I thought I knew social deprivation – I didn't.

Sid Dajani survives Christmas, funding cuts and public health service provision in a deprived area

 The Christmas period was as busy as ever, and so was Christmas Day. I took the liberty of taking both my nephews for the first time (one from each sibling, both aged seven) to start work experience.

I used to be the proud carrier of my father’s medical bag, chief A-Z reader, used to accompany him to stock up his bag from Richmond Pharmacy and watch him perform his magic on his patients every Saturday. That being 40 years ago I didn't get paid and we never dressed up in fine Christmas fare and Christmas-knit cool!

My nephews excelled and revelled in serving, posing with customers who wanted pictures with them and pulling faces at the security cameras. I hasten to add no errors were made and other staff didn’t complain.
Home to our first Christmas without our main man, my father, and a house full, so I was looking forward to a month of sanity and quietude. That was before the Department of Health via Keith Ridge decided to serve its own version of stuffing, normally reserved for turkeys at this time of year. Suddenly, quiet January was no more.

The pharmacy balloon

More cuts and the promise of doughnuts without the jam. Pharmacy is like a balloon, squeeze it in one place and you get a bulge somewhere else.

Cuts to staffing levels will have to happen and if the pinch point continues the less profitable or more time-consuming services will also have to go. This all comes at a time when we are looking at improving the public’s health through clinical screening and health services designed to improve access for people to get help and prevent disease.

It’s depressing that, as I look at my own career in a great profession, with a wonderful history, magnificent traditions and proud of its past, it is now strangely uncertain about its future. I had to stop thinking, not so much because of the flashbacks to the last time the DH had a revolutionary idea, but the flash-forwards where I knew the consequences and the dangers of what’s coming next. The commercial world and the DH are a graveyard for avaricious managers who do not understand that two turkeys don’t make an eagle.

For many contractors who have invested their lives in pharmacy, making money isn't necessarily about spending it on a fur coat for the mistress, or a new Lamborghini. It’s having enough money to make a 'margin'; repay borrowings, reward shareholders, send kids to school, invest in staff and develop services. Each cut leads to smaller compensatory mechanisms and an inability to cope with a negative cycle – increase in costs, increase in debts, running out of working capital, impact on the offering and quality, loss of liquidity and … bang!

Reaching out

So I wasn't in the most upbeat of moods when I received an email about providing services at a community centre on a sink estate. Word seems to have spread about my work at a health café and now I was being asked to provide similar services from a health wagon. This is a sponsored, refitted van that travels to outreach areas in our communities.

I imagine these are the type of areas where Donald Trump said even police fear to go – areas of great health deprivation and where social needs are greatest.

So about 10 of us met up, parked our cars and were advised to take nothing we couldn’t afford to lose. Some took off their watches, some decided to leave their wallets behind and it was only the bravest or the dumbest who took their handbags or mobiles.

We got to the community centre, set everything up and waited for 10am to strike. In the meantime, I got to meet the other 20 or so volunteers who made their own way in. They were mainly from health and social care, CV helpers, loan shark avoidance people, dieticians and enthusiasts with passions such as gardeners and modellers willing to teach others hobbies to give them something to do.

Welcome to reality

I joined the man in charge to open the doors. He motioned to a group of mums outside the entrance. They all had bare tattooed arms, a Superking in their mouth and half of them were sporting unfettered flabby stomachs – in January! I saw kids smoking, every other word was “yeh, doncha-fink” and some had such bad teeth that if they smiled, they'd turn wine into vinegar. I thought I knew social deprivation – I didn't.

I advised one guy who had been put on a course of metronidazole 400mg not to drink alcohol and he replied, "But it’s alright with cannabis, yeh?" I had to keep saving my Biros, my jacket and even my CO monitor from people.

I went home and had a very long hot shower. Everyone does their bit, but community and social care has to be the shop window, the pulse and the heartbeat for those more disadvantaged than us. Civilised society is judged on how well it treats its own, and for me the real heroes are those doing this work and calling it a normal day at the office.

Understanding healthcare

Isn't it weird that the people who control the budgets will never get their hands dirty at this level and so they'll never understand how the health system works or what needs to be done. They won't listen to those beneath them and that's why the inequality gap continues to widen. Department of Health take note ...