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Changing times, changing healthcare

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At a time when the NHS is reeling under pressure, student nurse Rosa reflects on the differences between the healthcare systems in the US and UK after a recent trip to New York

Rosa Milne

Rosa Milne

  Currently, on the news we are seeing frighteningly true images and accounts of situations in NHS hospitals over the winter period. There is deep frustration in the air on the parts of the public, NHS staff and politicians who wish to invest more in the NHS. Appointments and procedures are being postponed due to a lack of beds and the amount of time staff can spend with each patient is severely limited due to high levels of ward activity. With these happenings, it is easy to think that the NHS is crumbling. It is natural to look to other healthcare systems and see how and why they work. The United States of America and its healthcare system is also topical just now, as its new government wishes to make changes (some say backward steps) to how people access healthcare.

I try and make the most of being a student; discounts, access to all sorts of resources on campus and a generous annual leave. Last year, I spent a month in New York, living with my sister and exploring the city. One of the things that struck me was the number of vulnerable people on the streets. Unfortunately, in sprawling cities like Manhattan, homelessness is seen as an inevitable part of life. However, I was shocked not only to see very visibly unwell people on the streets but also the reactions of those who walked by. People whose symptoms I recognised from working in inpatient settings; responding to hallucinations, classic signs of a manic episode and even a man harming himself. I was shocked that no one seemed to recognise or maybe didn’t care that these people were extremely unwell. Instead, pedestrians walked by giving them a wide berth and once, to my disgust, recorded the person’s behaviour on their mobile phone. 

I know the city I currently live in is vastly different from Manhattan, in every way possible, but here if someone was in distress people would stop. On my way to work this week, a woman fell on the road and several people ran to her assistance. Here, healthcare is accessible and people know how to use it. The worries of money, insurance or being stuck with the bill don’t come into it. At university, we discuss peoples’ use of the NHS and the importance of promoting self-care and self-management where applicable. But a woman falling on the road in a Scottish city and a man repeatedly hitting his head off a wall in Manhattan both, at that point in time, need professional healthcare assistance. I remember on our last night, we visited a comedy club. One comedian focused on life in New York and at one point he ventured into mental healthcare. He said that walking through the city streets was like walking through ‘an open-air asylum’. This resonated with me because as a visitor in the city it perfectly described the state of mental healthcare that I had witnessed. 

As a student nurse, I think it is essential to travel, when possible. To see other healthcare systems, learn about various stigmas associated with diseases, and other views on whether healthcare is considered a human right. Gaining a global perspective of healthcare enriches your own values and can expose you to systems that are incredibly effective or incredibly ostracising. For me, certain travel experiences make me even more passionate about protecting a healthcare system, which allows access to all members of society, regardless of their economic standing. 

Rosa Milne is a currently in her third year studying mental health nursing at RGU in Scotland 

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