Scotland’s Health Service

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Wake up, wake up, Gareth ….. how have you been sleeping? Strange you should ask, nurse

I could begin and end with the statement that the Scottish Health Service is second to none and not bother to fill in the middle because that’s the flat-out truth. There are other nations, such as Thailand, where the health service is of a high standard too, but though massively overtaxed by England, Scotland has a free health service to all intent and purpose. England is well on its way to a pay now or poor house service. Yes, children in England play ‘Doctors’ same as children in Scotland, only the rules are different. One says ‘you operate and I’ll sue’.

A unique asset 

Scotland is this strange thing, a nation with its own health service yet allied to its bigger neighbour which is undergoing brutal and underhanded privatisation. Scotland is doing all it can to remain true to the principle of universal care for all irrespective of personal wealth, ethnicity or religion. The wealthy have recourse to private clinics but get the same doctor and surgeon who is employed by the main hospital, the equivalent of buying an Audi which is a VW in a dinner suit, as admitted by a past CEO of that over-priced car maker. Scotland keeps our health service separate from the private sort.

No one wants to face the sharp end of the surgeon’s scalpel, my fate of late, a man of revoltingly good health and physique ever since I abandoned adolescent dandruff, pimples and zits, enjoyed strong lungs, a non-smoker, the heart beat of a twenty-one year old, teeth that can still demolish a hard apple, who never needed to wear a shirt three sizes too large to hide his corpulence. I can take two stairs at a time, tuck away four scoops of ice cream in one sitting, yet suddenly struck down by the smallest of evils, an incurable cancer cell with the look and the dimensions of a pearl of tapioca. Awe, crap!

Why me? Why bloody me? Well, why not? Cancer doesn’t discriminate. Take solace knowing it couldn’t happen to a nicer person.

Eventually, we all go back to the sea

A great smile and vaulting ambition does nothing to hide the fact that we are all dying, one way or another, just that some are given an approximate date. I have a theory that the most ruthless drug lords and dictators spot that irony when they reach middle age and assume a fatalistic attitude to their fellow men, and then decide they have nothing to lose by signing a pact with the Devil.

There is no getting around it, the sum total of life for the human biped amounts to being born tiny, getting big, procreating, and then getting small again, swiftly. In between we screw up relationships, ourselves and the planet. Thankfully, the Scottish health service is here to keep us positive and cheery if not exactly doing chorus girl high kicks.

Scotland’s NHS – it should be renamed the SHS – gets kicked from pillar to bed pan by the scrofulous servants of Tory and Labour neo-liberal England, each dreaming of an OBE and an earldom announced in the Scottish Times.

A health service traduced

I go to see my doctor once in a blue moon. Don’t ask why, not to change my car tyre. I accept I am getting old but not as old as my doctor thinks. Inside my head is a thirty-five year old drama and philosophy student of easy sensuality. Which old guy are they staring at? Incarcerated in hospital, should I expect to see a sign hanging on the bed end, ‘Not to be resuscitated”?

What Celticphobes and carpetbaggers forget in their quest to pacify the natives, is how many of us are reaching late middle age or our dotage. We use the health service regularly, from doctor’s surgery to operating theatre via the local chemist. Unionists should drop the daily crap of  claiming it is falling apart.

We know it works, we know it is a good thing. And although the quality of the service can depend on where you live, it comes free and with an ambulance and a wheelchair if needed, and a pair of crutches thrown in for good measure. You have to pay when dead, the coffin, the carriage, the service, the burial or cremation. When ill, you can enjoy bad health for free.

Capital treatment

Living in Edinburgh, I used the Royal, the Western, and finally, St John’s Hospital in Livingston. There is a rivalry between them, a bit like football teams; who offers the most efficient care, the best meals, the most comfy recuperation facilities, the easiest way to bypass the ward nurses to an exit for a fly drag on a fag.

When told you have cancer, facing your mortality, every sense becomes acute. You see things sharper, can pick out sounds like a dolphin, and achieve a heightened awareness of the scent of flowers and the strength of birds on the wing. There’s no need to take up Buddhism to achieve deep contemplation, everything stops around you; life stands still. You can hear your heart beating.

Back in St John’s hospital, on the stretcher Americans call a gurney, counting the overhead strip lights pass by like a cheap hospital television soap, you try to look cheery on your way to the operating theatre. I decided to wave to people as if the Queen. That got a few muffled laughs from folk cloaked in face masks, humanity hidden.

Gallows humour is a useful tool to aid stress when the patient is wheeled in his bed out of the ward, off down the corridor to the operating theatre. To the American with the gammy leg, “Don’t let them amputate! Those surgeons are lazy. They want home early for a game of golf with their cronies at the Royal Burgess. They’ll take the quick solution!”

Hospitals are indeed places of comedic inspiration, but the joke is on mankind, we keep finding reasons to use them. On arrival at the outer surgery facility, staff in the anaesthetist’s room wear masks too, faces hidden, but I could see they were smiling. I warned them that I was quality and charged them with selling my body parts for the highest price. Another laugh. Doctors and surgeons enjoy gallows humour. I wish I’d worn my T-shirt on which I had printed: “The Complete Works of Gareth Wardell”.

From that moment until waking up in the ward, all is a blank. I was out at the time.

The real heroes

Nurses work like Trojans: twelve hour shifts, patients in, patients out, adhering to strict procedures, checking and rechecking and checking again your blood pressure, blood sugar count, temperature, dressings, changing your beds clothes, dishing out pain killers, bringing food, bedpans, jabs to stop blood clots and uppercuts to stop clots who think verbally goosing a nurse is smart.

To this add the cleaning staff straight out of a Brueghel painting, on their hands and knees disinfecting every part of the bed carcass, the side tables, floor and toilet, never a complaint as they suffer their own aches and pains while getting up again from the floor, a task so much harder than getting down. Whatever they get paid, it isn’t enough.

My ward saw men of various ages and backgrounds come and go, forget their social standing and play roles of equal measure, bed ridden, walking wounded. The patient with nose cancer and more tattoos than cigarettes smoked; the American with an infected leg wound happy to engage in political discussion; the semi-retired ophthalmologist, the first to identify I was Grouse Beater, the compulsive essayist and Twitter fanatic, he with a hole in his thigh and a drip; the bus driver whose bus no passenger would board knowing how jittery a person he was; and the drug addicted youth just out of prison for a serious assault. And then there was the poor pensioner, thin as a celery stick that needed craned in and craned back inside his Sheltered home. For all his screaming in the night he responded to my humour with the laugh of a child.

One bed held a succession of men who had sliced their finger, by band saw, drill, door slam, and a dustbin man who didn’t move his hand quick enough to stop the wind crash the wheelie lid on three fingers, he himself feeling ready for the rubbish bin. We were as one, equality restored, at the benevolent mercy of nurses and consultants.

Relax, you’ll live

What is the collective noun for a group of consultants and their attendant retinue of trainees and registrars dressed in all-green scrubs? A scrub of consultants? There is a kindness in the way the chief consultant explains your medical condition, the outcome and the consequences, his demeanour caressing, nothing like the stertorous authority of James Robertson Justice playing Sir Lancelott Spratt in a Carry On Nurse caper.

The group are a mixture from a dozen nations, from China to Ireland via Nigeria and France, the surgeon Scots, Irish or English. Nigel Farage won’t sleep nights. The head Royal College of Surgeons consultant and his troupe arrive punctually at 9 am, gather around your bed, drapes pulled shut, his students listen intently in strict hierarchy, as quiet as fish while he explains what has been done to you and the consequences of it.

I made sure I had at least two questions to ask, but not once felt patronised by the answers. The one question they never answer is how long you have left on this earth, no morbid exchanges of doom. Crack a joke in the midst of this medical throng and you can see the young registrars who get the punchline bite their lip to avoid getting sucked into frivolity while the chief consultant is holding forth.

The plastic surgeon who carved his initials on my breast popped in to check his handy work as I recovered in bed feeling sorry for myself, knelt to inspect the wound and the staples holding the skin floes together, stood up and with a broad grin under his Covid mask, said, “Textbook”, and disappeared for his holidays. Thank you, sir, whoever you are, for the extra time.

An inept doctor can be lethal. Mine, one of the best in Edinburgh, like me, an Italo-Scot, spotted my skin cancer on my upper arm at the primary stage. It lies under the skin, not the melanoma type on top, a rare type contracted by people who live in very hot countries, or as I did, work seven years in Los Angeles wearing sleeveless tops, and for it, forever getting hit by gay guys. The doctor is the start of the medical chain, the nurses at the far end, but all are magnificent in the sacrifices they make for their duty.

To hell with the politicians

Scotland’s health service is home to folk of far greater integrity and compassion for Scotland’s citizens than any grovelling unionist politician. We must protect it from the carrion crows of the right and the left who wear ermine.

Let no House Jock or second class Scot proud to be a colonial unionist tell you the Scottish health service is on its knees. It is a triumph of care over shoestring budgets. I owe whatever time I have left to those who serve in St John’s hospital; and the right to express my gratitude in this eulogy. The Scottish health service is here so we don’t have to crawl under a hedge to die like a wild animal.

With all the time I had to lie in bed looking out the window at the voluminous cumulus clouds that remind us we live in a wet country, I came to the conclusion only hypochondriacs enjoy bad health and they have none. For my part I think death sucks. I am definitely against death, and will not vote for it at the next election.

Death comes in many forms, one of them is telling a joke to the wrong people at at the wrong time, but I’ll risk more black humour: What’s grey, sits at the end of a hospital bed and takes the piss? A kidney dialysis machine.

Thank you, thank you; I’m here all week…..or whenever the ward sister lets me out.



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28 Responses to Scotland’s Health Service

  1. grumpydubai says:

    Top marks to you. So on the ball.

    No platitudes from me to you, since Scots guys don’t do that sort of thing but we all know where we are coming from. 😀👍

  2. Jim Neale says:

    It is a cleansing experience, I went through it in 2010/11, thankfully not terminal, I just consider it deferred though, I’m still convinced it is just bidding its time to do a ‘tra-la I’m back’ routine sometime in the future.
    I still remember driving down from East Kilbride towards Rutherglen on a bright, sharp clear morning with no atmospheric interference, it only happens a few times a year in winter normally. A great view of Glasgow in the valley and the hills in the backdrop you think you can see forever, but it’s just to the horizon in reality and thinking will I ever see this vista like this again.
    But at least I was in my fifties, sitting in the Beatson waiting for my radiotherapy a man older than me arrived with what I presumed was his young daughter (early twenties probably) and you think that’s good, accompanying her dad, only to be taken aback when it was her that went in for the radiotherapy. It washed away any feeling of personal injustice I had.

    After my preamble my real question was, as I drive a Seat is that a VW in a flamenco suit because that could explain the intermittent rattle from the console.

  3. Ed Taylor says:

    A wonderful read, and so true … hope your post op recuperation is going well

  4. gerry parker says:

    Echoes my recent experience Of all levels of the health service in Scotland after a recent bout of acute pancreatitis- and I’m teetotal btw. If there’s 20 years between bouts I should miss the next one. 😀. Hope your recovery continues apace, good to have you back.

  5. Muscleguy says:

    5 weeks ago my big strong, healthy back muscle spasmed twisting my spine in a very scary manner*. I had a hospital appointment at noon that day after ringing NHS24 in distress. Got assessed & diagnosed. Taken seriously. Prescribed. They gave me diazepam. That seriously.

    My spine is straight again and I’m so very grateful. All this on a Saturday during lockdown. Kings Cross Hospital Dundee.

    *The upper part of my lumbar spine was shifted to the right, the lower part pushed forward. My strong muscles added to my loose joints. I thought my vertebrae were collapsing. The bus trips home were much more comfortable knowing I was in no danger of paralysing myself.

  6. ndls61 says:

    Although we have never met in person Gareth, from our online interactions and as an appreciative consumer of your work, I expected no less than this brave and poetic response. Sending you all the best for your recuperation. Although I’m no longer on twitter, I still see some of the interactions on there, and read your blog.

    Be gentle with yourself and know that you and your efforts are appreciated by very many people. We cannot afford to lose your voice now of all times. I still hope to be sharing a dram with you at some point!

  7. Bob McPherson says:

    Thanks for this GB. Sharing widely. Sending love light and recuperative best wishes.
    “What is the collective noun for a group of consultants and their attendant retinue of trainees and Registrars dressed in all-green scrubs”? A Scrubbage?

  8. I hope your recovery goes smoothly and that you feel at your best soon. I’m looking forward to reading your blog posts again.

  9. Geejay says:

    Hope you are back doing what you do best before too long. We need sane voices in this time of madness.

  10. We have a fantastic health service in Scotland. I am a bit too familiar with it over the last several months, but looking forward to my invitation to the Xmas party. Hopefully recovered by then 🙂

  11. epicyclo says:

    Great article.
    I can only echo it. The Scottish Health Service has saved my life twice.
    Private health in Australia bankrupted my father dying of cancer, and he was a wealthy man. However much you have, the private health systems suck it out of you. We don’t realise how lucky we are in this country.

  12. CJRourke says:

    Greetings from the ward Gareth, I’m still enjoying our view to hills south of Livingston. I totally agree on the superb Scottish NHS. As an American I know the perils of private healthcare, and so wish they could get a semblance of this. Really glad you’re on the mend, keep well.

  13. jimmymorgan1 says:

    I wondered where you had got to Gareth! So pleased to hear you are now on the mend and will just look forward to your next update. If you need anyone to polish yer motors gies a shout… 😉😎😷 Stay safe 🏴󠁧󠁢󠁳󠁣󠁴󠁿

  14. Grouse Beater says:

    Much obliged, CJ, your Ahab satinwood peg-leg is in the post, courtesy of the delivered to your door Scottish health Service. 🙂

  15. angusskye says:

    Good to see you back and recovering, GB.

  16. Neil Anderson says:

    Very sorry to hear of your ailment Gareth, but you still managed to make it very funny. Was getting a bit concerned that you’d chucked it all in disgust! Don’t know what we’d do without your excellent essays. Get well soon!

  17. Colin Courtney says:

    Take a deep breath. Stick your tongue out and say AAAAAh. Works every time. Wishing you a speedy recovery.

  18. peeliewallie says:

    Wishing you all the best on your road to complete recovery. (Apologies for the overuse of clichés!)

  19. Hugh Wallace says:

    So that’s where you’ve been! Your absence is excused but don’t let it happen again.

    I’m not quite 46 but in the short time I’ve been alive I’ve worked within the Scottish NHS twice & been operated on 9 times in hospital. Is it a perfect healthcare system? Far from it! But it is, hands down, an excellent healthcare system & far better at delivering positive results to the Scottish people than the media allows us to believe.

    Good to have you back, GB.

  20. tom donald says:

    This is a superb piece of writing, finger on the pulse of the human condition let alone the SHS. Thank you and all good wishes to you.

  21. Howard Cairns says:

    Hi Gareth, I too have been wondering why I didn’t have anything to read from my favourite essayist. Sorry to hear of your problem. Hope everything goes well for your recovery. Drop me a line if you feel up to it. Cheers, Howard

  22. Grouse Beater says:


  23. Laura Cameron says:

    Love your writings GB – wish i had your talent. Get well soon.

  24. Grouse Beater says:

    Yer a pal, Laura. Am doing my best but this cancer knows neither friend nor mercy. Warm regards.

  25. diabloandco says:

    Get well ,take care and keep writing.

  26. socratesmacsporran says:

    Good to have you back Gareth. I hope we can avail of your good sense and intelligent analysis for some time yet. Keep fighting.


    Dear Sir,

    A bit slacking in reading your posts (plus a lot others because I cannot stand the inaction on the independence front [you goddamn know who you are]) and hope that you will ride this through. When I am in Scotland for the final push, whenever that might be, I hope to be able to pay you a courtesy visit at the very least. Perhaps talk about the film Joker. I find it odd that we are on the opposite spectrum in relation to the rating of the film.

    Till then, keep on writing. God knows we need more.


  28. Excellent read, as usual. It’s sad though that life is such a bitch. But as you say – who deserves cancer? I wish you all the very best to enjoy all the time you have left.

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