The last time I was on a plane
was way back in December 2019. I was on my way to present a keynote paper at a
mental health conference in Portugal. Now when I say plane, it was one of those airlines that charge you almost as much for your Whitley Neill Rhubarb and Ginger
gins as they do for the ticket. It wasn’t always like that. I had for many earlier
journeys got onto the plane and turned left. Turning left meant you could drink
as much G&T as you liked, and all for free. My favourite airline experience
was flying on the Airbus 380 with its double decker passenger seating. Not only
did you turn left, but also walked up a rather grand staircase to find your
seat.
I think the days of such planes
have probably come and gone. Even Emirates, whose Airbus 380s were some of the best
in the world, has started to replace them with the more familiar single decker
planes. Like many other sectors, the Covid19 pandemic has hit air travel hard. Likewise,
the growth in awareness of the damage being done to our environment through air
travel has driven the development of more efficient engines and aircraft
design. Personally, I have very little appetite for flying anywhere these days
and, even if I did, for other reasons I probably wouldn’t be thinking of
turning left when boarding a plane.
If you want to see a simple
example of inequality in action, just stand and watch how planes get boarded. There
is no waiting in long exhausting queues for business class travellers. Once
seated and even when the plane is still on the ground, business class passengers
are offered champagne, and/or Rhubarb and Ginger gin, actually whatever they
want, and of course, those super little bowls of warmed mixed nuts to nibble
on. It’s a different world for sure, and the differences in experience are stark.
I caught a glimpse of something
similar yesterday morning. I had been given an appointment to get my combined
Covid19 booster and flu jab at my GP surgery. Now my doctors’ practice is one
of two located in a purpose-built health and leisure centre. There is a swimming
pool, café, library, chemist and it’s also a base for a wide range of community
services. During the pandemic, part of the ground floor of the building was repurposed
as a Covid19 vaccination centre. When I got there, I had to turn left and go up
some stairs (a la Emirates) to my GP’s practice and not right to the
vaccination centre. I registered my arrival and after a short while I was ushered
into a consulting room, given my jabs and after a 15-minute recovery wait, I
was on my way home again. Coming down the stairs, I was amazed to see a huge
queue of people waiting in a line that snaked out of the building and around the
car park. These were all folk who had accepted the opportunity to get their booster
on a ‘turn up and wait’ basis. However, it was great to see such a
goodly number of folk keen to get their vaccinations done, even if the queue
didn’t seem to be moving very quickly!
It got me thinking. The pandemic has
been often described as being indiscriminate, a great leveller. Of course,
there is an element of truth in this, in that Covid deniers, antivax
protesters, and those who have been double jabbed can all become infected with the virus. We know the likely outcomes will be very different for those not vaccinated,
however. We also know that the pandemic was more devasting to some groups in
society, far more so than others. A number of generally recognised, and long
standing, social and economic determinates of health and wellbeing resulted in folk
living in the most deprived parts of the UK experiencing much higher rates of
Covid19 infection and deaths. Often many of these areas of deprivation had
already greater health care needs and as such, health care services in these
areas experienced much greater disruption than others. The North West of
England, for example is still facing much higher levels of community infections
than other parts of the country.
It’s also been much harder for
such health care systems to fully recover and effectively tackle the huge
waiting lists. Two weeks ago, the King’s Fund published their analysis of the
waiting list problems facing different health care systems. It makes for very
depressing reading. Those folk living in the most deprived areas are 1.8 times more
likely to have to wait for a year or longer for treatment that the rest of the
UK. Such an inverse care effect feels very unfair, as did Sajid Javid’s Conservative
Conference announcement last week that ineffective NHS leaders would be sacked
and replaced by leaders from business, if they couldn’t bring their waiting
lists down. It begs the question as to whether NHS leaders serving poor communities
are worse leaders. I hope Sajid’s announcement was just Party Conference rhetoric.
It was a timely report. Today is World
Mental Health Day. Whilst it is a day to talk about all things mental health,
how we need to protect our mental health and wellbeing, and the importance of
being there for others when they perhaps are struggling, this year’s theme is ‘mentalhealth in an unequal world’. Whilst recognising that the social detriments
of health and wellbeing require focused political and economic interventions,
the study also acknowledges the role new technology can have on enabling access
to services and mental health support. It was a recommendation I found somewhat
ironic. The title of that pre-pandemic keynote paper I delivered in Portugal way
back in 2019 was ‘Recovery, resilience, and research: the state of mental
health care in a digital age’.
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