Note from the Editor

Hannah Read

This is a relatively casual introduction to some of the thoughts I’ve had about ~radical ~left ~post-growth approaches to healthcare and healthcare futures since first considering it, as well as the situations that led me to turning my mind to this in the first place.


I hold a masters degree in biomedical engineering, and often joke that I don’t know why that is the case as I have little to no interest in designing medical devices (and didn’t at the time). Engineering (at least as my course would have it) leaves little to opinion and thought beyond correct or incorrect maths and science, and allows imagination only within very practical confines. I remember trying to shoehorn points into technical reports about how things like knee replacement design were only as important as the consideration of which populations would benefit from such technology. Another essay saw me segue into how much money the CEO of the company that produced the leading bioengineered skin replacement made relative to those burns sufferers who were predominantly of lower social status and in precarious housing or labour situations. I just about stopped myself short of suggesting that wildfires brought about by increasing global temperatures would lead to a higher demand for skin grafts. These little forays into the social implications of biomedical engineering were always in spite of the course rather than because of it. Part of my current exploration into these social implications has been an attempt to retroactively learn what I learnt at university but with this lens applied - although perhaps I’m just reading esoteric books and bumming along in the gig economy whilst all of my former classmates develop cutting edge medical technology.


One of the better jobs in my gig economy resumé is as a bank healthcare support worker for the NHS. This position I applied for at the start of the pandemic, after a short stint on universal credit having been left with no freelance work and been unceremoniously made redundant from another job. I had been applying to a few administrative positions in the NHS before the pandemic and was keen to get experience as part of the UK’s socialist behemoth employer. Working within this structure and later training as an operating department practitioner has enlightened me to the less than socialist hierarchies at play within varied clinical environments. I have first hand experience of what it means for patients when care workers are not paid enough, when wards have to rely on agency or bank staff, when societal prejudices lead to worse outcomes for minority groups. Throughout the pandemic there has been much discussion of “overwhelming the NHS”. This is not done by patients but by a lack of safeguarding for staff. The workload becomes unmanageable and care suffers when wards are understaffed and staff are underpaid and overworked - not when someone becomes ill. The incessant creep of private healthcare that seems to accompany claims of an overwhelmed NHS from the right will lead to a health inequality that will be devastating for the most vulnerable. A £70 Randox PCR test one day, the paring away of vital services for disadvantaged communities the next - something already evident in the provision (or lack thereof) of affordable healthcare for trans people in this country.


I am personally interested in navigating healthcare futures, particularly in the context of climate change - the role of degrowth in healthcare to reduce the resource consumption of medical therapy; pandemics and diseases that will arise (and are arising) from anthropogenic activity due to things like zoonotic spillover or deteriorating air quality; immediate disaster relief in the face of natural disasters and in providing healthcare for climate migrants; the rejection of pharmaceutical industry profits and a shift toward open source drug resources; and what healthcare could look like beyond the patient-practitioner dichotomy to name a few issues. Beyond discussing problems, I hope that The Guts Of It becomes a publication for the discussion of radical solutions to varied problems facing global healthcare now, imminently, and into the future, and am looking forward to sharing these in the coming months.