Hard Work by Polly Toynbee

 

A reedited version of an article I wrote on the original HPANWO blog in 2008.
I was given a copy of the book this book by a retired doctor I met on July the 6th 2008. I was attending a party hosted by the Lord Mayor of Oxford to celebrate the 60th anniversary of the National Health Service; I was representing the porters for our hospital's principle trade union UNISON. The doctor had been a young GP in 1948 and was one of the first British physicians to sign her practice over to the NHS. The 2003 book Hard Work by Polly Toynbee chronicles her experiences as she does some of the worst paid jobs in Britain. The author is a veteran liberal journalist who has been raising awareness of social injustice for almost forty years. There is serious poverty in Britain today; and for a change it's not because of unemployment. Fewer people are out of work than during the Thatcher years of the 80's, and most of the poor are not unemployed, but working. A whole sector of super-low paid jobs have emerged under the Blair regime. This has resulted in the emergence of an underclass of employed poor numbering over three million. The majority are women and a large proportion are foreign workers; simply grateful to be in this country after having escaped even worse poverty in their homelands, they are ripe picking for slave labour by public service contractors. The poverty today is less in-your-face than it used to be. Poor people don't wear cloth caps and flannel and more; because of low-cost fake designer clothes, poor people dress the same way as the rich. I found this book very poignant and the author is clearly enraged over the issue, quite rightly. She spent a few months with an employment agency going from one low-paid job to another: care home worker, shop assistant, school dinner lady, bakery worker and... hospital porter.
 
Obviously her experience with hospital portering interested me the most. As a young journalist in 1970 she worked as a porter at the Chelsea and Westminster Hospital in London. Then the foreign crew was made up mostly of people from India, Pakistan and the Caribbean; today they are mostly from Africa, the Arab world, the Philippines and Eastern Europe. Why? For the same reason: They are cheap, willing and easy to exploit. The hospital has changed since the author's last portering tour; the greasy red-bricked Victorian buildings have been knocked down and replaced by a steel and glass PFI corporate fortress; like the new development at my own hospital, the John Radcliffe. She does an outstanding job of researching the life of a porter there. The observations she makes are very perceptive and really strike a chord with me. There's the frustration of working in a depleted department of a depleted NHS; unsanitary levels of hygiene, inadequate equipment, training and tools to do your job. She understands that portering has the potential to be a truly enjoyable and satisfying occupation for all involved. She enjoyed her contact with the patients and the camaraderie with the other porters. She realized how important the role is and says: "The porters seemed like the life-blood of the place or perhaps like the engine oil that greases the system." We have a position and duty that can help patients at their hardest times: "Trundling along, waiting for lifts patients like to chat and tell their operation stories, worrying about what happens next, confiding about their families or the doctors and nurses they liked and feared." She also became aware of the social violence we have to experience from the Conformist Regime through the absurd and inhuman status hierarchy: "We knew the snappy receptionists in some clinics, the downright rude nurses in some wards, the very friendly ones elsewhere, the places where nurses would let you stop for a quick coffee, other kitchens where you would be chased away. An arrogant male staff nurse was the worse: 'You, porter person, come here!' he snapped with deep disdain. It was ever thus, the notch above in the hierarchy is always the class in any workplace that gives you a hard time; the Kulaks, the foreman. This was hospital life from the underside; where passing doctors belonged to another universe, even the young medial students (they never held the door open for a porter with a patient, letting it swing without acknowledgement). The nurses straddled the two worlds, snooty ones placing themselves beyond communication with porters and cleaners, the nice ones helpful and welcoming. You could bet that those who were nice to porters were nice to patients too. One thing became clear: people are recognized more by their status than their face. I was now a porter first, myself second. Passing by in the corridors and wards, I saw several consultants I had interviewed in the past; one of whom I knew quite well. But porters are part of the invisible below-stairs world, the great unnoticed. None of them ever recognized me". She sees that the pay structure is "Byzantine". The contractor itself employs so many agency workers that the staff are all paid differently for doing the same job. The fact that the ancillary staff at the hospital were contracted out gave her a feeling of being divorced from the health service family (as I do too). And the agency staff were "twice removed". Agency staff also have no contractual rights to the job they do; they can be hired and fired at will, which explains why they're so beloved by the PFI cowboys. They also don't have rights to things like negotiated pay deals, most are not unionized. Things have improved slightly since Toynbee wrote the book. At my own hospital the existing crew, including myself, were transferred over on the ROE scheme- Retention of Employment- which allowed us to stay in NHS employment and merely be seconded to the contracting private company. But because of the turbo-charged turnover of the casualized portering service, we pre-contract staff are already in a small minority working alongside agency slaves.
 
Toynbee feels very strongly that the situation could be improved through proper funding and long-term investment in the cheap-and-nastyfied public sector, and I don't deny that she's right; it would be a vast improvement. But in reality the problem runs far deeper than she realizes, and its solutions therefore have to be more drastic. This is an issue I address in more detail in the other HPANWO blogs. If you are a HP or work in one of the other so-called "menial and lowly" professions then quit walking round with your head down and your shoulders slumped! Hold you head high and let your arms swing! Polly Toynbee doesn't have her own website, but here's her Wikipedia page: http://en.wikipedia.org/wiki/Polly_Toynbee. You can find out more about Hard Work here: https://www.goodreads.com/book/show/991577.Hard_Work.