The Blog

NHS - Can We Fix It?

This spectrum of care that vacillates between the brilliant and the dreadful cannot be allowed to continue, it is not cost effective for starters! I hope the powers that be are coming up with a plan that will allow the NHS to do what it does best - primary care, emergency care and the very specialised life-saving stuff.

Headlines about crises in A&E and the failing quotas for the NHS appear to be omnipresent at the moment - and it makes for pretty frightening reading.

I am a 50s baby whose first memorable experience of the NHS was as a five-year-old when I spent a week in the local Eye Hospital to have a squint corrected. I recall the fear of being abandoned by my parents (no overnight accommodation for anxious mothers in those days) and I am sure they were just as terrified as me. I remember getting locked in a cupboard during a game of hide and seek on the ward, and the daily porridge, apart from the day I had my op, when I missed out on the 'Shreddies'... these things run deep!

I have very little memory of the quality of care, but I am sure it was dished out by kindly pretty nurses, in starched dresses and hats and somewhere there would have been a matron. I do remember the outpatients, post op and the handsome consultant who treated me; I even remember the machines I had to look into to test out my newly fixed left eye. The fact that said eye has never been quite as good as my right eye is down to me being too lazy to do my 'exercises' as often as I should!

But I digress; my admiration for those folks who go into the medical and nursing professions has never wavered; some of my best friends work for the NHS and they are dedicated and hard-working people who despair of the way things are these days.

However, I am not one of those people who believe that the NHS is a sacred cow that must be protected at all costs and must be given unlimited funding from now until the end of time. With a burgeoning population, longer life expectancy, spiralling costs of treatment and sophisticated equipment, not to mention the research, plus a national debt that needs to be addressed before it becomes the biggest cost to the UK Exchequer, something clearly needs to give.

I am not an economist nor do I have any expertise in how hospital administrators carve up the pie, but I do know that turkey's don't vote for Christmas, and it seems to me that when asked to cut budgets, the paper pushers appear to cut front line services over their own. Perhaps this is hearsay, but I have spent several days at a hospital recently supporting my mother after a 'routine' hip operation. Rather more time there than I had expected to, because she developed post op complications; no fault of her care per se, just one of those things - more of that later.

My being there for 10 hours a day, for three days consecutively, afforded me the unusual opportunity to observe the routine comings and goings of the Hospital. Having taken the time to study the uniform chart on the notice board in the ward and having some personal exposure to some of the outpatient and research functions, I was struck by the inordinately high number of apparently non front-line or care-giving staff I passed, as I paced the corridors en route to the car park and cafe, or in search of some fresh, cooler air - turning the ruddy heating down a notch or two might save the organisation a fortune and save a few lives too - after all germs love a nice warm environment!

The impact of this apparent imbalance on the provision of the 'health' and 'service' elements of this august national treasure was never more evident as I visited my darling Mummy. You hear about the nightmare scenario of the fairly healthy elderly individual going into hospital for something relatively straightforward or as the result of a slight tumble, and them coming out a confused, dribbling geriatric covered in necrotic pressure sores and ravaged by UT infections - no longer able to look after themselves. Or worse - not coming home at all, having succumbed to said infection. Why are we so bad at caring for our elderly in the UK; is this what we all have to look forward to - even if we have a loving family to advocate on our behalf?

I have friends to whom this has happened - but until you experience it for yourself, it is hard to really fathom. As I mentioned earlier, my mum had post op complications; initially we thought we were looking at a very scary pulmonary embolism, with a long recovery period and ongoing health implications; cue distraught sisters on the phone and the prospect of losing her (only 9 months after my father!). Thankfully the skilled physicians, after examining all the evidence, were ultimately able to fine tune the diagnosis as a severe chest infection - still a serious and acute condition and she was treated by a critical care nurse for a further 48 hours before responding well to the antibiotics. Game old bird my mother!

Meanwhile we negotiated to get her on a pressure mattress and chase up the staff to perform bed baths, turn her, change her saline drip and administer her drugs in a timely fashion.

So finally we are almost back on track, having lost a week. She is eating again, getting up on her new hip for a short while each day, she was thrilled to 'lose' the catheter and we returned to normal visiting hours. Home and dry we thought, not so!

The next day my sister arrived to find my mother distressed beyond belief, a stone cold meal in front of her because she was feeling a bit nauseous and couldn't eat; but worse than that, lying in a puddle of her own faeces (potentially devastating combined with the slight beginnings of a sacral pressure sore) and having exhausted herself pressing her call button without response for over half an hour; this is from a side room right by the nurses station at the front of the ward! This is simply not acceptable; the few nurses on duty are mostly lovely, caring people, but they have 21 other patients and all the attendant paperwork and administration, so my sister ends up having to enlist

Physio staff to help her to sort Mum out and using far more resources than if someone had come to help her to the bathroom in time. We have taken this and other issues up with the doctors when we see them, but again they are often nowhere to be seen as they are usually covering several wards or you end up with a junior house officer on rotation, who might have spent a fortnight in the department, if you are lucky.

This spectrum of care that vacillates between the brilliant and the dreadful cannot be allowed to continue, it is not cost effective for starters! I hope the powers that be are coming up with a plan that will allow the NHS to do what it does best - primary care, emergency care and the very specialised life-saving stuff. There needs to be some concession on how some 'elective' and cosmetic procedures are funded and it seems to me that means-testing should not be a dirty word in this context. As for all those drunks and potheads in A&E on a Friday and Saturday night - install a credit card machine in every hospital and charge the lot of them, before they even get to see a doctor!

Two days later and Mum is progressing erratically; indeed as I type, she has had to go back on the antibiotics and the oxygen as she has taken a slightly backwards step; still a cause for concern but hopefully not life-threatening. I am destined to spend more of my life in the hospital this week, it seems, but in the meantime I am off to research the cost of back to back cruises for my retirement - no wee and cabbage smelling nursing home for me in my dotage, no Siree! At around a forecasted £27000 a year for a second rate facility here, I plan to spend my nest egg being looked after in 4 star luxury, with clean sheets every couple of days, good food and a decent sickbay on hand if I slip over whilst perambulating or enjoying a game of deck quoits!