FIRST AID FOR NHS

It has these last few years been my misfortune to spend a good deal of time at various London hospitals, both on my own and others’ behalf.  So I have seen at first hand how the vast increase in NHS users, though not necessarily contributors, and the subsequent underfunding has led to a worsening of the service, particularly noticeable in the long waits at A&E, and the care given to our oldest and most vulnerable citizens, many of whom have been paying their dues since the inception of the NHS some 70 years ago.

The problem lies, I feel, in several areas: two of which are underfunding and bad management. Underfunding is often discussed and is apparent in wards in many hospitals in  insufficient staff and other resources, and bad management, leading to waste of the existing staffs’ time and such resources (equipment, medicines etc) as there are.

The constant ringing of patients bells which remain unanswered is a very audible reminder of this.  How often do we see elderly patients press their buttons (that is if they are lucky enough to have one left within their reach) because they need toileting, only for a nurse to appear, turn it off and say they’ll be back ‘in a minute’, which turns out to be an hour or more, during which time the person has soiled the bed, leading to distress for the patient and a lot more work for staff which could have been avoided.

Further evidence of the need for more funding lies in the need to employ more doctors and senior nurses.  This also can be seen especially in A&E, where patients wait hours to be triaged, then further hours in a bay (if lucky enough to get one), whilst waiting for a doctor.  Many of them will have spent the hours in the waiting room sitting on the floor, and will end up waiting on a trolley for a Doctor to arrive as no bays are available.  The bay availability problem can sometimes be relieved by a patient dying before a doctor arrives. I witnessed this twice during A&E visits over the last 2 months.  One can certainly understand these deaths simply because people give up.  Instead of Accident and Emergency the sign over the door should read ‘Abandon Hope All Who Enter Here’ a la Dante’s Inferno.

With regard to management, or lack of it, this waiting for doctors also leads to other staff through no fault of their own just standing around waiting for further instructions from said scarce doctors.  What a waste of staff hours, not to mention patients’ time, pain and worry. Or aforementioned death. This is both a management and a funding issue.

And let’s look at the clinic systems.  I am sure some hospitals have modern call-forward systems; but only too often the routines are positively stone-age.  Patient books in at desk.  File is pulled out and placed on a pile near the consulting room.  Next person arrives. His file is placed on top of first man’s file, who has now been waiting half an hour. Nurse takes top file and calls gent who has just arrived. Man 1 assumes Man 2’s appointment was earlier than his – until an hour and six patients later Man 1 asks the next person called what is his appointment time? Which is an hour after his. Man argues with desk person, gets apoplexic has heart attack and dies.  Well I made that bit up but it’s not impossible. We’ve been there. And all that could be avoided by proper systems in place.  Not necessarily costly electronic ones, just proper management and staff training.

On a wider point, which political idiot decided it would be a jolly good idea to close many of London’s local hospitals, as it would be much to patients’ advantage to be treated in huge establishments which would have of course all the best staff and equipment?  A very cunning plan – my bet is they knew this would cut patient numbers at a stroke (literally in some cases), as many would be unable to face long arduous journeys across London, unbearable to well and unwell folk alike packed like sardines standing on public transport. 

Ah you say, why not come by car?  But my friend, the powers-that-be have thought of that; the remaining hospitals have been enlarged by building on every inch of the site – including car parking spaces.  They then removed any possibility of street parking by ensuring there are double yellow lines everywhere nearby. And any public car parks in the vicinity are owned by NCP who charge an arm and a leg almost literally in this case as sick people have to walk a long way to the actual hospital.

But, I hear you cry, Isn’t there a system of Hospital Transport?  Indeed there is. And it is extremely over-subscribed due to the vastly increased numbers of patients in the outrageously expanding London population, the aforementioned travel/parking nightmare, and of course the large numbers of elderly people needing to use the service.  In fact it has got much worse since I first had the misfortune of trying to use it back in 1999 when I was back and forth with my Mum from Lewisham to Guy’s Hospital in London for Chemotherapy.

So imagine an 80 plus Lady who clearly would be better off in bed but is determined to stay alive as long as possible to be with her husband and family. Her daughter (i.e. me) and her equally aged husband (my Dad), her adoring childhood sweetheart to whom she has been married for nigh on 60 years, realise she is so frail that she needs proper transport to her chemo appointment in Guy’s hospital, a long way from Lewisham..  Private car is out of the question (see above mentioned parking problems). So Hospital Transport is booked.  Appointment is for 10 a.m. Ambulance transport arrives eventually (after many phone calls, and with me waiting anxiously at Guys having braved buses and trains - you are only allowed one carer to escort and that only after much pleading and argument - at 3.00 pm. Lady has been waiting downstairs since 8 a.m. and now is in state of collapse.

Traffic (as usual in SE London) is awful, especially at the Elephant, and ambulance arrives at Guy’s at 4.30p.m.  Stagger to ward (no porter or wheelchair available) for chemo – nurse says ‘Sorry you’re too late, we’re closing at five and the chemo takes longer than that!’  I make very big noises, sick Lady hangs head and weeps silently until I say ‘well you can lock us all in overnight then I ain’t moving!’ quick referral to cancer Big Cheese who is appalled at the story (Consultants etc. still have no real idea of what actually goes on when their patient is out of sight); and chemo commences. At end of the day, no more transport available but I’ve said ‘sod it’ already, and called a cab, which costs a fortune.  Thereafter we used cabs – the cost of which was not recoverable. Neither was the Lady’s health or confidence, she died soon after.

From our subsequent similar experiences with my Dad, and very recent experiences with Mum in law, hospital transport is no better now.  It is 15 years since above mentioned Lady passed away, and nothing seems to have changed, presumably due to the failings of the above-mentioned Funding and standards of management.

So what is the answer to all this?  Obviously more funding and better management as discussed.  However, there is one more factor, which certainly applies to the London area, (though we chatted to some Welsh ex-steel workers we met on a day trip to the coast recently, who quite unprovoked by me said much of the above, and much of the following). This is the sheer numbers of people seeking treatment at NHS establishments.  Short of Nazi-style mass murder, the only way this can be helped is to reduce the numbers of people coming in to the country, with special attention to illegal immigrants.  Back in February this year, my elderly Mum in law was in hospital having her leg amputated, and I was with her every day.  However, I was taken ill on site and carted off to A&E.  Where I sat for hours queuing behind healthy looking young men of indeterminate origin demanding attention from hard-pressed staff who pointed out they had no NHS numbers and couldn’t speak English.  There were at least 6 languages going on there apart from our own. This being Croydon with a large Immigration and Home office department; some see hospital as a way in. 

Now I do not exactly know how this third point can be achieved. But it must be achieved. It is so not fair that we are treating our old folk who have endured a war fought for our freedom, and have paid into the system (including NHS) since the beginning of the Welfare State, so shabbily whilst having to deal with people who have never paid a penny and seem to think we are a bottomless pot of gold.

This is one reason why me and so many people voted for Brexit. The sooner Mrs May decides what she is going to do about sorting out our borders and controlling who is allowed to stay here, the better.