The War on Health

A. H. Cassells


 ‘It’s not my fault I can’t work. The app says I’m genetically predisposed to lethargy.’

The chubby woman, dressed in dirty stretched joggers, hadn’t even reached my desk and was already complaining. Huffing and puffing, she pressed her thumb on the fingerprint reader of her slab phone and instructing it to display her diagnosis. Grinning smugly, revealing the poor state of her stained and decayed teeth, she waved the screen in my direction.

‘We’re not here to discuss your work status, Miss Chambers. Please sit.’

‘But I thought this was about my benefits.’ She peeked suspiciously at the tablet screen in front of me on my desk and slowly sat down, like she was testing the chair could take her weight.

‘A lot of claimants get confused about the merged Health and Social Care Service. This is a health check.’

‘But the app does that. It’s how you know I’m ill.’

‘I know it does but I need to verify the legitimacy of your data.’

‘What does that mean?’

I knew too many syllables would confuse her. ‘I need to check the health of your app.’

‘Why do you need to do that?’ She snapped off the question a little too quickly.

‘These are random checks. Part of your benefits’ contract. It’s nothing to worry about.’

‘But I do worry. I’ve got mental health issues. It says so.’ She asked her phone to display her mental health report.

Ignoring her, I picked up my tablet. This was my sixth scan of the day. And every single one had had a complaint to voice. I wanted to scream at them that I was only doing my job. But instead I said politely, ‘Please stand up.’ I stepped around to her side of the desk.

‘Is this because of those reports? Bio-terrorists changing medical histories, overdosing people?’

I could see the beads of sweat forming on her forehead, matting her purple fringe. Her tattooed-on eyebrows offered no resistance so the trickles dripped onto her cheeks, making it look like she’d been crying though her piggy eyes remained dry. She was hiding something. Maybe she’d let someone hack her app to qualify for additional benefit. Or tampered with it to adjust her blood sugar level reports to compensate for the illegal high she was surely on. Either way, I would catch her out.

I scanned her vitals and asked for her phone. At first, she refused to hand it over and then slapped it into my hand so hard she must have hopes the force would break it.

‘The comparison analysis doesn’t take long.’ I placed the two devices side by side on my desk.

‘What happens if they don’t match? Do you take away my benefits?’

‘That’s not for me to say. I just verify the data.’

‘But I need them. I’ve got four mouths to feed.’

I wondered where she hid the other three. If nothing else, four mouths would explain her obesity. The scan was bound to reveal the extent of her sweet tooth. From her size, she must have developed quite a habit. I didn’t understand why people did it, scoffing street sweets from illegal confectioners. Sure they were cheap, with no Sugar Tax heaped on top, but they were gambling with their lives.

While waiting for the analysis, I began the supplemental questions. ‘Do you follow the app’s diabetic diet plan?’

‘I rely on food banks. What do you think?’ She sneered at me.

‘You’re not helping yourself.’

‘I tried that. Got a caution for shoplifting.’ She smirked, not showing her teeth this time, squishing her face so much her cheeks engulfed her eyes.

‘Have you considered a return to education? Finding employment? Do you exercise?’ The government was big on promoting the 3E’s. With advertising mainly. They didn’t have the money for anything practical, especially with spongers like her screwing the system. She shook her head slowly, not in response to my questions. Her face was becoming flushed, lips forming a snarl. I could see her drawing a deep breath. I rolled my eyes and prepared for the tirade. I hated my job.

‘I’m fat, so what? It’s cause I’m sick. My pills make me fat. Maybe I could afford a healthy diet if you paid me more money. I bet you never needed to borrow a token for the foodbank because-‘

I tuned out. There was no point in arguing because she was right. Society was unfair. The rich could afford to be healthy because they had choices: private medical plans, university educations, enough money to do a weekly shop at a supermarket. They didn’t have to choose between feeding the children or feeding the electricity meter.

Her rant was interrupted by the green light illuminating on my tablet screen. She looked at it, then at me, waiting to find out what it meant. I couldn’t believe it. Her app had passed. My scanner had to be faulty. I considered running the test again but I didn’t have time. Today was the deadline for the last of the claimant assessments and my schedule was full.

‘Thank you for coming in. You’re free to go.’ I forced a smile and waved her towards the door.

‘What? Is that it?’

‘Yes, unless you want to complete a service satisfaction survey?’

‘Whit? No.’ She rose, swiping her phone from my desk. I noticed her movement was a lot less strained this time. She half smiled a ragged grin, the shock of passing obviously still sinking in.  As she closed the door behind her, I ran the diagnostic tool on my scanner. It was working fine.  With no time to worry about it, I buzzed in my next client. His huge frame, wheezy cough and purple face ticked all the boxes for diabetes, COPD and high blood pressure. ‘Here we go again.’


On my cycle home, I longed for a new form of heart disease, one that stopped me caring. I had seen so many clients today with avoidable conditions. How could they let themselves get into such a state and not do something about it? What was wrong with getting a job, regular exercise, eating smaller portions and avoiding unhealthy habits? Why was the message being ignored?  Did it have to come with fries before the public would consume it? Had an over-reliance on apps ruined people’s ability to think? Could they not see that the apps only measured data and relayed information? They didn’t change anything.  I channelled my frustration to power pedal through the park.

On the former football pitch, the local Health Initiative Charity had erected exercise equipment. It was now vandalised beyond use and resembled an art installation expressing the nation’s broken attitude to fitness. A gang of chubby youths dressed in either retro chic or hand me downs reclined on the broken apparatus. Their vaping generated a vile fug that smelled worse than the damp in my flat. They stared at me warily, like I was an alien. I certainly was a minority: thin, fit, employed and exercising in public. Maybe if someone had shown them how to use the equipment or, better yet, incentivised them to do so, it would have been used properly, not become an uncomfortable bench.

Before I reached home, I stopped off at the mini-mart for some fruit. I had generated enough pedal credits in my dynamo to pay for two bananas and an orange; only, the assistant was new and didn’t know how to transfer the energy. He lied and said the machine was broken. I put the bananas back and swiped my phone across the payment terminal. I’d treat Uncle Verne to the orange.

Uncle Verne lived with me in the tower block. I’d taken him in after cancer claimed Aunt Vera. I was the only family he had left. I found him in the flat’s living room sitting in the dark.

‘I couldn’t find the switch,’ he mumbled.

‘The lights are voice activated, Uncle.’ He looked a poor soul. Thinner than me, he only remembered to eat when I put the food in front of him. I took the orange out of my pocket. He smacked his lips, his eyes brightening like he was seeing a long lost friend. ‘Have you got one for Vera too?’ he asked.

‘Vera’s not with us anymore. She passed. Remember?’

His smile faded, eyes hurt with the news. ‘I’ll keep it for later then, in case she’s hungry.’ Taking it from me, he placed it in his dressing gown pocket.

I noticed his phone switched off on the coffee table. I reminded him he needed to keep it switched on and passed it over to him. He pushed it away. ‘A man with a brown face keeps calling.’

‘He’s your doctor.’

‘Doctor Anderson’s my doctor.’

‘Dr Anderson retired.’ Twenty years ago. ‘The Indian man is your new doctor.’ I took Verne’s hand and pressed his thumb on the phone’s fingerprint reader. The phone flashed into life, red warning lights glowing.

‘Look. You’ve missed your last two doses. That’s why the doctor called. You must keep your phone on and answer if it goes off.’ His eyes began to fill up at my scolding. I gave him a hug. ‘Never mind, uncle. You take your pills and I’ll make the tea. What do you fancy?’ Don’t say chips.


I shook my head. ‘Okay. Just this once.’


‘Prime Minister, are we green to go?’

The question broke the silence. The four gentlemen, one in military uniform, sitting on either side of a dark mahogany table in the windowless, wood panelled room fixed their attention on the woman at the head of the table awaiting her response.  Her weary eyes drooped, glazed in thought, the weight of the decision hanging heavy. Over the last six hours, she had listened to the controversial briefing, each advisor agreeing Operation Lifeline was the only way to move forward. The country was bankrupt, with the merged National Health and Care Service on the verge of collapse. Steps had already been taken to implement the plan, with the prisons emptied and hack-ware installed on the home tags and designated health apps. The final stage just needed her agreement. The men at the table expected her to comply. Avoiding their eyes, she peered at the empty tea cup, wishing for something stronger.

‘Are we all absolutely certain there is no alternative?’

She already knew the answer. They had no more money and no more time. When it came to health, the scales had finally broken, despite the best efforts of her predecessors to improve matters.

‘With respect, ma’am, the time for discussion is over.’ The General clenched his square jaw, tightening and lifting his fist. The veins in his temples protruded. Watching him grow increasingly impatient, she wondered if he would have been so emphatic if he had been on the sick list.

‘With respect, it is not you that are being asked to euthanize millions of British citizens.’

‘Michael’s right. We can’t wait.’ Sir William Fotheringham, head of MI5, nodded towards the General. ‘The equipment is primed. The army and the emergency services are on standby. Public notices have already been posted on social media about the likely security threat. Now is the time to act.’

‘I wasn’t elected by the people to sign their death sentence.’

‘Not everyone’s death sentence. Just those you can’t afford.’ Timothy Butterfield, the American Corporate Liaison from ODC, tapped the report in front of him.  ‘You’re only eliminating the weak, the criminal and the infirm. Everyone that is a drain on your society.’

‘Do you have any doubts?’ She turned to Simon Carnaby, her Chancellor.

‘Absolutely not. Operation Lifeline will free up hundreds of millions of pounds for the Exchequer. We’ll be able to ditch the abysmal NHCS in favour of Americare, which ODC will implement.’ He smiled at Timothy who returned the expression with equally polished white teeth. ‘With a fresh start, we can reframe the health agenda to make Britain fit for purpose again.’

She always suspected Simon was a psychopath. That’s what made him such a great politician. His bill for austerity cuts was a work of genius if you factored out the actual effect it would have on people’s lives. She was privately glad it had been voted down in the House. She hadn’t expected Lifeline to be his backup plan.

‘Are we sure the projections are accurate: 95% success rate over twenty-four hours?’

‘We are.’ General Trenchard jutted out his chin like a bulldog.

‘And it won’t be tracked back to us?’

‘We’ve laid data crumbs back to North Korea. Their statement accepting responsibility has already been prepared.’

‘What contingency plans do we have in case it doesn’t work?’

‘It will work.’

She nodded her head. There was no alternative. ‘In that case, Operation Lifeline is green to go.’


Having finished her deep fried jam donut supper, Chantal was wiping the spilt sugar from her sweat top when her phone rang. Her mother’s number appeared requesting a video chat. She screamed at her three kids to keep the noise down then sucked her thumb clean of sugar granules and pressed the fingerprint reader to open the call.


From the living room, I heard Uncle Verne’s phone buzzing in his bedroom. He must have forgotten his bedtime medication again. Then I heard a yelp and a thump. Worried, I went through. Alarm bells triggered in my head as I detected the smell of burning coming from his room.  As I pushed open his door, a distraught scream from the flat upstairs caught me unawares. It was awful: piercing, painful and raw. It spoke to my gut and my heart at the same time.  More shrieking erupted from other parts of the building like a wave of distress. Verne was slumped on the floor, smoke rising from his phone. I dialled the emergency service on my own phone but got an engaged tone. I checked his vitals. Nothing. I dialled again. Same result. I began CPR. I don’t remember how long I continued before I gave up.

I sat on the bedroom floor crying, holding Verne to my chest. I didn’t want to let him go. He was the only family I had. I heard a van appear in the square below then brakes screech and doors slam shut. Heavy boots clomped and orders were barked. A glass object smashed like a firework explosion. A loudhailer instructed us to stay calm and remain indoors. I went to the window and saw soldiers in riot gear setting up. A flat screen television struck the roof of the van, shattering its windscreen, triggering a volley of shots  flashing up at the building. I ducked down and scrambled away, pulling Verne with me. I don’t know why I did that. He was already dead.

The news channels were off air, a ‘No Signal’ notice appearing on each station. Social media was in frenzy though, filled with questions and accusations and angry vitriol. No one knew exactly what was happening, or why, but opinion blamed North Korea. The deaths became the number one trending news item. Then an announcement went viral that the Prime Minister would be issuing a statement at 9am. The T.V. news channels began broadcasting again, speculating hard about ‘the attack’ as it was being called. No one knew the exact extent of the massacre. We were instructed not to use our phones until told it was safe to do so.


At exactly 9 am, the Prime Minster stepped across to a podium outside No10, flanked by armed police and officials in suits. ‘Last night, the nation suffered the worst attack the world has ever seen. The entire country is in mourning. More lives were taken in one evening than has been lost in any war. We know who is responsible. It was us. We did it.’ She paused, not attempting to talk over the audible gasps from the assembled audience of cameramen and reporters. The PR people looked at one another in stunned surprise. Thinking I’d misheard, I rewound the live feed to listen again to what sounded like a confession.

She took out her phone. Holding it up for the cameras, she stated, ‘This was our weapon.’ She paused again to let the information sink in. ‘I was supposed to feed you a lie today. Instead, I’m giving you the truth. The war on health was one we were never going to win. The deepening health crisis facing our nation was one we could no longer afford.  By targeting and eliminating the sections of society that weighed most heavily on the system, we have wiped out the burden affecting our nation and struck a positive blow for our health and wealth. Moving forward we will no longer be a sick nation. We can dedicate our energy and resource to creating a better Britain, rebuilding a new National Health Service dedicated to preventing disease and maintaining our nation’s good health. By dealing a terminal blow to Benefit Britain, we have set ourselves on a path to make Britain Great again.’ She stepped back from the podium, visibly drew in a breath, then turned and walked stiltedly back to No10. Cameras flashed and a cacophony of questions erupted unanswered.

I struggled to take in the information. The phone was their weapon. But my phone hadn’t killed me. The image of the green light on my work scanner flashed into my head. I pictured all the people I had assessed. Were they all dead? Was I unknowingly complicit? I opened the window and screamed, joining the many voices. The soldiers were stacking the corpses in body bags awaiting uplift like it was bin day. I understood what I had to do. I said goodbye to Uncle Verne and jumped.


In Whitehall, Simon Carnaby caressed a whisky glass having watched the announcement with Timothy Butterfield. ‘Who would have thought it? An honest politician.’

‘She’s upset our plan, Simon. ODC went to great lengths to lay those breadcrumbs back to North Korea. We’ll need compensated.’

‘I’m surprised those armed police officers didn’t shoot her on the spot.’

‘This is serious. How can the other G10 countries follow through with Lifeline now?’

‘Tim, as far I am concerned, nothing’s changed. We’ve just trimmed the fat to make Britain lean and efficient and you still get to buy us at a rock bottom price. As I see it, that puts both of us ahead of the competition.’ He raised his glass towards the American. ‘A toast. To ODC’s latest acquisition, Great Britain. Your good health, sir.’



A. H. Cassells lives in Paisley, Scotland, with his wife Karen and dog Coco. He works as a community pharmacist in the west of Scotland and writes as a hobby. He has had two short stories published thus far, one in an anthology Alternateas, and the other as a highly commended entry in the ‘To Hull and Back’ 2016 humourous short story competition.  His favourite authors are Jasper Fforde, Genevieve Cogman and Ross Mackenzie for their exquisite turn of phrase and extraordinary imaginations. He hopes one day to emulate their ability.