teenage years, I ended up in Morriston Hospital in Swansea, late at night, having fallen off a flat roof in the dark. Don’t even ask or wonder as to how it came about, it was embarrassing for an acne bedecked thirteen year old and very painful.

On that first night, isolation and loneliness set in, even though the sounds of the night gave me hints that I was not entirely alone. I was to learn later that I was in a ward of thirty beds, all in the one long room. The camaraderie of the early mornings and the dawning day, raised the spirit, even though they were the old days. Matron, clearly a direct descendent of Boudicca without any blood mix, would ‘pay a call’. If you were ill in bed, you had to be ill tidily, no crimpled bed-sheets tolerated. Visitors were constrained in numbers, two to a bed, no children allowed. They had to be held up to a window to wave to their grand-parents, much like these days of coronavirus non-contact and isolation. If you found yourself as one of three around a bed during ‘visiting’ and the clarion call went up that ‘ Matron was on her way’, you quickly looked for a bed with just one visitor, or none at all, then you swiftly moved to it, indulging, possibly, in intimate medical conversations with someone you didn’t know at all.

The hospital regimes, and the wider health field, had order, respect, responsibility and discipline in those days – it was accepted. Society, these days, in many scenarios and in the minds of those who challenge norms at every turn, does not allow that acceptance to lie comfortably with their freedom of everyday life as they see it. Selfish behaviour, by a sizeable minority, in the face of directives given during this health crisis, is proof of that. Social distancing, reasoned behaviour and self isolation are far from some wayward minds. Thank heavens for the reasonable majority.

The coronavirus crisis is testing in the extreme for everyone, causing immense stress in the health and care sectors in terms of provision. The cohesion of society is being stretched beyond measure, but communities will rally and individuals will respond wonderfully.

The simple event of that special night, the 8 o’clock ‘clapping for carers’ gives hope. Neighbours, who years ago, perhaps lived in a street where, over the back wall, a ‘chat and check’ unofficial care system was in place could possibly and hopefully, just have resurrected that system. I have a strong suspicion that life has changed and will continue to enhance in the coming months, our attitude towards our fellow beings; on this planet, and on your road. The community and national spirit of goodness will prevail.

Good will come from this extreme adversity and the National Health Service will grow from this. In my privileged role as a Bevan Commissioner I have the opportunity to see the NHS at close quarters. The Bevan Commission is Wales’ leading health and care think tank, bringing together a group of international health and care experts to provide independent, authoritative advice to the Welsh Government and leaders in Wales, the UK and beyond.

The Bevan Commissioners provide an independent lens to vet and view progress and performance in the health and care sectors of Wales. They represent a cross section of professional and highly respected practitioners, managers and academics, with huge swathes of past, or present experience across the whole spectrum of health provision and practice. Their aim is to ensure we have a sustainable health and care system that is fit for the future – and recognisable to its originator Aneurin Bevan.

Through our Bevan Advocates, who have experience of treatment within the NHS and Bevan Exemplars, who are innovative practitioners, the Bevan Commission gleans ideas, procedure and possibilities and canvasses boards and government, to instigate action and to help translate its thinking into practice.

I hasten to add, that I am at the ‘pavement’ level’ the patient and customer end of the service but I like to think that I can somehow represent the view of the people. And one thing I think would be shared by many, is the hope that after this distressing and challenging time, the NHS will be re-energised, even further respected, a pillar and back-bone of what this country is and stands for.

As for the NHS and care staff, over the past weeks and in the face of pressures yet to come, they have displayed an extraordinary selflessness, professionalism, commitment, co-operation and sheer bravery. The number of volunteers, hundreds of thousands, who have joined its ranks to help, express a groundswell of support, indeed of love, for the service. This is truly uplifting.

It is vital that once this crisis is over the NHS, over the combined sectors of health and care, will be encouraged and supported in innovation and development. It is a jewel which is precious and invaluable to have.

Roy Noble is a writer, broadcaster and a Bevan Commissioner.