Pay to push? What future for free healthcare

If you go into an American hospital be sure to have your credit card visible at all times or you may find that you are taken firmly by the arm and shown the door. This is not in fact true but what is true is that the first thing that you will be asked upon arrival is how you're going to pay and relieving you of your life savings and the roof over your head is a dead cert if you don't have insurance. Consequently if you want to avoid 'checking out' you will find that check out is the first and most prominent area you will find when you cross the threshold.

Contrast this with a British hospital. I don't know if you have ever been to the cashier's office in an NHS hospital but they're the devil to find. In the hospital where my wife gave birth it was buried in the bowels of the basement. The lugubrious lady behind the counter informed me that in decades of working there she had never seen daylight. It was plastered in stickers informing medical staff how to claim expenses.

When I explained that I had come to pay money the woman looked slightly taken aback and apologetically explained that the card machine was not working. The fact is that having kept us in (wholly unnecessarily) overnight after our baby's arrival my wife, not unreasonably, asked if we might be able to stump up for a room rather than enjoy the close harmony choir of the wailing ward.

Evidence that this was not the American way came from our being ensconced in the room BEFORE payment was taken and although the piece of paper proclaimed that we would be chivvied for bed and board if payment was not made before departure I wasn't so sure. I, of course, paid gladly.

As I trooped off to the cash machine with a spring in my step that I was not making imploring phone calls to my bank manager from the lobby of the Lindo Wing or portico of The Portland I reflected on how lucky we are to have all this laid on for free. Then a few days later, inevitably, this article appeared in The Mail: https://www.dailymail.co.uk/news/article-7355681/Government-warns-NHS-hospitals-prepare-charge-newly-arrived-EU-citizens-No-Deal-Brexit.html

It claims that EU citizens already resident in the UK won't be liable to pay but who's going to chance a Eurostar trip to Paris after 'Independence Day' when the loss of free healthcare to my German wife may be the unexpected extra of being arbitrarily deemed a new arrival.

We have already endured absurdly more onerous requirements to obtain a British passport for our British born second son than his elder brother was subjected to applying in pre-lapsarian days. No explanation has been provided as to why the British passport authorities need to see the original German birth certificates of my in-laws complete with authenticated translations in order to issue a British passport to the British born child of a British citizen.

But the thing about slippery slopes is that they always start as imperceptible inclines. Not to worry though, the sovereignty is free, for everything else there is Mastercard.

The wisdom of innocence & baby gazing

When our first child was born I would lift him as I would a Ming vase. Every movement deliberate and risk assessed. And while I wouldn't say I tuck the second under my arm like a rugby ball I am a lot more attuned to the robustness of very small babies. And they are pretty robust; I certainly don't want to put any bounciness to the test but equally I know they don't collapse like souffles upon the slightest touch.

It is always an interesting business having visitors around when a newborn is in the house as you immediately detect who can handle a baby and who definitely can't. Those that decline to hold them or do so as if having a ticking bomb placed in their arms invariably cite anxiety about the baby's fragility. However I have a theory that this reticence is actually a manifestation of the baby dodger's fragility.

As adults we like to think we are pretty robust, young adults in particular can think themselves indestructible hence engaging in crazy sports like ski flying and sand sailing. Confronted with a baby however and we have a visceral and tiny reminder of how susceptible to damage and injury our mere flesh and blood is.

But this is not just an observation about how insubstantially corporeal babies are. They are the embodiment of blank slates. Watch people's features as they look into the face of a newborn and you will see them soften and melt. So soothing is looking at a baby's face I think it is a genuine shame that doctors are not able to prescribe the experience for the downcast and anxious. These are faces completely and utterly unmarked by the vicissitudes of life. Every expression that of pure instinct unmediated by life's hard lessons.

I believe that some people find this purity unsettling and like looking into a mirror that reflects back the beneficent innocence of one's beginning. This can, for some, be an overwhelming experience. As for the baby, every second that passes is a cascading torrent of the new and fascinating. Very small babies are rheumy eyed. At the very beginning they can only discern light and motion, then faces and shapes with the ability to make eye contact coming in after about a month.

There is an awful lot of the world to take in and it's not by chance that nature only enables babies to do that by degrees. We benefit and learn from experience but our most fundamental humanity is reposed in our innocence and if you ever need reminding of that just cradle a babe in arms.

Mother and baby are doing well

Any woman who has given birth and anyone who has witnessed a birth will know that this rote phrase encompasses pretty much any situation in which all main players are drawing breath at the end of the saga no matter how many midwives, obstetricians, tongs and vacuum cleaners were required to get there. Thanks to the power of television and the internet there must be few in the UK today that have a baby without ever having watched a birth on screen.

But watching a birth on screen is like watching parachuting on screen. It shows but it does not feel and really it's all about the feels. Such is the magnetic appeal of appearing on the box there seems, astonishingly, no shortage of women willing to be filmed in what is almost certain to be their most undignified moment.

What I find surprising is that no hospital seems to offer the chance to watch birth live from behind a two way mirror as in a police station. This would be the real service to expectant mothers and fathers, not the edited clips of One Born Every Minute. All hospitals, absurdly, offer tours of their maternity units which are as useful as a tour of the Somme in peacetime when 4 weeks later you're being sent over the top with your Lee-Enfield.

Truth be told I was a lot more anxious about birth this time around as first time ignorance had proved to be bliss. Obviously as second timers there were no classes for us and so I did what I always do when something is making me anxious which is pretend that it isn't happening. Consequently there was a real moment of vertigo when my wife woke me up at 1 o'clock in the morning to say that actually it was happening and such was my level of denial that she had to remind me to put the child seat in the car when we set off for hospital.

One of the most unsettling things about labour is that you have no idea how long it will take and so mentally you don't know whether you're settling in for a YouTube clip or a viewing of every Harry Potter film back to back. In fact this time around the whole thing was over in 3 hours which is about the length of a standard superhero film these days, aptly in my wife's case, as it allowed her no time for the administration of any pain relief.

It would be fair to say that our interaction with the midwives was extremely brisk bordering on the brusque and despite the large notice on the door reminding them to introduce themselves we did not have the faintest idea of the name of any of the women that marched in and out of the room where my wife was valiantly trying to put into practice her hypno-birthing visualisations.

Eventually the boss midwife turned up when it was clear that new life was, quite literally, at hand. She stood at the end of the bed as if she was breaking a disobedient puppy, fixed my wife with a fierce eye and commanded: 'When I say go you GO! When I say stop you STOP!' It would be fair to say that I have seen police directing traffic with more politesse.

Notwithstanding that my wife got the baby out in remarkably little time it was plain that the midwife was not impressed by her adherence to her orders. She rebuked her loudly: 'I told you to stop BUT YOU DID NOT STOP!' It was all my poor wife could do to murmur a weary apology for her insubordination. It was at this stage that I realised that the exorbitant cost of the Lindo Wing and the Portland is simply to ensure that one's wife is not addressed like a calving cow. I asked the midwife once the dressing down was over how many she'd delivered; she said she had stopped counting at 600.

One constantly reads in the newspapers about NHS bed crises which makes it all the more remarkable how astoundingly difficult it is to get discharged from hospital. Indeed there were some startling similarities between our day and night on the labour ward to my early days in the magistrates' courts. Eventually, with some substantial wheedling and determined lurking at the nurses' station we were sent on our way.

And so to home where our 3 has become 4 and our 2 year old is slowly becoming used to the realisation that his brother is forever. I feel that a balance has come into our home and that while it is possible to drive around on three wheels a Robin Reliant family just isn't properly weighted.

Most importantly: mother and baby are doing well.