I first came into contact with the NHS when I was 18, and that time it didn’t come free: I didn’t live in Britain then. I lived in Ireland, where abortion was illegal – but I needed one and so I flew to London. I had just sat my final school exams and had no income, so the cost of travel and the procedure was scraped together between my boyfriend and my mother.
I was terribly frightened. I was frightened of the money it was costing, and the secrecy involved. I was frightened of what sort of pain might be involved and how I would deal with it on the flight we had booked home later that afternoon (would I bleed into the Ryanair seat?). I was frightened, too, by the thought of the clinic, and the foreign health-care system I was entering, and what the doctors and nurses would say to a silly, scared girl who didn’t even belong to their country. In Ireland, the doctor wouldn’t meet my eyes and snorted with unconcealed disgust when I explained that my contraception had failed. I imagined a building full of snorting medical professionals like her, only with English accents.
When it came to it, everyone who spoke to me that day was so unfailingly reassuring and helpful that I cried from start to finish with relief and gratitude. Before we left, I insisted on sitting down and writing a long note on the feedback cards, in an attempt to explain what their professionalism and kindness had meant to me. As I did so, I glanced around the waiting room at the other women and girls. I couldn’t believe they would all receive the same compassion, with none of the money and stress it had cost me. In my tearful hormonal state, it struck me as a profound expression of basic goodness, an ordinary miracle you might not even notice if you grew up inside it.
Then I moved to the UK, and the NHS touched my life again, in various ways big and small. I can still be brought to tears at the abstract thought of it on a wobbly day. I am not an American; I would never have had to pay, as they do, for lifesaving procedures if I still lived at home. The comforts the NHS have brought me are less dramatic, but in their own way illustrate its worth just as effectively: they helped me live my life when I desperately needed a break.
One: I was not long in London and was pitifully broke. I was also technically without an address, floating between sublets and friends’ couches, so I put off finding a GP until I could put it off no longer: I ran out of my contraceptive pill. My doctor wrote out my prescription and I walked into Peckham to fill it at Boots, gritting my teeth. My pill cost about €15 a month in Dublin, money that seems like nothing when you have it, but is three days’ budget when you don’t. The pharmacist went to fill all six months of the prescription at once and I stopped her. “I can’t afford all six months right now,” I said. “Can I just do a month at a time?” She looked confused and told me, “It’s free.” “What, all of it?” I squeaked back in disbelief. Yes, all of it. I laughed aloud with the sudden freedom this news brought to my life. I could have sex and not worry about pregnancy, and it would cost me nothing at all.
Two: a year later I was still struggling financially, and my anxiety was through the roof as a result. A terrible pattern emerged in which I was sick with nerves and depression about my finances, which made me too mentally unwell to concentrate on work. I knew that what may clinically have been referred to as depression or anxiety disorder was a direct result of my precarity. With this in mind, I dragged myself to the GP to ask to be put back on antidepressants, which I thought I’d finished with years before. I am not here to advocate uncritically for antidepressants: naturally I would like everyone to have access to therapy, and in any case it is clearly not ideal to treat a social problem like poverty as a physiological one. But the fact is, in my case, I needed them to become functional enough to escape the circumstances that were creating most of my problems. And here is the crucial point: I was able to access that medication without paying €40-€70, as I would have done in Ireland. I know that, had I been back home, I wouldn’t have felt justified in spending that money on a GP visit, as illogical as that might seem in retrospect. Who knows how much longer I would have wallowed in my defeated inertia, how much debt I might have ended up in, had that visit not been free of charge?
Three: during my first smear test last year, abnormal cells were found in my cervix. The language around these cells was necessarily obtuse until they could treat me and find out more, so of course I was terrified. The word “cancer” was introduced into the conversation, in phrases such as “potentially cancerous” and “pre-cancerous”, but “cancer” was the only thing I heard. Quite a long time passed between the first alert that something was not as it should be, and the first treatment to remove the offending cells (which, if left untended, would at some point grow more malevolent). I became addicted to online medical forums – where you can always find that your exact symptoms lead to certain death if you look hard enough. In the crowded waiting room in Lewisham hospital I felt doomed, recalling all the sins of my past, framing them as having led me to this moment, sure that they had somehow caused my rotting insides.
When at last I saw the doctor who would remove the cells, she held my hand and let me cry even as she explained that everything would be fine, understanding how difficult it is to feel the fragility of your body for the first time. I go back to be treated every six months, and I am filled with the same sense of miracle I felt ten years ago each time I look into the faces of the people treating me and think, Imagine. What if.
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