I have had a very mixed relationship with the NHS. Almost exclusively, I have unbounded admiration for staff at the sharp end – nurses, doctors, paramedics, healthcare assistants, porters… Where it all falls down is communication and, unfortunately, that is largely due to administration – with some exceptions. I have, however, met the occasional impossibly arrogant consultant (real Sir Lancelot Sprat characters – as played by James Robertson Justice – if you remember who he was – in the 1970s ‘Doctor in Distress’ series of films). Similarly, there are NHS Directors, Associate Directors and Managers unworthy of their inflated salaries (given that they wouldn’t last five minutes in the private sector) and who retire on magnificent pensions. I have seen it from both sides, as a patient and carer, and as an employee.
Last month, when Martyn broke his leg, we received unstinting care from the paramedics who transported him from Port Isaac to the Royal Cornwall Hospital, Truro, the medical practitioners who triaged, X-rayed, diagnosed, prescribed treatment and carried it out (this meant a seven hour operation). Thereafter, Martyn and I were subjected to an alarming degree of apathy that elided into contempt regarding the problem of getting him home to Devon. A Deputy Manger advised us that Cornish ambulances would not cross the Cornish border because they were needed in Cornwall. Several members of staff, ranging from nurse to ward clerk, suggested we should have had travel insurance. “No,” we replied, repeatedly, “we shouldn’t need medical travel insurance. Britain has a National Health Service”. They were resolute in their opinion that we should have thought of it.
36 hours following his operation, an Occupational Therapist insisted that we experimented with loading Martyn into a Mini – with a full leg brace. Of course, it wasn’t possible. “But I was nearly right,” she chirruped. Eventually, we were told we would have to pay for a private ambulance. Apparently, the transport department in the RCH has been privatised. Say no more. I resorted to enlisting the aid of his surgeon, who must have said the right words.
Thank heavens for the Torbay Hospital long distance ambulance team who came to our rescue after 24 hours of angst – during which time I had to go to the car on many occasions to take deep breaths and remind myself not to lose my temper – and Martyn grew steadily more depressed.
Back in dear old Devon, we now face a situation where lack of communication means that he has slipped through the appointments system and we have to ring, ring again and ring again, each time waiting up to 30 minutes holding for a reply, to make these essential appointments happen. This is balanced by an extraordinary level of care by the Dawlish District Nurse Service and the Intermediate Care Team. Thank you, my friends, you have been valiant.
In 2006, I lost my mother in circumstances that bore an alarming similarity to this administrative distancing from patient need. Thanks to the Patients Association, I told the story on BBC News 24 – interviewed by Huw Edwards, also to BBC Radio 4’s Today programme and to a committee at the House of Lords. It didn’t bring my mother back and, quite clearly, the situation has become worse.
Some time after my mother’s death, I actually worked for the NHS – as a Healing Arts Manager. I was appalled by the degree of complacency and disconnectedness of many staff in a service designed to care. I was also, as an ‘outsider’, subjected to an astonishing level of bullying. It was never resolved and the perpetrators never addressed. Then, once I had fulfilled my remit, I was made redundant.
While in 2019, at management level, patient care seems to have regressed, younger GPs really seem to have returned to the concept of care in a holistic sense, something to applaud and celebrate. At the same time, nurses and other frontline staff work beyond their hours to keep the system going for no overtime, worthy of praise and great thanks – but they shouldn’t have to do it.
There are many reasons for the huge organisation that is the NHS being unwieldy, but we are still envied it by the world. Unfortunately, it remains the target of pharmaceutical and private healthcare companies that would like to undermine and profit from it. The Tories (Andrew Lansley & Jeremy Hunt particularly), have been eroding it for some years. Beware.
This ends on a pragmatic note: patients are now expected to project manage their own cases. If you think you are not receiving proper care, you must highlight it, politely but assertively; it is your right to receive treatment at the point of need. Lastly, always, always, keep a written record of everything that happens.