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Today I was planning to write about MPs and their pay and second jobs, but then one of my lovely readers flagged up that the brilliant Richard Murphy has been covering this in his blog, and he’s right. Anyway, I don’t like to double up on things you could read elsewhere, and Richard’s also one of my readers (hello Richard!), so I’d highly recommend that everyone follows what he’s up to. While I’m at it, could I possibly make another recommendation? The brilliant investigative journalist Peter Geoghegan now writes a really excellent Substack newsletter about all things politics, money and lobbying, and it’s fantastic. I’m a paying subscriber and I’d really recommend it if you’re looking for new things to read!

So... today I’m going to write about something different; something that’s been hovering around at the back of my mind for a while. It’s a recurring thought that pops up when I’m listening to podcasts, reading opinion pieces from journalists, or reading posts on social media from political commentators. As time passes, this thought has transformed from a low buzz to a roar, so I think it’s time to talk about it and find out what you think. In fact I was so compelled to write this that while I was on my way somewhere I stopped at a coffee shop, started typing, and didn’t want to stop in case the roar dissipated again. So here goes...

Lots of you know that I used to work as a doctor; I worked clinically for ten years before giving up my medical career to campaign for the NHS, its staff and its patients. But before that- aeons ago, when I was a child imagining what my future might be like, I actually wanted to be a writer. Whenever I brought this up with my parents, I’d be told that writing was a hobby and definitely not a job, and that if I pursued this it wouldn’t lead anywhere. Essentially, I was told to stop being silly. I was a swotty type and I liked science and people a lot, so I sort of just shelved my dreams. But it meant that when I arrived at medical school, I took every opportunity to do un-mediciney things.

We had the option to take other university modules alongside our core medical curriculum, and looking back there was a pattern to the subjects I chose. I chose to attend tutorials about how the pharmaceutical industry worked, and the problematic relationship that pharma had with healthcare systems around the world. I spent a term attending sessions with an eminent developmental biologist about the “selfishness” of our genes and the inherent desire to survive. I took an intercalated BSc in the History of Medicine at the Wellcome Institute for a year too, and the thing I was most fascinated by was systems. How did healthcare fit within our societies? What was the interplay between capitalism, philanthropy, public services and care? How had we ended up with the NHS in the first place? The circumstances were precarious and random, and resulted in the building of an extraordinary and unique system in the aftermath of the second world war. When you think about it, it’s almost unbelievable that the NHS exists at all.

After I qualified as a doctor, those days of walking around the campus thinking and wondering felt a million miles away. Qualifying as a doctor and taking on the responsibility of a job in the NHS can be brutal. It’s often romanticised by TV dramas and books, but the reality is very tough. Most of us moved away from the places we had trained, and so we lacked the support networks we’d relied on at medical school. Many of us didn’t know any of our colleagues or the towns we lived in either. We entered a world of hospitals and on-call rotas and took on a level of responsibility which felt completely overwhelming.

My first job on a medical ward was during the winter of 2010 which was a very cold winter, and I’m not exaggerating when I say that I cried on my walk home every single day…