Douglas Ireland

Tag: NHS

  • Thank You, Ward 27: The Safety Net and the Spider Web

    Soundtrack to this post.

    I have been out of hospital for three days now. The silence of my own bedroom is still a bit jarring after weeks of beeping monitors, rattling drug trolleys, and the constant theatre of the ward.

    Five NHS Scotland healthcare workers standing in a row against a white background, wearing various blue and navy uniforms representing different clinical roles.
    The backbone of the service. It is the staff, not the system, that holds everything together. Image by the Scottish Government. Licensed under CC BY 2.0.

    First, I need to say it: the staff on Ward 27 were marvellous. From the consultants to the cleaners, they are the glue holding a fraying system together. They treated me with dignity, humour, and skill. They saved my life.

    But now that I am out, I can say something else: the system they work in is breaking.

    I was part of the problem. For three weeks, I occupied a bed that could have gone to an emergency admission. Why? Because my consultant knew that if he discharged me and requested my scans as an “outpatient,” I would be waiting months. By keeping me in the bed, he could order them as an “inpatient” and get them done in days.

    It was a brilliant workaround for me, but a disaster for the NHS efficiency stats. I was essentially “bed blocking” my own recovery just to navigate the bureaucracy.

    And looking around the ward, I realised I wasn’t the only one there because of a systemic failure.

    It seemed to me that a huge number of patients were there not because of bad luck, but because of what we clinically call “lifestyle factors” and what we should politically call “despair.”

    The data backs this up. In Scotland, we see nearly 30,000 hospital admissions a year purely due to alcohol. Drug-related hospital stays are rising again too, with over 11,000 cases in the last year alone.

    The NHS is currently functioning as the emergency room for a society that is failing its citizens long before they reach the hospital doors. We are treating liver failure in Ward 27 because we didn’t treat the alcoholism in the community ten years ago. We are treating malnutrition and obesity because healthy food is expensive and addiction is a salve for poverty.

    We cannot “fix” the NHS just by throwing money at hospitals. That is like trying to fix a leaking roof by buying more buckets. We have to fix the roof.

    If we want to protect the NHS, we have to talk about:

    1. True Preventative Care: We need to stop treating addiction as a crime and start treating it as a health crisis before the ambulance is called.
    2. Social Care Integration: We need a social care system that actually works, so patients don’t have to stay in hospital simply because there is no one to look after them at home.
    3. Honest Triage: We need a system where a consultant doesn’t have to game the system and block a bed just to get a patient an MRI scan.

    The NHS is the greatest achievement of our society. It is the only reason I am here to write this. But if we want it to survive the vultures who are circling, we have to stop using it as a sticking plaster for broken social policy.

  • The View from Ward 27

    Soundtrack to this post.

    A view from a high hospital window looking out over Paisley on a cloudy day. In the foreground is a large car park filled with vehicles. To the left stands a tall, thin concrete industrial chimney. In the background, a mix of modern suburban housing and high-rise flats sits in front of rolling green hills. A grassy area in the middle ground contains a helicopter landing pad.
    The view from Ward 27. From the “incinerator” chimney to the Oldbar Hills, with the helipad waiting on the green. Image by Douglas Ireland. Licensed under Creative Commons CC BY-SA 4.0.

    When you are confined to a hospital bed, your world shrinks to the size of a room. The only connection you have to the outside is the window. It becomes your television, your cinema, and your clock.

    I have spent a lot of time staring out of mine.

    The foreground is dominated, as all hospitals are, by the car park. It is a constant ballet of arrivals and departures. You see the relief of people going home and the anxiety of people arriving. It is the most honest theatre in town.

    Beyond the tarmac, the view gets more interesting. To the right, there is a sprawling, somewhat soulless new build estate. It stands in stark contrast to the three solid blocks of council flats rising up in the distance. It is a little slice of social history right there in the architecture.

    Then there is the chimney.

    It is a massive, grey concrete finger pointing at the sky. I have decided, based on absolutely no evidence whatsoever, that this is where they incinerate the amputated body parts. I am sure the hospital facilities manager would tell me it is just the boiler flue or part of the laundry system, but my version fits the mood better.

    In the distance, I can see the tops of the Oldbar Hills. They are a nice reminder that the world is bigger than this ward, and that the weather is doing something other than recirculating through the air conditioning.

    But the real highlight is the helipad.

    Every so often, the air around the hospital changes. The noise builds, the downdraft hits, and the air ambulance comes in to land. It usually arrives from the Scottish Islands, bringing someone across the water for care they can’t get at home.

    A dark grey air ambulance helicopter hovering just above a grass landing pad next to a hospital building. In the background are suburban houses and bare winter trees under a grey sky.
    The dramatic disruption of the day: the air ambulance arriving from the islands. Image by Stephanie Crew. Licensed under Creative Commons CC BY-SA 4.0.

    It is a dramatic disruption to the slow routine of the ward. For a few minutes, we all stop what we are doing, patients, nurses, cleaners, and watch the machine touch down. It is a reminder of the incredible logistics that keep this whole system running.

    For now, I am just a spectator. But the view isn’t bad.

  • The Vultures Circle: Defending the NHS from the Tech Bros

    Soundtrack to this post.

    The vultures are circling our infrastructure, both physical and digital. Photo by Sam Cherone on Unsplash.

    I am writing this from a hospital bed in Paisley. For over two weeks, I have been a guest of the state. My treatment, my meals, and my recovery are being powered by a system built on a simple, radical principle: that human life has an intrinsic value which cannot be calculated on a balance sheet.

    The NHS is the closest thing we have to a sacred institution. It is socialism in practice. And because of that, it is hated by the most powerful people on Earth.

    Across the Atlantic, Donald Trump is back in power, emboldened by a coterie of Silicon Valley “tech bros” and venture capitalists. These are men who view the state not as a protector, but as an obstacle. To them, the NHS is not a triumph of civilisation; it is an “inefficiency” waiting to be disrupted. It is a market they haven’t been allowed to corner yet.

    Make no mistake, they are coming for it.

    This is not a conspiracy theory. We have the receipts. Donald Trump has previously stated on camera that in any trade deal with the UK, “everything is on the table,” including the NHS. His trade negotiators have consistently pushed for “full market access,” which is diplomatic code for dismantling the price controls that stop US pharmaceutical giants from charging us American prices for life saving drugs. They want to break the NHS model because it is bad for their shareholders.

    And the tech invasion has already begun. Look at Peter Thiel, the billionaire co-founder of Palantir and a vocal Trump supporter. He has described the British public’s affection for the NHS as “Stockholm Syndrome” and claimed the system “makes people sick.” Yet despite his contempt for the institution, his company was awarded a massive contract to run the “Federated Data Platform” for the NHS in England. They are not waiting at the gates anymore. They are already inside the server room.

    The danger isn’t just that they want to sell us insurance. It is that they want to mine us for data. To the tech oligarchs backing the US administration, the NHS is just a massive, unexploited database. They see millions of health records, genetic profiles, and histories that they can feed into their proprietary AI models to generate profit.

    They want to turn patients into products.

    This is where my physical reality here on the ward meets my digital reality on the server.

    I have spent the last few months aggressively moving my digital life onto my own VPS. It is a modest setup: 8GB of RAM, an 80GB SSD, and a 1TB storage box. But it is mine.

    When I run my own cloud, I am removing myself from the jurisdiction of the Silicon Valley data brokers. I am refusing to let Google or Microsoft scrape my emails, track my location, or feed my photos into their algorithms. I am reclaiming my digital sovereignty from the very same people who are eyeing up the NHS for parts.

    There is an ideological line between defending socialised healthcare and self-hosting your data. Both are acts of resistance against a worldview that says everything, your health, your memories, your location, your blood, must be for sale.

    A protester wearing a face mask holds up a large hand-painted banner outside the UK Parliament. The banner reads "Thank the NHS... STOP THEM PRIVATISING IT!" in large black and white lettering.
    A reminder that the fight for the NHS is happening on the streets as well as in the wards. Image by Alan Shearman. Licensed under CC BY 2.0.

    The Counter-Offensive

    It is easy to feel helpless when you are up against billionaires and governments, but resignation is just another form of privatisation. If we want to keep the vultures away, we have to make ourselves indigestible. Here is where we start:

    1. Lock the Gate: In England, you can click a button to opt out. In Scotland, they have made it harder. The easy “SPIRE” opt-out system was closed in 2023. But you still have rights. You have the “Right to Object” to your data being processed for research and planning under data protection law. It isn’t a simple form anymore; you have to write directly to your GP Practice Manager and explicitly state that you object to your data being shared for purposes other than direct care. It is a hassle, but that is the point. Make them work for it.
    2. Join the Frontline: Campaign groups like We Own It and Keep Our NHS Public are fighting the stealth privatisation of the service. They need members, they need money, and they need voices. Join them.
    3. Support the Staff: When nurses and junior doctors strike, they are not just fighting for pay; they are fighting for the safety of the service. Support them on the picket lines. A well-funded workforce is the best defence against a private buyout.
    4. Reclaim Your Digital Self: You might not be able to build a server in a hospital bed like me, but you can take small steps. Switch to privacy-focused browsers. Use Signal instead of WhatsApp. Every byte of data you deny Big Tech is a small victory for sovereignty.

    The Line in the Sand

    The tech bros want a world where you rent your digital existence from them, and where your healthcare is determined by your credit score. They want us to be serfs in a digital company town.

    I refuse.

    I will defend the NHS because it treats me as a human being, not a customer. And I will keep maintaining my little server because it treats me as an owner, not a user.

    The vultures are circling, both in Westminster and Washington. Keeping them away from our hospitals and our hard drives is the most important fight we have.

    Don’t let the bureaucracy stop you from locking the gate. I have prepared a sample letter for Scottish patients to exercise their Right to Object. Click here to view it.

  • The High Cost of Being Nasty

    Soundtrack to this post.

    I am currently on day 16 as a guest of the NHS. When you spend this much time on a ward, you have a lot of time to observe the ecosystem around you. You see the stress, the rush, and the incredible patience of the staff.

    Today, while I was down getting a plasma exchange, I spotted a poster on a roll-up banner that stopped me in my tracks. It wasn’t a warning about infections or a guide to washing hands. It was titled INCIVILITY: THE FACTS.

    A blue roll-up banner titled 'INCIVILITY: THE FACTS' displaying statistics on the impact of rudeness. Key figures include: 80% of recipients lose time worrying, 38% reduce work quality, 48% reduce time at work, and 25% take it out on service users. A central box states 'Less effective clinicians provide poorer care.' It also notes that witnesses suffer a 20% decrease in performance, and service users feel 75% less enthusiasm for the organisation. The footer reads: 'Civility Saves Lives.'
    The “Incivility: The Facts” banner I spotted on the ward. A stark reminder that rudeness has a measurable cost to patient care.
    Image by Douglas Ireland. Licensed under Creative Commons CC BY-SA 4.0.

    It turns out that being rude isn’t just unpleasant. It is dangerous.

    The poster laid out the hard data on what happens when someone is rude in a medical setting. The numbers are staggering. 80% of recipients lose time worrying about the rudeness. That is a massive amount of mental energy being diverted away from the job at hand. Even worse, 38% reduce the quality of their work and 48% reduce their time at work.

    In an office job, a 38% drop in quality might mean a bad spreadsheet. In a hospital, as the poster bluntly states, “Less effective clinicians provide poorer care”. The slogan at the bottom really drives it home: Civility Saves Lives.

    It got me thinking about a post I wrote a while back about catching flies with honey rather than vinegar. I wrote then that I had tried vinegar, sharp words and cold silences, and found it useless. This poster proves that it is not just useless; it is actively destructive.

    When you are nasty to someone, you are not just venting your own frustration. You are throwing a wrench in the gears. You are creating a blast radius. The poster notes that even witnesses to rudeness see a 20% decrease in performance and a 50% decrease in willingness to help others.

    Think about that. Being rude to one person makes the people watching half as likely to help someone else. It spreads like a virus.

    I learnt this lesson when I was a toddler. It didn’t take a Harvard Business Review study for me to figure out that it is infinitely easier to get someone to do something for you if you are nice to them. If you scream and stamp your feet, people shut down. If you smile and say please, doors open.

    It is beyond my belief that fully grown adults still struggle with this concept. You see it in shops, in traffic, and sadly, even in hospitals. People seem to think that being aggressive displays dominance or gets results. The data shows it does the exact opposite. It makes the people trying to help you slower, more worried, and less effective.

    My stay here has reaffirmed what I have always suspected. Being nice is not just a “soft” skill. It is an essential survival mechanism. Whether you are trying to get a nurse to check your IV or trying to navigate a difficult meeting at work, civility is the grease that keeps the machine running.

    So, if you can’t be nice just for the sake of being a decent human being, be nice because it is the only way to get anything done. As the banner says, incivility affects everyone.

    We could all do with remembering that politeness costs nothing, but rudeness can cost everything.

  • Let Scotland Go: A Kindness to Both Nations

    Well, this isn’t how I planned to spend my evening. I’m writing this from a hospital bed, thanks to a sudden issue with my right eye. It’s nothing serious, but it does mean I’m stuck here overnight. No access to my VPS terminal, no proper keyboard, just me, my thoughts, and a surprisingly comfortable NHS bed. And since I’ve got time to kill, I might as well write. Again.

    First off, let’s talk about the NHS. It’s not perfect, but it’s a bloody marvel. Free at the point of use, staffed by people who actually care, and despite years of underfunding and mismanagement, still managing to keep people alive and relatively well. I’m grateful for it. We all should be. So, if you’re reading this and you’re English, remember that the next time someone tries to tell you Scotland’s better off without independence. The NHS is one of the best arguments for why the UK should work. But it’s also a reminder of how badly Westminster can mess things up when it wants to.

    Right, now that’s out of the way, let’s get to the point. Why should the English support Scottish independence? I’m English myself, by the way. Grew up near Manchester, moved to Scotland ten years ago. And I’ve always believed in independence for Scotland. Not because I don’t like being English, but because I think it’s the right thing to do. So, let’s break it down.

    Democracy Actually Working

    Scotland votes one way. England votes another. And yet, Scotland gets dragged along with whatever England wants. That’s not democracy, is it? It’s like being in a flat share where one person always picks the TV programme, even when everyone else wants to watch something different. At some point, you’ve got to ask why you’re even sharing a flat.

    Scottish independence isn’t about nationalism in the flag-waving, chest-thumping sense. It’s about having a government that actually reflects the people it serves. Scotland’s more left-leaning. It’s more progressive on social issues. It’s greener. And yet, it’s stuck with a Westminster government that doesn’t give a toss about any of that. So, if you’re English and you believe in democracy, you should support Scotland’s right to choose its own path.

    A Greener Future

    Scotland’s got ambitious climate targets. It’s investing in renewables like it’s going out of fashion (which, let’s be honest, fossil fuels should be). But Westminster’s dragging its feet. More runways, more roads, more North Sea oil. It’s like trying to run a marathon with someone tying your shoelaces together.

    An independent Scotland could set its own environmental policies. It could push harder for wind, wave, and tidal energy. It could show the rest of the UK what a proper green transition looks like. And if you’re English and you care about the planet, wouldn’t you want that?

    Brexit (Yes, Still)

    Let’s not pretend Brexit’s going well. It’s not. Scotland voted to stay in the EU. It got dragged out anyway. And now it’s stuck with the economic fallout, the trade barriers, the whole mess. Independence would give Scotland the chance to rejoin the EU. To rebuild those trade links. To be part of a bigger, cooperative project again.

    If you’re English and you’re still clinging to the idea that Brexit was a good thing, fine. But if you’re one of the many who’ve spent the last few years watching in horror as the economy tanks and the government flails, why wouldn’t you want Scotland to have a way out?

    A Left-Wing Alternative

    Scotland’s politics are different. The SNP’s not perfect, but it’s miles ahead of Westminster on social issues, welfare, and public services. Labour’s resurgence in England? Great. But Scotland’s already got a left-leaning government. It’s just being held back by Westminster.

    An independent Scotland could be a proper left-wing alternative. It could show that another way is possible. Higher taxes for the rich, proper investment in public services, a real commitment to reducing inequality. If you’re English and you’re sick of the same old Westminster politics, wouldn’t you want to see that happen?

    It’s Not About Separation, It’s About Choice

    This is the big one. Supporting Scottish independence isn’t about wanting to break up the UK for the sake of it. It’s about recognising that Scotland should have the choice. That it should be able to decide its own future. And if you believe in self-determination, in the right of people to govern themselves, then you should support that.

    And here’s the thing: it’s not like Scotland and England would become enemies. We’d still be neighbours. We’d still trade, still cooperate, still share a history. But Scotland would finally have the chance to build the kind of country it wants to be.

    So, What Now?

    If you’re English and you’re reading this, think about it. Scottish independence isn’t a threat. It’s an opportunity. For Scotland, yes, but for England too. It’s a chance to rethink what the UK is, what it could be. To move away from this centralised, London-dominated mess and towards something better.

    And if you’re Scottish? Well, keep pushing. Keep making the case. Because independence isn’t just about nationalism. It’s about building a fairer, greener, more democratic country. And who wouldn’t want that?

    (Now, if you’ll excuse me, I’ve got to try and get some sleep in this very bright, very noisy hospital ward.)