My life changed forever one Monday morning at the beginning of March when I was diagnosed with AIDS related cancer at the age of 33. It was the end of the 1990s. Tony Blair had just become prime minister, Scotland was preparing for a referendum on devolution and Princess Diana was on holiday in the Greek islands.
It was about eighteen months after the ‘protease moment’ when doctors treating AIDS patients in America discovered that giving HIV positive people three different drugs, all at the same time – combination therapy – reduced the amount of HIV virus in their blood to almost undetectable levels. After a few months on a combination of drugs (one class of which were called protease inhibitors) patients CD4 cells recovered to near normal levels. Over time their immune systems were restored, allowing people with HIV to live a normal, healthy lifespan.
At the time of my diagnosis on that bleak Monday morning, I had a viral load (the amount of HIV present in my blood) in the hundreds of thousands. CD4 count is a measure of the relative health of the immune system. In a healthy adult CD4 count is usually in the region 800-1200. Mine was 168.
I was also suffering from Kaposi’s sarcoma, a rare form of cancer. I was initially treated with the drugs saquinavir, epivir and AZT plus a prophylactic anti-biotic septrin to ward off pneumonia. I subsequently underwent six months of chemotherapy followed by radiotherapy to treat the AIDS related cancer.
At one point I was given six months to live. That I survived is due entirely to the NHS; to the consultants in sexual health who treated me with the then ground breaking combination therapy, the oncologists who treated my AIDS related cancer, the nurses, the dietician and the clinical psychologist who helped me comes to terms with having to live the rest of my life with a chronic life threatening medical condition.
For the past 17 years I have taken between six and 25 tablets a day just to stay alive. These days I go to the Chalmers Sexual Health Centre in Edinburgh every six months, to have my blood tested to check the virus remains at undetectable levels. At my last appointment two weeks ago my CD4 count was 645. The consultant I saw is the same doctor who, as a registrar, diagnosed me as having HIV/AIDS seventeen years ago. We are fortunate indeed to have a first class National Health Service here in Scotland.
By contrast I look with something approaching despair at what is happening to the NHS south of the border in England. In Surrey since 2012 sexual health services have been provided by Virgin health care (no pun intended), a branch of Richard Branson’s empire. In parts of England the NHS has become little more than a brand, a logo, a cover for a privatised health service.
Last December the British Association for Sexual Health and HIV and the Royal College of Physicians voiced their concerns about the privatisation of sexual health services in England. The key threats the doctors’ leaders flagged up were decreasing access to clinics and treatment, a reduction in the quality of patient care and the undermining of existing services.
Concerns have also been raised about private companies cherry-picking lucrative areas of sexual health medicine such as automated testing for sexually transmitted diseases as well as along the way acquiring valuable property assets in city centres. Doctors fear all this will be at the expense of services to unprofitable and difficult to treat groups of patients like people with HIV or Hepatitis C.
I owe my life to the National Health Service. I think it is vital it is properly funded and protected from privatisation. Think about it; all of us are only ever a GP appointment and a hospital test away from depending on the NHS.
Devolution will not protect the NHS in Scotland from further cuts – another £25 billion are planned after the 2015 UK general election. I fear the consequences of a No vote on September 18th. I don’t want to see health services cut as part of Westminster’s austerity consensus. I believe a No vote presents a real danger to the NHS. Only in an independent Scotland will the NHS be safe from Westminster’s privatisation agenda.
For me Scottish independence isn’t about flags and borders. Rather it’s about whether Scotland’s oil wealth should be spent on nuclear weapons or hospitals and schools. It’s about the kind of society we want to live in and what its priorities should be. I never want to see the NHS in Scotland reduced to a brand run by private companies investing in healthcare stocks for shareholders’ profit and come September 18th that will be the main reason why I’ll be voting Yes. Seventeen years ago the NHS saved my life and in the independence referendum, I’ll be voting Yes to save the NHS.
Kellan MacInnes is a new Scottish writer. The paperback edition of his first book Caleb’s List (Luath Press) will be published later this month.
Image from Simon Baker