My ambulance crew is forced to put a plaster over society"s failure

However good the NHS is, it is not a lot of things; it isn’t social care, it isn’t a hotel and it most certainly isn’t a miracle worker. I work as an emergency care assistant on ambulances at the weekend. I can see the amazing things the health service does, but also why it sometimes appears to be falling apart at the seams. The NHS is stretched to breaking point every day. There are a lot of reasons for this and some of them are easy to see.

I’ve lost count of the number of times I have been called to patients who aren’t really patients at all. They are desperately in need of help, but not medical help. They need social care. Or social housing. They need their basic needs to be met, but not an ambulance crew. It’s just that there is no one else who they can call on a Sunday afternoon when, for example, they are at the end of their tether. When the loneliness hits hard, the prospect of not seeing a friendly face for another week is more than they can bear.

In the past this would have been dealt with by ringing another family member, or by a carer or a respite centre to give the family a break. These days, though, families are spread far apart and cuts to local authority budgets mean social care has been decimated. There is no one to call. There is no relief or respite in sight for a lot of these people and so, in desperation, they call an ambulance.

In turn, because the ambulance crew can see that the family cannot cope, that it’s just too much, we have no choice. We take them to hospital in the hope that given a few hours of space the family feels better, more able to continue in the thankless task of caring. We put a plaster over society’s failure.

And so there goes a hospital bed. A nurse, a doctor, all of whose time is taken up, instead of looking after the sick. There goes the protected NHS budget – the one that the government has pledged to increase. Only it’s not really an increase or protected at all, because now, instead of the money being spent on social care, and coming out of local authority budgets, it is coming out of the NHS one.

Then there are the lost souls. Those who drift, who sofa surf or sleep on park benches. Many of them mentally unwell but not acutely so. They don’t need a hospital, they just need somewhere warm and safe. It takes a cold-hearted person to leave someone on a park bench when you know they have nowhere else to go and it is -3C outside. Yet again we, the ambulance crew, paid for by the NHS, spend our time and your money phoning around charities, forgotten contacts in our patient’s phone, in the hope that we can find them a warm bed for the night. If not, due to cuts in social housing, there being no easy access hostels, we take them to the warm waiting room of the hospital. As we sit there sticking plasters on the plight of the homeless, another cardiac arrest call goes unanswered. Another person dies.

Other patients are just too old; their bodies far too weak. Sometimes it happens slowly, other times it is quick. I recently went to a patient who was in his 90s and barely lucid. His daughter insisted he had been fine until he got pneumonia and was taken into hospital for a month.

There was no point telling her that maybe it was just his time to go. That he had lived longer than most people, that the hospital she was blaming for the state of her father was probably to blame, only not in the way that she thought. Years ago, her dad wouldn’t have been taken to hospital to be treated for the pneumonia that nearly killed him. He would likely have just died at home. Instead we dragged him off to A&E for more interventions. When he isn’t restored back to full health, no doubt his daughter will claim that the hospital killed him. Blame, it would seem, is easier than the truth. Sometimes we just need to allow people to die and not play God and attempt miracles.

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My ambulance crew is forced to put a plaster over society"s failure

Want to know how society"s doing? Forget GDP – try these alternatives | Mark Rice-Oxley

Here are the week’s leading indicators. The Dow Jones industrial average topped 20,000 points for the first time. British GDP grew 0.6% in the final quarter of 2016. The FTSE 100 and Germany’s DAX 30 persisted close to record highs, while US GDP softened slightly.

Bored yet? I am. As a former financial journalist, I’m well acquainted with the merry-go-round of indicators that blip in and out of our lives like digital dopamine, telling us how well we’re doing. As a human being, I’m increasingly alarmed that these are just irrelevant numbers that have little or no bearing on how well we are really doing.

Stock market indices have long been decoupled from what is happening in the real world. All they reflect is the performance of big private pension pots belonging to the haves (in Britain only 58% of people have private pensions and the majority of those really very small), and how big the bonuses of a few thousand money men (yes, mostly men) will be this year.

Indeed, a company’s share price rising might be an indication of a round of redundancies or other cost-cutting which makes shareholders richer at the expense of staff. The number of people who should celebrate the Dow hitting 20k is truly tiny. Most of them wouldn’t be much fun to go out for a beer with.

As for GDP, has there ever been an acronym as spellbindingly dismal as this? GDP goes up if you sit in traffic for an hour with the engine ticking over. It doesn’t if you stay at home, caring for a sick child. GDP has soared in China over the past 20 years. Now its people wear masks in the street to filter the smog. GDP can’t measure the things that are really important to us – our health, relationships, environment – but can and does measure when industries strip-mine the Earth to make gimcrack that nobody wants but which people buy anyway, and then throw away.

This is not to deride the herculean efforts of journalists who follow this stuff, like our own Graeme Wearden, who tries to makes sense of the blizzard of financial data spewed out every day here.

Instead, I’d rather suggest a series of other metrics that give a clearer indication of where humanity is at. Perhaps these are the key performance indicators we should hardwire into our reporting calendar:

If we must focus on financial instruments, make it edible commodities. You can’t eat a Treasury bill, after all

One of the lessons of the 20th century was that inequality breeds revolt and revolutions never end well. One of the lessons of the 21st century is that people seem to be determined not to learn the lessons of the 20th century. The Gini coefficient is a crude measure of how unequal societies are becoming. Some economists have been toying with another measure, the Palma ratio, which is better at discerning how much richer the richest cohort are getting, compared with the poorest. Both tell us much about our direction of travel.

If we must focus on financial instruments, edible commodities are surely more interesting than stock and bond prices. You can’t eat a three-month Treasury bill, after all. In 2007/08, a wave of riots swept the developing world as the cost of basic foodstuffs soared. Governments fell. A dotted line joined that manifestation of unrest with the Arab spring four years later. Food matters. We routinely write that as many as a billion people on the planet are hungry, malnourished. That’s far more than the number with Dow Jones tracker funds.

The most scary dataset of all. It goes up every year. And so do global temperatures. If this carries on for another couple of decades, people won’t be inspecting their portfolios – they’ll be foraging in the woods. Has anyone read The Road?

Carbon dioxide graphicCarbon graphic

A veritable bellwether for so much – from the wretched state we’re in psychologically to the inadequacies of our healthcare systems. Prescriptions have doubled in England in the past decade. An interest to declare: I take them, and believe they work for me. But I also firmly believe they are prescribed far too readily, by overstretched GPs who have only six minutes to speak to patients and little recourse to anything other than pills. Personally, I’d be willing to shave a couple of points off GDP in return for a more comprehensive programme to address this 21st-century epidemic.

Not just in the UK, where it’s risen for six years in a row, but in California, Paris, Moscow. Surely, one of the first questions a newly arrived alien might ask upon landing in Britain would be “why do so many of you earthlings live outside?”, and not “how are my BT shares doing?”

Admittedly, this is not a thrilling one to monitor as it doesn’t move much. But it is moving – and in the wrong direction for lots of developed countries. The dependency ratio is the number of working-age people compared with the number of children and those over retirement age. According to the Resolution foundation, there are currently seven dependants for every 10 working-age Britons, but this will increase to eight in the 2020s and nine by 2050.

I’ve barely scratched the surface. Everywhere you look, there are better benchmarks than these tired old financial yardsticks. Let’s retire them, and find a new set of data to measure the performance of our leaders.

Want to know how society"s doing? Forget GDP – try these alternatives | Mark Rice-Oxley

Our children are paying a high price for society’s vision of success

Yet another report has been published showing frightening levels of mental illness among children and young people in England. The figure now stands at about a quarter of a million. I have written before, downplaying the phenomenon, usually along the lines of “children have never had it so good” and pointing to the increase in child-centrism, the boons of technology and the growth in living standards for most.

I can’t keep my head in the sand any longer. Something is going seriously wrong. Owen Jones, in an article in this newspaper, recited the usual suspects – overcrowded and poor housing, poor diet, lack of exercise, family conflict, the stresses of poverty and lack of state support. I am dubious about most of these explanations, largely because such matters have long been with us without an accompanying crisis of mental illness.

My explanation is that our children are having their childhood stolen from them, and at some level they know it. They kick against this with rage and frustration. But it is important to note that this is a rise in mental illness, not unhappiness. They are different things. Mental illness is an unhappiness that is unsanctioned, denied essentially. It is unhappiness that does not know itself. It is unhappiness that arises from confusion and double standards. Why this confusion? Chiefly, it is down to the idea that achievement and competition are all important. There is nothing wrong with this as an ethos, but achievement of what? Competition for what? And when does it end?

In the world I grew up in, when mental illness among young people was largely unheard of, achievement, although desirable, was not considered particularly important. Many people from my very ordinary background didn’t pass any important exams. Few went to university. And it wasn’t thought a big deal, because it was recognised that not everyone could be outstanding or high achieving. It wasn’t a failure to get a job in a local shop or factory, find somewhere OK to live and have a couple of kids. It was normal and many people embraced it.

But things have changed in the world of societal expectation. The myth seems to have arisen that individual striving and effort will always get you what you want – money, status or a satisfying career. A few generations ago, we were more realistic. The class structure of society, and our own individual limitations – such things were acknowledged then – meant that few of us could hope to hit the heights. But it didn’t matter as long as we had a reasonable job, our community, our homes, our families. Expectations were in line with reality.

Now that middle-class aspirational values have seeped and bled everywhere, this is no longer the case. Not only are we told that we can do anything if we want to, but that we should. We must all become middle class, or count ourselves a failure. Competitive narcissism runs rampant.

It is bad enough for those who come from a background that invests in this – the ambitious middle class. To get sucked in from a culture that does not invest in it, or have much of a chance in the race – well, no wonder some children are either rejecting education, or experiencing mental illnesses.

Achievement is healthy, but we don’t all have to hit the heights to feel good about ourselves. Society is made up of mostly low- or medium-achievers, and to make us feel ashamed of who we are is a great burden. Success should be redefined as achieving what you feel capable of, and what lies within the realm of possibility – not what society tells you that you must achieve in order to conform to a fantasy that, for most, only exists in glossy magazines and university prospectuses.

@timlottwriter

Our children are paying a high price for society’s vision of success