14 January 2016
NHS 24-7
Shaw Sheet’s personal experience of weekend health-care on the eve of the doctor’s strike.
By Neil Tidmarsh.
So the junior hospital doctors have finally gone on strike, in protest at Jeremy Hunt’s apparent attempts to transform the NHS into a twenty-four hour a day, seven day a week service. Coincidentally, I have a personal and timely anecdote this week which might cast a bit of light on the issue without going into the details of the debate.
Yes, yes, I know there’s nothing more boring that listening to someone you don’t know rambling on about their ailments. I apologise, but please bear with it. This isn’t really about me. It’s about something much bigger and even more important.
Remember those torturers in “Game of Thrones” whose favourite trick was to pop a rat into a metal pot, strap the pot’s opening against some unfortunate captive’s stomach, then heat the pot with a flaming torch so the rat – desperate not to be cooked alive – begins to gnaw its way out through… Yes, well, that gives you some idea of the stomach ache which hit me last Friday evening. By two o’clock on Saturday morning the agony was so intense and so relentless that I woke my wife up and gave her the choice of blowing my brains out for me or taking me to A&E. God bless her, she chose the latter option (possibly because we don’t have a gun in the house). So she called for a taxi and we were soon speeding through the dark streets of Bloomsbury on our way to UCH.
I had just one clear thought in my otherwise pain-addled brain. Friday night is the very worst time to fall ill. Everybody knows this. I’d read and heard so much about it in recent weeks. The NHS closes down for the weekend. On Saturday and Sunday you can’t find a GP, or get test results in a hospital, for love or money. Falling ill on Friday night is more or less a death sentence. And on top of that were those recent stories about over-stretched A&E units on the point of collapse. And the doctors’ strike was due to start next week!
I cursed my luck. That burst appendix or ravenous tumour or Alien baby gnawing away at my insides will have chewed me up and spat me out before I even get a diagnosis, let alone any treatment. Will this taxi-ride prove to be a one-way journey? Should I let my wife have the passwords to my computer, so she can find that recently completed novel and get it out into the light of day posthumously? But hang on a second; am I certain that she won’t find any disgusting and shocking downloads on my hard-drive? Graphic images of naked Finns rolling about in the snow and beating each other with birch twigs, for instance? Perhaps I’d better slip those passwords to my son somehow, get him to check it out first, he might understand… (What? What? OF COURSE there are no such images on my hard-drive – I blame the pain – I was more or less hallucinating by this time.)
To be fair to UCH, I’d been to their A&E department before, so I knew they weren’t on the point of collapse. Almost exactly a year ago, and on another Friday evening as it happens, I came off my bike in Farringdon Road and an A&E doctor did a great job stitching my chin back together. In fact her stitching was so expert that I now have no scar whatsoever; which is just as well, because I’d have had to grow a hipster beard to hide it, and get a load of tattoos to go with the beard, and move to Shoreditch, and I’m too old for any of that.
At three o’clock on Friday night/Saturday morning we found UCH A&E to be calm and efficient, orderly and polite, just as I’d found it at five o’clock on that Friday evening a year ago. Within not many minutes of registering at reception I was assessed by a nurse and sent to the appropriate A&E department (there’s more than one at UCH). I was seen by a doctor after waiting less than an hour. He listened to my story and gave me a thorough examination. His manner was good-humoured but professional, without a hint of impatience or rush. He diagnosed a relatively trivial digestive disorder, treated me, got a nurse to give me a couple of injections, gave me a couple of pills, advised me on medication, and away we went. Back home by six o’clock Saturday morning.
As soon as the shops opened my wife went out and bought the recommended medication. (God bless her; after all, this time she could have bought a gun instead.) I munched away on the pills but wasn’t convinced. The pain wasn’t getting any better. In fact it was getting worse. At four o’clock on Saturday afternoon I gave my wife another choice; operate on me herself on the dining-room table with the carving knife and kitchen scissors (there’s bound to be an appropriate video on U-Tube to guide her through the relevant procedure) or get me a second opinion. Selflessly she declined this valuable and unique opportunity to broaden her skill-set, and phoned NHS direct. I spoke to a nurse immediately, who listened to my story and promised that a doctor would phone me back. Which he did, straight away. He doubled-checked my story and made an appointment for me to see a GP at St Pancras Hospital’s Out-of-Hours department at 5.10 pm. Just like that. So my wife bundled me (doubled-up, twitching and whimpering) into another taxi and away we went through the dark streets of Camden.
As with UCH, I’d been to the St Pancras Hospital before, a memorable visit over thirty years ago when it was a centre for tropical diseases. I’d seen my first corpse there, laid out naked on the dissection table by the pathologist to whom I was delivering bone-samples from another London hospital. He was kind enough to offer me a drink. Tea? Coffee? A bite to eat? I remember glancing around the place and seeing no kettle, no coffee-machine, only glass jars and bottles of what I took to be embalming fluid, with strange organic forms floating in them. In near panic I declined his offer and cleared out of there sharpish, an act of cowardice and rudeness which I regret to this day. He was obviously a pleasant and interesting character simply eager for a bit of company, isolated as he was with only the dead to talk to.
We found the Out Of Hours unit at St Pancras hospital to be as calm and efficient, orderly and polite, as A&E at UCH. The GP saw us promptly. He went over my case and gave me another examination. Again, his manner was pleasant but professional, with no suggestion of impatience and hurry whatsoever. He even took my pathetic failure to produce a urine sample with good grace. He confirmed the A&E doctor’s diagnosis and his recommended medication. He also wrote a digital note to my regular GP, so I could have all the necessary tests in due course just to make sure and cover all possibilities.
So home we went again. And the pain continued. By one o’clock on Sunday morning I was ready to grab the carving knife and kitchen scissors myself, lie down on the dining-room table and log-on to U-Tube, and I would have done it if I hadn’t been so incapacitated. A bit of basic auto-surgery. Nothing too complicated, just the total amputation of the whole stomach. I reckoned that would do it. But I must have fallen asleep eventually, because I woke up at six o’clock on Sunday morning, and guess what? No pain. A slight stomach ache, a slight headache, but the unbearable agony had gone!
The doctors had been right after all. Their diagnosis had been right. Their treatment had been right. The NHS had come up trumps, and at the weekend, too.
It had been raining all night, and the sun rose into a clear blue sky. It was a beautiful day. I was so glad to be alive. It was incredible. Only a few hours ago I could have quite happily killed myself, but now life and the world were wonderful! The NHS was wonderful! How lucky we were to have it there, ready to look after us whenever we needed it!
My point is that, as far as my experience last weekend goes, the NHS already is a seven-days-a-week, twenty-four-hours-a-day service. And what’s more, it’s a good service. I was passed effortlessly through the system and seen by expert doctors. On a Saturday. At the weekend. I saw not one doctor but two – a hospital doctor and a GP – at unsociable hours, in a single day. And talked with at least three nurses. And a third doctor helped me on the NHS Direct line. I know my own personal experience is necessarily subjective, but nevertheless…
Perhaps I was just lucky. Perhaps the people I just happened to catch at UCH, NHS Direct and St Pancras were also exceptional in the sense that they don’t represent the average service available around the country. But I don’t think so. I suspect that the same excellent level of service would have been available if I’d fallen ill in Pitlochry or Glasgow, Builth Wells or Cardiff, Ballymoney or Belfast. Perhaps I was lucky in my timing. If I’d turned up an hour or two earlier or later, would I have encountered more typical crowds and queues? Again, I don’t think so. Perhaps I was lucky that my complaint was relatively trivial after all. If it had turned out to be something serious, would I then have run into weekend problems with resources and test results and treatment? I suspect not. From what I’ve heard from other people, it’s the serious cases where the NHS really comes into its own; it’s the trivial day-to-day eventualities where it can’t always be relied on.
I have a second point to make. Almost everyone I met, working so efficiently in that out of hours world, whether taxi drivers or cleaners or receptionists or doctors, was a first or second generation immigrant. While most of us are fast asleep at night, or out enjoying ourselves on a Saturday evening, these people are carrying a whole civilisation on their shoulders. I salute them and thank them. And worry even more about David Cameron’s strange campaign against benefits for in-work migrants.
