Ambulances are seen at the Accident and Emergency department of St. Thomas' Hospital in London. Photograph: Getty Images.
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We need to talk about the NHS - Cameron must break the Crosby-imposed silence

If the Tories won't face up to the problems in the health service, it's time to make way for a government that will.

David Cameron used to say that his priority could be summed up in three letters: NHS. Now, it seems, he prefers not to talk about it. The word in Westminster is that, on the advice of Lynton Crosby, the Prime Minister has asked his ministers for a period of pre-election silence on the NHS. So the Queen's Speech came and went without even a mention of Mr Cameron's erstwhile priority.

The list of reasons why Mr Cameron no longer wants to talk about the NHS is growing longer by the day. The last week has brought a stream of statistics confirming what many people suspect: the NHS is heading downhill under his government.

First, we learnt that the NHS missed its cancer treatment standard for the first time, leaving a growing number of people waiting longer for the start of treatment and families facing prolonged anguish.

Then, on Wednesday, came news that the deterioration in cancer care was worse than we thought and extended to people with suspected cancers waiting for tests. Waiting times for diagnostic tests are at a six-year high, with 17,000 waiting longer than they should.

Thursday brought the news that the number of people on NHS waiting lists had gone past the three million mark for the first time in six years - highly embarrassing for a Prime Minister who once said that the test of his NHS re-organisation would be its effect on waiting times.

Finally, it was revealed on Friday that A&E departments across the country are in the grip of a summer crisis, with record numbers attending and tens of thousands waiting too long to be seen. The NHS overall has now missed its A&E target for five weeks running; more worryingly, hospital A&Es have not hit it 47 weeks.

A&E is the barometer of the whole health and care system. This barometer is now clearly warning us that there are severe storms ahead for the NHS unless urgent steps are taken to put it back on track. Perhaps this explains why, after a run of negative statistics, there were reports that the government had resorted to panic measures to shore up England's hospitals.

Without any great announcement, or even so much as a press release, it emerged that large amounts of money are to be thrown at the NHS in a bid to keep further bad headlines at bay. It is not clear what the government has decided because of the lack of a clear statement. Some newspaper reports this weekend said £650m in "new money" had been found, while others believe it to be £250m. Whatever the amount, what is clear is that is that is unprecedented for a Prime Minister to have to throw millions at a summer A&E crisis. What is also clear is that, right now, the NHS is in a very dangerous position. All the signs show that it is slipping into a serious condition but it has a government in charge that is not prepared to talk about it. This is not good enough.

Minsters cannot be allowed to take such significant decisions without any explanation of why they are doing it or where the money is coming from. Cameron must order his ministers to come to the Commons early this week to answer these points.

Beyond that, there must now be a proper debate about what is happening in the NHS, why it is going wrong and what must be done to put it right. The reason why David Cameron is so desperate to avoid this debate at all costs is because it brings him back to his biggest misjudgement as Prime Minister: allowing Andrew Lansley to proceed with his ill-considered reorganisation. He was explicitly warned it would damage standards of patient care - and it has. Throwing money at the problems of his own making is no long-term solution for the NHS he has so disastrously destabilised.

David Cameron's great problem is that, though he thinks he can keep things quiet with a few bungs here and there, the public can see for themselves what is happening. They know it has for much harder to get a GP appointments. They are hearing the stories of friends and family being told that they can't have the treatment they need and facing the agonising choice of waiting in discomfort or paying to go private.

The voters are on to Mr Cameron and his damage to the NHS. Worryingly for him, a poll this week found that, for the first time in a long time, the NHS has risen to the top of voters' concerns. Storm clouds are gathering over the NHS, but it is trapped in a situation where the government of the day is not prepared to discuss them. This won't do. If they won't face up to the problems in the NHS, it's time to make way for a government that will.

Andy Burnham is the shadow health secretary

Photo: Getty
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We argue over Charlie Gard, but forget those spending whole lives caring for a disabled child

The everyday misery of care work is hidden behind abstract arguments over life and death.

“Sometimes,” says the mother, “I wish we’d let him go. Or that he’d just been allowed to slip away.” The father agrees, sometimes. So too does the child, who is not a child any more.

On good days, nobody thinks this way, but not all days are good. There have been bright spots during the course of the past four decades, occasional moments of real hope, but now everyone is tired, everyone is old and the mundane work of loving takes a ferocious toll.

When we talk about caring for sick children, we usually mean minors. It’s easiest that way. That for some parents, the exhaustion and intensity of those first days with a newborn never, ever ends – that you can be in your fifties, sixties, seventies, caring for a child in their twenties, thirties, forties – is not something the rest of us want to think about.

It’s hard to romanticise devotion strung out over that many hopeless, sleepless nights. Better to imagine the tragic mother holding on to the infant who still fits in her loving arms, not the son who’s now twice her size, himself edging towards middle-age and the cliff edge that comes when mummy’s no longer around.

Writing on the tragic case of Charlie Gard, the Guardian’s Giles Fraser claims that he would “rain fire on the whole world to hold my child for a day longer”. The Gard case, he argues, has “set the cool rational compassion of judicial judgement and clinical expertise against the passion of parental love”: “Which is why those who have never smelled the specific perfume of Charlie’s neck, those who have never held him tight or wept and prayed over his welfare, are deemed better placed to determine how he is to live and die.”

This may be true. It may also be true that right now, countless parents who have smelled their own child’s specific perfume, held them tightly, wept for them, loved them beyond all measure, are wishing only for that child’s suffering to end. What of their love? What of their reluctance to set the world aflame for one day more? And what of their need for a life of their own, away from the fantasies of those who’ll passionately defend a parent’s right to keep their child alive but won’t be there at 5am, night after night, cleaning out feeding tubes and mopping up shit?

Parental – in particular, maternal – devotion is seen as an endlessly renewable resource. A real parent never gets tired of loving. A real parent never wonders whether actually, all things considered, it might have caused less suffering for a child never to have been born at all. Such thoughts are impermissible, not least because they’re dangerous. Everyone’s life matters. Nonetheless, there are parents who have these thoughts, not because they don’t love their children, but because they do.

Reporting on the Gard case reminds me of the sanitised image we have of what constitutes the life of a parent of a sick child. It’s impossible not to feel enormous compassion for Charlie’s parents. As the mother of a toddler, I know that in a similar situation I’d have been torn apart. It’s not difficult to look at photos of Charlie and imagine one’s own child in his place. All babies are small and helpless; all babies cry out to be held.

But attitudes change as children get older. In the case of my own family, I noticed a real dropping away of support for my parents and disabled brother as the latter moved into adulthood. There were people who briefly picked him up as a kind of project and then, upon realising that there would be no schmaltzy ending to the story, dropped him again. Love and compassion don’t conquer all, patience runs out and dignity is clearly best respected from a distance.

All too often, the everyday misery of care work is hidden behind abstract arguments over who gets the right to decide whether an individual lives or dies. I don’t know any parents who truly want that right. Not only would it be morally untenable, it’s also a misrepresentation of what their struggles really are and mean.

What many parents who remain lifelong carers need is adequate respite support, a space in which to talk honestly, and the recognition that actually, sometimes loving is a grim and hopeless pursuit. Those who romanticise parental love – who, like Fraser, wallow in heroic portrayals of “battling, devoted parents” – do nothing to alleviate the suffering of those whose love mingles with resentment, exhaustion and sheer loneliness.

There are parents out there who, just occasionally, would be willing to set the world on fire to have a day’s respite from loving. But regardless of whether your child lives or dies, love never ends. 

Glosswitch is a feminist mother of three who works in publishing.