Augustus Young’s Heavy Years is getting unbelievable reviews which he surely deserves but mostly, alas, written by internet bloggers. You need to be geared to the new media to read them. You might well ask why traditional newspapers and magazines have failed to give the book even a mere mention. Is it because it is a remarkable mix of memoir, polemic and fictional illustrations of events from a long career in the National Health Service? His internet reviewers all call it both entertaining and intellectually stimulating. Yet it is a pity that the public at large, who are aware of what is going in today’s ailing NHS, are not given the chance to read what he has to say on this very important institution from first-hand experience.


Paul Burke, in his riveting review, says the author has a very specific view of the role of the NHS as the fundamental foundation of our nation’s politics rather than, as some see it, a toy for politicians to play with. He is very good at pointing out the Kafkaesque aspects of life within the NHS:

From the very start Young sets a detached tone and style of the writing that make it clear that the narrator is an interloper. Initially that’s a bit disconcerting and hard to get to grips with or even like, but it is this detachment that helps makes the points that Young wants us to get. So situations and arguments can be developed exclusively of personality although, of course, the arguments are very personal to him.

He carries on: ‘Young is acerbic, very witty and at times excoriating – at no time he attempts to endear himself to the reader.’ Some observations can be straightforward:

My pittance was paid from grant-support reserves, and for the first-year project, were within the hospital. And I wouldn’t be working for a pension. The ultimate object of work for me was the practical application of an idea. Being paid off with a golden handshake was something else.’ But most of his arguments are erudite and incisive. Heavy Years is a highly intellectual memoir that regularly strays into literary and philosophical musing. Topics can spring from very obscure beginnings: Young studies Bentham’s model for a perfect prison based on Brunet’s Pantechnicon with the intention of absorbing ideas for the Health Service. There are many flights of literary fancy and strange stories; the Sumerian man with the X-rays stands out for me. It’s a highly individual and eccentric means of story-telling but Heavy Years is engrossing. At the end of it you realise that Young has presented the original ideas of the Service (slaying the five goliaths as Aenurin Bevan saw it) and to put that in the context of today’s much altered needs for a modern service, Young nails a dysfunctional hierarchy of power and how it works – fails from the political to the practical delivery to service users. The politicians top the list, the mandarins civil to nobody and servants to the devil come next, all the way to the ground troops who actually do the work of medicine. Young reveals the machinations of management, the pompous and the ignorant as well as the good. We get a sense of the changes wrought by political ideology and the work of real people, including the mistakes and the basic humanity. A masterly work of erudition. Enlightening.

Published by Quartet Books last month, this work, as you can see, is very topical now as the NHS is subject to many an argument and needs a great deal of thought and more investment, which must be used wisely as the nation can ill afford to squander financial resources, given the present economic mess and the instability brought about by Brexit.

Buy the book, and find out for yourselves the enormity of the problem the NHS faces as to its future.

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