It shouldn’t be treason to criticise the NHS
Until we stop treating the NHS with reverence, we'll never have an honest discussion about improving healthcare.
The UK National Health Service is like a relative: we are allowed to slag off this national treasure, but woe betide anyone else who tries it. I have no idea if the health secretary, Andrew Lansley, really wants to improve the institution or dismantle it and sell it off to the highest bidder, but whatever his motives, anyone who uses the system knows it needs surgery; no amount of knee-jerk op-eds will change that salutary fact.
In this unhealthy climate I feel obliged to state that I believe in the NHS; many medics do a fine job and healthcare should be free at the point of need. Yet having witnessed the care provided to my grandmother, 89, following a diagnosis of lung cancer, I believe that unless the NHS is willing to admit and tackle its flaws, it will have to shoulder some of the blame if the private sector convinces politicians it can run things better. (Though the BBC current affairs show, Panorama, did an exposé on private-sector care last week that might make any case for privatisation a whole lot harder.)
Last November, my nan was fortunate enough to have a mild heart attack: as part of the standard checks following her admission to hospital, scans revealed a shadow on her lung. Further scans were arranged; during one hospital appointment, she waited for two hours in reception and then discovered her notes hadn’t been passed on and had to go home. She didn’t make a fuss.
When nan went to see a specialist I went along, partly for moral support, but also to stop her going along with whatever was said (like many of her generation, nan regards doctors with perhaps disproportionate reverence). In this case, her faith was justified; despite my prior reservations about major surgery, by the time the consultant had finished we were convinced it was the best option.
As the operation was early in the morning in central London, the specialist advised that nan ‘check in’ the night before. Giving me a letter confirming her appointment, he ordered me to call the hospital on the morning she was due to ensure there was a bed available. When I called the hospital, not only did they not have a bed available, but according to their records, nan wasn’t due to be admitted until the next day. A flurry of calls followed, until – with reluctance – a bed-allocations manager agreed to give nan a room in the visitor’s block.
The room was bare, and there was no food or water available; when I called to see if nan was okay, the guy on reception refused to connect me on the grounds her phone didn’t work. I had to put on a posh voice to persuade him to put me through; her phone worked fine.
Next morning, before nan’s operation, a young anaesthetist went through a checklist to see what medication she was on. The specialist had told her to stop taking Warfarin, but nobody had mentioned Clopidogrel, which she was still using. This seemed to worry the anaesthetist, but he must have decided the risk was small and the operation went ahead as planned.
When I went up to the intensive-care unit (ICU) afterwards, I was told nan was still in surgery. Several nurses and admin staff told me this, even as nan was wheeled past on a trolley.
After collecting my father from the lobby, we went back to the ICU. A bossy woman at the nurse’s dock insisted she wasn’t on that ward; I had to point nan out, in one of the few occupied beds behind her. The woman compounded her mistake by acting as if we were in the wrong. Many users of the NHS will be familiar with this attitude: that ill people and their relatives are simply a nuisance preventing the otherwise smooth running of the system.
Nan was moved to another ward to recover and here we found some staff worked hard under trying circumstances to keep up standards, while others appeared less motivated. One nurse advised her not to go to the loo pulling two large drips in case she strained herself; another told her to use them as dumb-bells.
When another elderly patient, delirious with morphine, began yanking out her own drips, nan had to get out of bed and go to reception to raise the alarm. On another occasion, when nan and I were talking to an extremely helpful occupational therapist, a porter appeared and insisted she be taken for an X-ray; when we politely asked if we could have a few more moments he stormed off, visibly furious.
Finally, nan was ready to go home. Sadly, the NHS now only provides transport to and from hospital in exceptional circumstances. Eventually, a senior nurse went out of her way to arrange transport, explaining she’d have to ‘face the music’ with her superiors the following day.
When an 89-year-old who has worked her whole life, and never claimed benefits, is expected to take a taxi 15 miles home after major lung surgery, something is obviously wrong with the system. Yet how are we supposed to have a mature debate when any criticism is seen as treason?
The doctors organisation, the British Medical Association (BMA), reacting with customary promptness, has called Lansley’s reforms ‘mad’. They may be right, but the BMA, like the politicians, has a vested interest in how the NHS is run. As can be witnessed by its endless lectures on the evils of alcohol, the BMA appears to be in the fortunate position of being able to get any message, no matter how authoritarian, to the media, who then obligingly splash it across every front page and news bulletin. Perhaps we haven’t really changed that much from the days of my grandparents, who always believed that doctor knew best.
Mark Piggott is a freelance journalist and the author of two recent novels. Visit his website here.
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