Malcolm Barker: Them that are still here owe it all to the NHS

Most people, probably a majority, will not be able to respond, learning by heart not being much in vogue of late. However, them that do will fall into two categories.

Some will petition for their trespasses to be forgiven “as we forgive those who trespass against us”. Others will say “as we forgive them that trespass against us”.

Those are the ones who identify themselves, the “them thats”. They are the older ones, who learned their Catechism probably before the 1939-45 war, and certainly prior to the Church of England’s meddling with the English of the Book of Common Prayer.

There are a lot of us about, “them thats”, I mean. We are old, too. The class of 1931, to which I belong, together with a group of friends, reaches 80 this year.

We are perhaps not at our sell-by date, a term used by Prince Philip while navigating his 90th birthday (we “them thats” do not celebrate birthdays any longer; we try to pretend they are not happening). But we have to acknowledge that we are well on the way towards it, and it behoves us to think about, and perhaps prepare for, life’s last Great Adventure, death itself.

Most of the “them thats” in my group should not be here anyway. Almost without exception, we owe progress into our eighties to the National Health Service. Some of us totter forward on replacement knees or hips. One has a pace-maker. Another has survived a stroke with wits unimpaired, and mobility largely restored. Two keep Type 2 diabetes at bay by swallowing lavish numbers of pills.

We meet in country inns, but it might be more appropriate to foregather in a surgery waiting room.

If we did, I doubt whether we would be welcome. Doctors nowadays have enough on, without a descent of malingering ancients. They are so busy, in fact, that it is not always easy to get to see them.

I rang a local surgery asking for an appointment for the following day, Friday. That was quite impossible However, there might be a vacancy in the list on Tuesday, but it could not be booked immediately. I would have to ring again on Monday.

Doctors are now paid legendary sums, and have weekends free. Things have changed vastly in a lifetime. I remember a Christmas Day at Whitby, in 1962, when dear old Dr Akeroyd clumped though snow on a house call, and accurately diagnosed abdominal pains as acute appendicitis requiring emergency surgery.

But he would have been impotent in the face of many ailments treated as routine nowadays. While he was in practice, such pioneers as Geoffrey Wooler, at Leeds General Infirmary, were exploring the possibility of heart surgery. As a result, once-feared operations like coronary by-passes are now undertaken with as little fuss as a tonsillectomy, and with a similar success rate.

The process is continuing. Last month, a study in the United States indicated that the breast cancer war was being won, with patients more likely to die of heart disease than cancer. This is a wonderful achievement of which the medical profession may be justly proud.

As recently as the 1970s, breast cancer was sometimes regarded as a death sentence, a cruel disease that was eventually tackled in earnest, partly due to the efforts of the Women’s National Cancer Control Campaign, which alerted women to the need for early detection and treatment, and also encouraged research.

Another extraordinary advance, newly announced by the Yorkshire Post, is the development at the University of Leeds of a vaccine that destroys prostate cancer tumours while leaving healthy tissue untouched.

So far, it has worked on 80 per cent of mice in trials, and although there is some way to go, it promises the eventual conquest of a condition that affects 35,000 men in this country every year, and causes 10,000 deaths.

Thus, these and other conditions that might have carried off the “them thats” are being conquered or held at bay. Many others have been seen off almost altogether, including pneumonia, once known as “the Old Man’s Friend”, for it might have seemed to ease the passage through the Great Adventure.

What form our eventual “Friend” will take is knowledge we are spared. In the meantime, we must look with sympathy and hope to those responsible for coping with the National Health Service’s very own side-effect, a huge increase in the number of old people. Most of them, I suspect, would settle for a peaceful end in their own homes, with memories still functioning and wits in something like working order.

Those unable to stay at home face huge costs. According to the charity, Age UK, the average cost of a care home in Yorkshire in 2010/11 was £447 per week. Nursing homes nationally averaged £694 per week.

The alternative might be hospital, where half the nation dies, but the standard of care varies enormously. Some hospitals are world class, but three years after the deadline, about 100 have yet to achieve foundation trust status, a benchmark of clinical excellence and financial probity.

We look with hope to the coalition’s health reforms. The expectation is that our wonderful palliative care system, underpinned by the hospices, our doctors and our district nurses, will be encouraged by the Government to manage patient care in the most effective way possible.

If this is achieved, we who think of ourselves as the lucky generation may find our good fortune continues right to the end.

Malcolm Barker is a former editor of the Yorkshire Evening Post.