In his 46 years of service, Nick Hulme has seen the best and the worst of the NHS. He issues a stark warning about its future

I catch him before he slips out of the NHS ahead of Christmas. After 46 years in the health service, no better time for an exit interview with a leading NHS trust chief executive, who has seen the best and worst of it. Nick Hulme is in brutal truth mode. He has one foot out of the door of his East Suffolk and North Essex NHS foundation trust, just as the resident doctors strike for the 15th time, amid a rampant flu crisis. But he’s off, his time is up.

“I can’t remember a time when the NHS was at such risk,” he says. Labour has put in more money and staff, productivity and activity has risen a bit, waiting times down a bit, yet waiting lists stay stubbornly high. “That’s dangerous ammunition for Nigel Farage and the Conservatives,” says Hulme, “a narrative for people who want to kill the NHS.”

With the US threatening to support ‘patriotic’ parties here, we need better defences, starting with tough new rules about political donations

The new threat is so dizzyingly bizarre that Europe, and especially Britain, is slow to believe it. The US declares itself our enemy. Europe emerges as its main adversary in the US national security strategy. Russia is its friend, not us. Everything that looked solid since the second world war is turned upside down; the land of the free becomes the destroyer of democratic values. Appeasement fails.

He may ramble, but Donald Trump speaks plainly. He means what he says, and he hates everything European. Except its emerging “patriotic” parties, which he wants to support. His strategy warns of “civilizational erasure”, claiming Europe will soon “become majority non-European” and parroting the racist conspiracy known as the great replacement theory. Describing Europeans as “weak”, “decaying” and “destroying their countries”, with “real stupid” leaders, Trump responded to the question of whether they would still be allies, in a Politico interview, with a hint of threat: “It depends.”

Polly Toynbee is a Guardian columnist