2006 update

It has now been 10 years since I cautiously began home care visits for a few hours a week. Initial clients included a young blind man living on a council estate, and a bizarre elderly Bangladeshi gentleman who was always keen to tell me about his adventures with prostitutes! Within a year nursing and carework had grown to be my main income and it has remained so to this day, apart from a couple of years when I was pushing my astrology more, and a brief spell managing a cafe in Brighton.

"Rewarding" is a word that many people associate with this line of work. When wiping an old person's bottom, or being confronted with a psychotic schizophrenic screaming in your face, rewarding is not always one of the words running through one's mind at the time! However for me there is genuinely a certain satisfaction from earning a living for reasons other than status and money.

Why I am not a fully qualified general or psychiatric nurse

Many people choose to train to be a nurse after a few years experience as a Health Care Assistant. For many this is an obvious step forward that leads to a proper career and relatively (not a lot) more money. This also leads to more paperwork, personal politics and general stress, with pressure from management, families of patients, and so on. Over the years I have spoken to many trained nurses who went into nursing because they cared about people, but who have ended up spending much or most of their time filling in forms and dispensing pharmaceutical drugs. Not being a great fan of conventional Western medicine anyway, I am more interested in spending my time dealing directly with people. Not having a mortgage or family, I can just about afford to do so.

A few words about the National Health Service

The well-publicized crisis in the British NHS has certainly been felt by the two hospitals where I mainly work. In fact I recently took a pay cut down to around £7 an hour as a result of NHS pressure on my agency. "Where has all the money gone?" has been a frequent cry in the British media recently. Apparently on overpaid consultants, administrators and excess management? And also on schemes such as the laughably named "NHS Professionals", which at least from what I have seen, must have wasted an astonishing amount of public money. Perhaps it will be more successful in the long term. If the NHS wants to discourage people like myself from working for private agencies, all they have to do is pay their staff more. Isn't it?

The next time anyone reading this complains about the treatment they or a loved one or family member is receiving in an NHS environment, remember that most of the people doing the hard work are paid around £6 an hour for a job that is often physically, mentally, emotionally and spiritually demanding in the extreme. "Rewarding" or not, people do tend to function better if they are paid enough to live on.

Times are changing and the NHS is now 40 or 50 years old. Perhaps some degree of privatization is necessary. It is difficult to imagine people paying more taxes, another possible solution. Taking more care back into the community and people's homes strikes me as a good move, as are belated government efforts to facilitate a healthier diet for all. If people took far more responsibility for their health (see macrobiotics), not only would people be healthier and happier, there could be a huge cut in unnecessary public spending. I myself have kept clear of doctors, pharmaceutical drugs, headache pills and the like for 30 years and believe that my health is all the better for this.

Picture courtesy of staff nurse and musician Phil Morris who has a website here

Letter to The Independent 10th January 2007