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.

Let's Go Round Again

In a few short days I shall be a dad again. And just like you never get the first pancake right now is my chance to start again with a blank canvas. Except, unlike the first pancake, I have not put my first child in the bin (however tempting that sometimes feels). I am of the strong view that if any mother could remember anything of what happened to them during childbirth they would neve ever have another. And yet somehow a universal amnesia descends and as night follows day where once there was one there soon are two.

We have been trying to get the firstborn ready and after much show and tell and dramatic role play he has just about grasped the concept of a sibling. However he has guaranteed himself disappointment as his resolute and unequivocal order is for a big sister and whatever’s coming it ain’t that.

In particular we have been reading the bizarre ‘There’s a House inside my Mummy’ in which the newborn’s arrival is hotly anticipated by his brother with this extraordinary verse:

“I just can’t wait to meet him

I hope that he’s all right,

My daddy says be patient

As his door is rather tight.”

In truth my son and I do share a thwarted wish which is for a girl. I know you’re not supposed to express a preference but I’ve seen mini-me and any further pint sized replication seems extremely ill-advised.

Furthermore I feel the age of men has run its course and I was rather relishing the challenge of being a daughter’s father. The silver lining is that I have had more than one parent comment on how ‘complicated’ girls can be; as if having a son is the quick crossword to the daughter’s cryptic.

It seems to me that being a parent to a child of any description is a fiendishly difficult undertaking the absolute impossibility of which is never made apparent until it’s far far too late. But I have always supposed that there is some difference to the challenges.

Raising a son is like climbing a mountain, the peak usually remains in sight, it’s physically hugely demanding, dangers are usually clearly signposted and serious harm is the likely outcome of foolish risk taking.

Raising a daughter is like traversing a mature and dense forest, the path seems clear but suddenly one can lose one’s bearings in a sickening moment of uncertainty, there is no obvious reason to fear but a stray root can trip at any moment or a darting adder draw blood with poisonous bite.

Anyway, I am not one for generalising and I know my son will be his own person as are we all and I’ll love him come what may.

Parents' Pride

It shouldn't be news but it is. Progress should have completed its journey but it hasn't. Prince William won headlines and praise for the wholly ordinary and normal statement that he'd support his child if it was gay while at the same time sounding a note of caution that he would worry about 'hateful words, persecution and discrimination.' LGBT Pride Month ends on Monday with, inevitably, numerous bigots complaining that it is now a whole month that we pause to think about the death, misery and incarceration that is still visited upon those that deviate from heterosexuality in certain parts of the world.

Sure we've made progress here but it's at times seemed like an inexorable ice climb with a constant reminder of the dizzying void that lies beneath. Slowly people are learning that difference does not mean one thing different from another but as different as there are people on Earth. There aren't enough colours in the rainbow to reflect that but it's as good a reminder as any. A joyful banner prompting us to rejoice in difference not to fear it, never to hate it.

Becoming a parent has caused me to reflect on a particularly bittersweet vein of coming out stories. They regularly crop up on social media. A youngster (sometimes not so young) recounts how after years of fearfulness they showed themselves to their taciturn father or conventional mother only to be delighted at the parent being absolutely cool with it. Obviously this is on one level heartwarming but in other respects it is a tragedy to think of completely needless adolescent turmoil which could have been headed off by some basic talking.

Children see far more than their parents know and parents understand far more than their children realise. The reality is unless a parent is unusually obtuse they will soon notice if their child is eyeing up the boys or the girls, or both, or neither. It is not necessary to wait until that moment to have a simple but important conversation with your child. In truth it is not really a conversation more an assurance: love is love.

The child that loves generously and freely, in whatever direction, deserves every encouragement from its parents. The notion that children need to be protected from the knowledge of this is the real perversion. No child is too young to learn that it is loved for its authentic self and never too young to be taught that love is sharing that self with another.

It is incumbent upon every parent to ensure that their children understand implicitly that the home is a place of absolute sanctuary against a still hard world where still hateful prejudice subsists. The greatest parental pride is a child knowing it is safely loved to safely love.

The Favourite - The parenting taboo that dare not speak its name

Like most parents I swore blind before junior arrived that I would preserve his privacy with my life. I scoffed and scorned at those parents who documented every moment of their child’s life riding roughshod on their child’s autonomy over their personhood. Needless to say, two years down the track, I had to promise my wife I would pay a £1,000 fine if I put another picture of our child on Instagram. Sharenting doesn’t come close: this was true #nofilter voluntary intrusion on our child’s privacy.

Still - there’s the evidence of my love for him. Not for me the wistful photographs of pints and champagne flutes and fond reminiscing of when I was footloose and fancy-free. So much have the traditional taboos been broken down that these days one occasionally sees pieces in the papers from parents prepared to go public that having kids was the worst thing that they ever did and they wish them away every moment. Although, notably, these articles seem to be confined to when the children in question are not yet at school to be confronted with the documentary evidence that that they were a terrible mistake and constant source of regret.

There remains still one topic that even the boldest parent will not own to and that is favourites. We have favourite colours, favourite ice cream flavours, favourite football teams and we have our favourite child. I thought I should write this post now, when we have only one, and there can be no doubt that my one and only really is my one and only. (Although I have a slightly challenging theory that if your favourite child is not your firstborn then even when your first was your only child they were still not your favourite, but this is no place for philosophy).

Being the favourite is of course not an unalloyed blessing. Nothing in life is more galvanising than the realisation that you have to fight for attention. Also an awareness that you’re second best makes it much more likely that you will venture into the world with a clearer sense that nobody owes you anything. That being said if there are only two of you it must be hard not being the favourite. If inclinations were fairly calibrated it would obviously be equitable if one child was the favourite of one parent and the other of the other but, as we know, life’s not fair.

I’ve often thought in very large families, rarely found these days, that there must be a real sense of camaraderie in not being the favourite. After all if you’re one of eleven, as a Catholic priest friend of mine is, only one of you is going to be family captain. One thing that I think is important is to be reconciled to your status. Favourites are immutable and no endeavour is more bound to fail than a child’s attempt to usurp its sibling’s status.

Don’t whatever you do broach this as a topic with your parents, they will deny favouritism to their dying breath, all any good parent can do is seek to suppress those instincts lest the truth too uncomfortable rears its ugly head.

Harry, Here's How Its Done

So, you're a dad. And, as you observed, it is a wonder that women do what they do to give life. As I say, if you want to know how childbirth feels ask a mum, if you want to know what actually happened ask a dad. Not even a fortnight has passed and you will be realising that all those months thinking, worrying and meditating about the journey to base camp are as nothing compared to the climb ahead.

Your wife may be a duchess and a global figure but one thing she will share with all mothers is the 'benefit' of unsolicited advice. This pours in from all corners, often at the most unexpected times; although I suspect she won't be enjoying the unasked for mothering tips that often accompany a meltdown in the supermarket checkout queue.

You, on the other hand, may be spared much of this received wisdom. Most dads don't regale each other with advice on the best way to tie a baby sling. The mothers' WhatsApp group from our NCT class has generated more words than the Complete Works of Shakespeare, the fathers' group's collective output would struggle to complete a haiku and such content as there is amounts to a proposal for a father and child get together down the pub during the Six Nations.

You have the benefit of a brother and one that has ridden the rodeo three times, if he's feeling generous he might offer a few pointers. But if you really want to know how to be a better dad go and speak to a mother. Many mothers will offer the same advice: the mother's job is to look after the baby, your job is to look after the mother. Be very careful about interpreting this advice too literally. A few back rubs and the occasional bunch of flowers is definitely not going to cut the mustard.

In fact that advice is nonsense because the best thing you can do as a new dad is give your wife sleep and the only way you can do that is by looking after the baby. In principle this may seem a fair and obvious step to take but, as you will rapidly discover, it makes no allowance for what the baby wants. And if what the baby wants is its mum even your best effort at the three o'clock in the morning feed will end in dismal failure.

You, me and baby makes three. I often feel, when it comes to a woman's affections, that having a baby is a bit like losing the Boat Race. You come second and last. A lot of men aren't very good at talking about their feelings and, in particular, about what it is like having their place in their wife's heart dislodged by a mewling, puking infant. Well the answer is that it feels weird, unsettling and occasionally infuriating. You have become three but your wife's time for you will more than halve.

You will have to find a way to reconcile yourself to those feelings because this is forever. One way to ensure that you don't  become dislodged from the nest entirely is making sure that you pull your weight. This is easier said than done because another truism of being a dad is that no matter what you do with the child you will almost certainly do it wrong, even if you're doing it right, if, by chance, you are doing it right never, ever point out that you're doing it right. That is the most wrong thing of all.

Apparently you've changed some nappies, this is in fact one of the easiest things to get at least nearly right and if you really want to get ahead put yourself in sole charge of this, it's likely your wife will be prepared to delegate. On no account buy any clothes or dress the child without consultation. 

If you come, in a few months' time, to have any thoughts about bedtime routine I strongly counsel that you keep those thoughts in your head. Likewise never say how tired you are and, in particular, state or even imply that you might be more tired than your wife.

The most important thing is to enjoy yourself because, as I said, it's forever.