Day 1 of my hunger-strike

My hunger-strike started at 8pm on Sunday Sept 30th, 2012.

Going on a hunger-strike is like going on a journey into the unknown. I am not a practising Hindu, in fact I am not a practising anything, but I like to keep in touch with Hindu traditions as it makes me feel a bit closer to my late father and mother. There is a Hindu tradition that when you go on a long journey, especially one that has some unknowns and some hazards, you light a candle. So here is me lighting a candle on Sunday evening, and in the background is the Hindu Goddess of travel, Vaishnodevi. There is probably a Hindu goddess for everything, and they always come in quite handy (please excuse the pun, since most photos show them with many hands!).

 

We set off around 10 o’clock to head to the site of my demo, outside the Department of Health headquarters in Whitehall. So here is a photo of me on the tube train (I had two kind helpers who helped me carry things on the train).

The first day was of course interesting, as this was a venture into the unknown. I set myself up in a corner against the wall, not causing any inconvenience. The photo actually shows me in front of the main entrance, but for most of the time I was more unobtrusively to the side. I had a good supply of journals and books to read, and I had my ibook and my ipad. It is surprising how much I was able to get done – no interruptions from students or colleagues!

The main challenge for the first few hours was coping with the rain, but the ‘golf umbrella’ I had was quite effective in keeping the rain out. The rain petered out by 2 o’clock. A couple of security officials from the Dept of Health came out, but they were quite pleasant and kind, and were happy to let me sit where I was. A couple of policemen were equally cordial. Several people stopped to offer their support and encouragement. A funny part was where tourists asked me for directions to places!

Physically I was fine, and had one glass of water. Somehow plain water does not taste quite right, and it is interesting that Gandhi reported the same when he went on fasts, so I may get some flavoured water.

What are the risks that I am taking?

Taking part in a public protest and going on a hunger-strike is not something I enjoy doing, so why am I doing it?

I have a very simple philosophy – that if you are privileged, you have a responsibility to use your privileges to make the world a better place; the greater your privileges, the greater the responsibility. I have been lucky in the life I have lived, and I am lucky to have the knowledge, experience, skills, resources, determination and support to do some good in the world. A number of my colleagues have in recent years died in their 50s, so I sometimes regard myself as living ‘surplus years’. At my stage in life, I feel I should be giving rather than getting. There is a nice quote reportedly originating from the famous American philanthropist Andrew Carnegie, It is more difficult to give money away intelligently than to earn it in the first place. I feel that also applies to knowledge and experience that one is fortunate to have – how you give it away can be a challenge. I myself have already tried to do this in a number of ways, such as writing books to pass on my knowledge, writing patients booklets to help them cope better, writing clinical guidelines for junior staff, giving my book royalties to healthcare charities in India, and so on. Perhaps in a sense by this action I am also giving away part of my reputation and dignity, but I am prepared to make that sacrifice. However, in this situation, where there are miscarriages of justice in the NHS, and where there is harm to patient care and to the well-being of staff, I feel a moral and ethical obligation to use my knowledge, skills, experience and resources to bring about real and meaningful improvements. There were reported to be around 1000 avoidable deaths in the Mid Staffordshire Hospital scandal, and helping to prevent just one of those in the future makes efforts like mine worthwhile.

Many people who work in the NHS are not in the position to take a stand for a number of reasons, not least of which are the huge costs involved when you go down the legal route; some have been so traumatised by their suspension or dismissal that they have lost the will to fight their case; some may be unwilling or unable to take the risks of going ‘public’; or, if they are still working, they may fear that they will get into trouble or lose their job if they speak out.

I realise that I myself am taking a risk in what I am doing – I have to think of the effects on my wife and children, I have to think of the effects of a hunger-strike on my health, I have to accept that some people may ridicule me as being a ‘crackpot’ or that I am doing this as a ‘publicity gimmick’ or that ‘this just shows you are a difficult person’…. it is interesting that when Gandhi went on hunger-strikes he faced similar forms of derision (as did the person who inspired Gandhi, Terence MacSwiney, the Mayor of Cork who went on hunger-strike to death in 1920). It is unusual for academics or professionals to take the plunge and get involved publicly in controversial issues, but there have been exceptions – while Professor Noam Chomsky of MIT is probably the best example, a number of Nobel Laureates, such as Albert Einstein, did get involved in issues of public concern in the later stages of their lives. As long as I follow my conscience and key Gandhian principles such as truth, compassion and self-sacrifice, I am not concerned about what others might say. I recall Gandhi’s famous quotation – First they ignore you, then they laugh at you, then they fight you. Then you win.

This is a journey into the unknown for me…although I have practised fasting over the past few months in preparation for this occasion, I have not done it for a full five days. However, I am just as concerned about getting soaked in the rain than any ill effects on my internal organs!

Thanks for reading this blog, and please keep in touch.

What drives me and inspires me?

Welcome to this blog, the second blog of my campaign.

When you take part in something as major and potentially stigmatising as a hunger-strike and a public protest, you need inspiration and I get this from several sources.

I have been driven to what I want to do because of the many heart rending stories I have come across of staff, often NHS whistleblowers, who have been wrongfully suspended or sacked. Around the time of my dismissal, a talented and respected consultant gynaecologist was also sacked by Addenbrooke’s…he has two young children, and he has had to move house and move in with his parents. He has not worked for a year, and his situation is in many ways much worse than mine.

In terms of inspiration, I have been a follower of Gandhi for around 20 years and have written articles about him, and his words and actions have inspired me in recent times. When I was wrongly dismissed in 2010, I took inspiration from this story of Gandhi when he found himself at the railway station in South Africa having been thrown out of the first class carriage due to his colour, having to spend the night on the freezing platform. This was in Pietermaritzburg, and there is now a memorial at the railway station and a statue in the town square in Pietermaritzburg.

I have also been inspired by the courage and determination shown by the paralympian athletes in the Paralympics we just had in London.

On my facebook page I mention a few individuals who have inspired me, doctors such as Karen Woo who showed such bravery and kindness in the work she did in Afghanistan before she was tragically killed there.

A final source of strength and inspiration for me in my hunger-strike is cases of hunger and poverty in individuals in the third world. I have two examples here – one was reported by the BBC Correspondent in India at the time, Damian Grammaticas.

The other one is from a July 1993 issue of the Sunday Times feature, A Life in the Day…It describes a day in the life of a poor, destitute lady in Calcutta.

Monara remarks – Some days I earn nothing and we drink water. The children whimper, so I go and beg. I hate it, but I’ve no option….Sometimes when there isn’t any food for the children I think I’ll lie down on the railway lines and sleep for ever. But then I think, who will look after my girls? That’s what keeps me going.

Individuals such as these do not have the choice as to when to stop eating and when to start eating again, a choice that I am privileged to have.

Why this campaign?

Welcome to this blog, the first of my campaign, and to my website.

My name is Narinder Kapur….I am a consultant neuropsychologist and visiting Professor of Neuropsychology at University College London. I am married with three children. I was born in India, but I grew up in N Ireland. You can find out more about my story on my website, www.abetternhs.com. Essentially, I was employed at Addenbrooke’s Hospital, Cambridge from 2003-2010, when I was dismissed for an alleged breakdown in relationships with my line manager. I took my employer to an employment tribunal, and won my case of unfair dismissal in 2012.

I am very reluctant to take the course of action I have embarked on….I have never taken part in a public demonstration or public march in my life, even when they were in vogue in my student days in Belfast when there were civil rights marches galore, and taking part in a hunger-strike is the very last thing I would ever think of doing. However, the situation is so serious, with so little apparent awareness of the wrongdoings that have happened or are happening in the NHS and of the need to make improvements, that I have decided as a last resort to take this course of action. I think I am the only employee in the history of the NHS to go on hunger-strike to try and make the NHS better for patients and staff.

My main concern is that management in the NHS is in a mess – at times is intellectually and morally bankrupt – and that this results in harm to patient care, to a huge waste of taxpayers’ money, and in some cases to terrible distress to NHS staff and their families. There are of course some excellent and courageous managers in the NHS, and I salute them, but the system itself can be very dysfunctional.

When I say management in the NHS is in a mess, I mean several things –

  • Whistleblowers are often not listened to, or worse, are treated as troublemakers and given a really difficult time
  • Some NHS staff find themselves suspended or dismissed for trumped-up reasons, and have to go through proceedings that are grossly unfair, and resemble a show trial or a kangaroo court. This often leads to major miscarriages of justice.
  • There is little in the way of proper regulation or accountability of managers, or of clinical staff who take up management roles
  • When management mistakes do occur, unlike in the case of medical or surgical mistakes, little changes afterwards. Currently in the NHS if a major medical or surgical error occurs, there are detailed investigations carried out, numerous meetings held, reports submitted to external regulatory bodies, sometimes a site visit by external experts, apologies to those who have been harmed, and no expense is spared to ensure that lessons are learned and that similar mistakes do not happen again in the future. However, when mistakes in management occur, it is very rare that anything even remotely similar occurs. This is clearly not right.

Patient care can be harmed by management failures in a number of ways –

  • If whistleblowers’ concerns about patient care and patient safety are not respected and listened to, then harm can come to patients
  • If staff are suspended or dismissed, this invariably causes major disruption to a clinical service, often with expenses incurred, and it can take months or years to get the clinical service back to normal
  • Millions of pounds are spent on legal expenses, compensation settlements, and compromise agreements. This money has to come from somewhere, and we cannot afford this luxury at the present time, especially when the NHS is trying to save £20 billion. Such wasted money could be better spent on patient care.

Please pay a visit to my website, where these issues are discussed in detail. There is also a free downloads page where you can download booklets such as the Cambridge Memory Manual that I have written, if you want to improve your everyday memory! There is an option to make a donation to a couple of charities, the Karen Woo Foundation or Unicef. And there is a final page where, if you feel inclined, you can sign an e-petition to support my campaign.

So thank you again for reading this blog, and I will be putting out further blogs in the next few days.