The Good Samaritans

J P W Mallalieu at Stoke Mandeville Hospital in 1956 argues foreigners have every right to use the NHS: after all, they built it.

Early this year, a friend of mine had his appendix removed in Moscow and was presented with a bill for £100. He protested that a Russian taken ill in Britain could have the operation free. He was not believed and had to pay. But when, some weeks later, he was about to come home, his £100 was returned to him—in blocked roubles. The Russians had been making inquiries, had caught up with at least one of the facts of British life and had decided that for one individual Briton, at least, there should after all be reciprocity.

When the National Health Service was launched the proposal that it should be as freely available to foreigners as it was to Britons was strongly and understandably criticised. But Nye Bevan persisted. He reminded the House of Commons that for centuries the Catholic Church had freely given treatment in its monasteries to all who asked for it, no matter from what country they came and he insisted that Britain should set an example to the rest of the world by reasserting the principle that in healing there should be no bounds. The fact that only one country, Sweden, which has plans to give free treatment to Britons taken ill there, has followed our example and that a country like Russia, so far from following the example, did not seem even to have heard of it, has tended to revive the criticisms made eight years ago. The critics find it hard that when, as a nation, we are barely keeping our heads above financial water, foreigners should get cheap teeth and spectacles at our expense or have their babies or operations in hospital beds which are badly needed for British patients. It was with this criticism in mind that I have just visited one of the more famous hospitals in the National Health Service.

Stoke Mandeville was built early in the war by the Ministry of Pensions to handle air raid and service casualties. It is now under the Royal Buckinghamshire and Associated Hospitals Management Committee. It is a general hospital catering like others for the normal ills of mankind and is able to provide a better than average service, partly because its buildings are relatively modern. But its service is not confined to the people of Buckinghamshire. I found that the general surgery wards, while I was there, were full of patients from Northampton. In a month's time they may well be full of patients from Oxford and, later on, from Reading. For the hospitals in those towns are so overloaded that there is a long waiting list for all but emergency cases. So Stoke Mandeville breaks down the boundaries, at least, of county and helps to take the load off its neighbours.

Further, the research which it is carrying on into, for example, rheumatism, under Dr A G S Hill, and the experience it has acquired in such things as plastic surgery, under Professor Pomfret Kilner, are attracting patients to its specialised services from all over the country. It is, I suppose, possible that some people in the neighbourhood of Aylesbury, who occasionally have to wait for treatment rather longer than they might otherwise have to do, resent the intrusion of such "foreigners" from other parts of the country—though I did not hear such resentment expressed. But I have heard resentment about a far more spectacular breach of boundaries which has followed the development of the Stoke Mandeville Spinal Injuries Department.

Years ago many people who suffered spinal injuries were abandoned. They were left to rot in bed, developing horrible bed sores, without hope for themselves and knowing that they were a burden to others, until they died. Stoke Mandeville, more perhaps than any other hospital in the world, has begun to change this. Paralysed men and women come there unable to do anything for themselves. By special machines and by special exercises they are taught to make other muscles do the work previously done by muscles which the paralysis has wasted. I saw a racing cyclist, whose legs no longer had feeling in them, managing to keep his leg muscles from atrophy by means of a specially designed bed cycle which he worked with his hands. I saw men in wheel chairs developing new strengths by practising archery, or playing table tennis, basket ball and even polo. Above all, these patients, who would once have been considered, and would have considered themselves, as rejects from society, are being taught that they can have a new and fully useful life. They are taught new jobs so that a steeplechase jockey, for example, who broke his back, eventually left the hospital having qualified as a chartered accountant; and he is now practising as such.

Despite the seriousness of the complaints with which it has to deal there is an atmosphere of gaiety in the Department; and in that atmosphere men and women who felt that they would never walk again are wheedled, cajoled and bullied by staff and fellow patients into taking their first, effortful steps. Inevitably, the successes here achieved are attracting patients not only from all over this country but also from all over the world. While I was there, I talked with a Frenchman, a Portuguese, a Turkish lady and a little Cypriot boy. In the hospital as a whole there were 16 foreign patients—a small number out of the total of 390—yet a number which may well seem exasperatingly large to some helpless Briton waiting for his turn. When I saw the treatment being given there to paraplegics and thought of my own god-child who is on the waiting list for a bed, I myself began to wonder whether in this, at any rate, charity could not begin at home and still be both Christian and Socialist.

And yet . . . it was impossible not to be moved by the sight of that black-eyed paralysed Cypriot boy, slowly regaining the power of movement in the same hospital where a British soldier was recovering from the wounds he had received in Cyprus; or by the sight of the boy's mother working in the wards, so that she could be near her son and help to repay the hospital for its care. It was impossible not to realise that but for the work of 122 foreigners, who now help as nurses, porters, cooks and maintenance staff at Stoke Mandeville, the general work of the hospital could not be carried on. Above all, it was impossible not to realise that, but for the work of a foreigner, the paraplegics in the hospital and, indeed, throughout the world would not have the hope which they feel today.

For the hospital's Spinal Injuries Department was founded and is still supervised by a 55-year-old German Jew who escaped from Hitler; and among his assistants are another German, Dr Michailis, and a Czech, Dr Melzak. Their skill, persistence and imagination have helped to create something of immeasurable value for a hitherto abandoned section of British people. I cannot believe that British people will want to deny to foreigners a share in something which foreigners have helped to create. But I hope we shall continue to go beyond quid pro quo's and accept into our care, as Stoke Mandeville has accepted into its care, with equal warmth both the British soldier shot by Cypriots, and the Cypriot boy paralysed by a cruel misfortune almost before his life had begun.

The entrance to the Spinal Injuries Unit at Stoke Mandeville Hospital. Photo: Getty.

J P W Mallalieu (1908-1980) was a Labour MP and New Statesman Westminster columnist.

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From probiotics to poetry: how Rachel Kelly keeps depression at bay

Kelly describes herself as a people-pleaser and yet 12 years ago she fled her own Christmas party, crushed by a deep depression. Now she's written 52 Small Steps to Happiness.

Rachel Kelly describes herself as a people-pleaser and yet 12 years ago she fled her own Christmas party, crushed by a deep depression. Hours later, she returned to her home in Notting Hill, west London, where her husband helped her to bed. The party continued downstairs – the Camerons and Osbornes were present, joined by the family’s other high-flying friends. “The struggle was over,” she wrote in her 2014 memoir, Black Rainbow. “I had tried and I had lost.”

Kelly’s suffering came as a surprise to many. A journalist at the Times, with a successful husband, beautiful house and healthy children, she had achieved everything she had wanted. But her mental health declined after the birth of her second child in 1997 and it took years of medication and therapy to recover.

Kelly’s latest book, Walking on Sunshine: 52 Small Steps to Happiness, describes the strategies that have helped her stay “calm and well” ever since. Drawing equally from science and art, each chapter (one for every week of the year) offers salves for both body and mind, from probiotics to poetry.

When we met one recent evening at a café near her home, Kelly barely remembered to drink her water, so eager was she to share her experiences. She hopes that her new book will be for “those of us who, at times, find life stressful, or who wish to try to feel a little steadier”. It’s the kind of book she wishes she had read before becoming ill. “I’m a believer in prevention rather than cure,” she said. “I do a lot of work in schools, where we have a massive problem with teenage mental health. What makes me feel so exhilarated is that there really are things you can do.”

Having seen depression from both sides, as a sufferer and a campaigner, she is acutely aware of the stigma that mental illness still carries, particularly among people working in middle-class jobs. “If you’re unemployed or facing real social deprivation, there’s an expectation that you might get depressed. But in that middle cohort – of lawyers, bankers, doctors – there’s a lot of pressure, yet it’s hard to admit you might be suffering.”

Challenging such stigmas is vital. The head of the charity Mind estimates that 75 per cent of people with mental health problems do not receive any treatment. The number of those who do has continued to rise: the NHS issued roughly 53 million prescriptions for antidepressants in 2013, an increase of a quarter in three years. In some cases “antidepressants can be life savers”, Kelly told me. For others, “it’s empowering to take responsibility for what you can do yourself”. In her own case, she found that useful strategies came not only from professionals but from family, friends, readers and those who took part in the workshops she runs. She has found the words of poets helpful. It was a poem, “Love (III)”, by the 17th-century clergyman George Herbert, that she credits with kick-starting her recovery: “Love bade me welcome. Yet my soul drew back.”

Pointing to work being done by the Royal College of Music and a new charity, ReLit, which promotes the use of imaginative literature in treating stress and anxiety, Kelly is hopeful that the bonds between well-being and the arts will grow.

“The NHS rightly has to be evidence-based,” she said, “but I’m absolutely certain that the arts have an important part to play in mental health and we’re beginning to see the research that proves it.” Though Kelly spoke cheerfully about her experiences, her present life is not without anxiety. Like anyone, she worries about the future. “I suppose if I wish for something, it’s for my children to avoid what I went through,” she said. “You wouldn’t wish depression on anyone.”

India Bourke is the New Statesman's editorial assistant.

This article first appeared in the 19 November 2015 issue of the New Statesman, The age of terror