The first thing I saw as I woke up from surgery was the tanned face of my surgeon leaning over me. “It’s bad news, I’m afraid.” Surgery was my last hope. I’d been diagnosed with suspected vaginal cancer at Christmas the previous year. As the lump was still small, my oncologist was optimistic. With radiotherapy and chemo she thought we’d beat it. And, indeed, by last summer I’d been given the all clear. But the tumour returned, and by the time I had surgery it was too late: it had spread and was inoperable. I still can’t get my head around the brutal fact that I’m dying. I’ve always been incredibly lucky and incurably optimistic. I had a privileged, middle-class childhood, in the care of scientist parents who spent their money on my education. I sailed through an engineering degree at university, then a master’s and a PhD. I worked for NGOs in Uganda, Kenya and Ethiopia, before getting my dream job with the London School of Hygiene and Tropical Medicine, where I’m now a professor, researching sanitation and hygiene all over the world. Part of my extraordinary luck, I thought, was to have been born in a country where good medical care was a right for everyone. It never occurred to me that our brilliant National Health Service could have been so diminished over the past 10 years of austerity that it would fail me completely. The first intimation of failure came at the start of my cancer journey. It took two months from my initial referral to the start of my radiotherapy treatment. I begged the oncologist for an earlier appointment, but the waiting list target was 62 days, and so I had to wait out the full 62. After three gruelling months of daily radiotherapy delivered inside a rotating sci-fi machine, I remained optimistic; the treatment had been tough, but the odds of a cure looked good, and if that failed, there was always surgery. I was on a train on the way to the women’s semi-finals at Wimbledon last July with my daughter Naima when my oncologist called. “The scan is clear,” she said. “You’re free of the cancer.” I blessed the wonderful NHS staff, we had a celebratory day out and, yet again, I felt I was living a charmed existence. But by September I was having symptoms again, this time rectally. The oncologist thought this was radiation damage, but agreed to further investigations after several appointments. It then took four weeks for an appointment to see a gastroenterologist and a further two to actually have the sigmoidoscopy and biopsy. And then two more spent waiting for the results. There were multidisciplinary meetings and a plan for yet another scan, to check that the cancer hadn’t spread too far to be operable. I was the last patient through the PET scanner on a chilly Christmas Eve last year. The results, which came in early January, were encouraging, but I’d need radical surgery to remove large chunks of my internal organs. And, guess what, I’d have to wait for an appointment to see the surgeon, who would only then put me on his list, which had a six-week wait. By this time my faith in good luck and the NHS was becoming shaky. I begged the oncologists for an earlier appointment and asked my GP to step in, all to no avail. To its credit, the hospital wasn’t going to allow any queue jumping. But that left me with an agonising wait, knowing this aggressive ball of cells was dividing and growing. The operation finally took place on 27 February, almost five months after the cancer had recurred. Once he’d taken a look inside, my surgeon closed me up again, with a heavy heart. It was now impossible to remove all the cancerous tissue – they got there too late. Every day since coming to in that recovery room, I’ve woken in a state of optimistic disbelief. I’m 61, at the peak of my powers, with plans for cholera eradication, for global sanitation, to write more books, to get more students through their PhDs. I had plans to become a ferocious old battleaxe and then to enjoy my golden years. Luckily I’m still able to work, for now. But each day, as I get more frail, and I have to take more painkillers, reality is gradually dawning. My luck truly has run out. My story is only one of many thousands of people in England whose deaths can be linked to austerity. The past 10 years have seen health services cut back to the bone. Workloads have been managed by extending waiting times, postponing scans and surgical teams working nights and weekends in desperate attempts to shorten waiting lists. Now, with the added burden of coronavirus, the NHS has given up the pretence of being a comprehensive health service. The pandemic may cause an estimated 35,000 extra cancer deaths in the UK, and more people like me will be fighting a waiting list for their lives. I’m going to die soon, but before I do, I want to see a plan for a better NHS, one that does not needlessly lose lives. There is a large majority in the UK in favour of properly funding the NHS. Now is the time to present the country with a visionary plan for a fully functioning, joined-up health service, free at the point of use, delivered by our committed and dedicated NHS health professionals who have proven during the pandemic what a heroic job they do. Give them a plan and the resources they need to do what they desperately want to do – to save lives like mine. • Prof Val Curtis is director of the environmental health group at the London School of Hygiene and Tropical Medicine