Photo by Ehimetalor Akhere Unuabona on Unsplash
We’ve all seen the news reports about the dire state of the NHS – a third of GPs saying they plan to leave in the next four years, acutely overworked frontline doctors thinking of moving into the private sector and plans to recruit more medical staff failing because those who would have come from abroad in the past are now deterred by Brexit. At least 13,000 staffed beds are needed, we are told, to deal with A&E queues, ambulance response times and cancelled operations, with immediate funding for social care vital to allow the discharge of medically fit patients into care in the community. Like everyone else, I wring my hands and wonder what is to become of us but it was not, until recently that I had first-hand experience of the situation.
I wrote several weeks ago about my unfortunate accident when I fell and clunked my head on the corner of the granite worktop in our kitchen. Fortunately, the soft tissue of my ear took most of the force – had it been my skull things might have been much worse. As it was, I ended up at our local walk-in centre – a godsend for anyone with minor issues such as cuts, sprains and bruises, minor infections etc who wants to avoid going to A&E at one of the bigger hospitals.
As the kindly medic was stitching up my ear, we chatted about, amongst other things, his work in the NHS. I asked if he enjoyed it. “I did”, he answered “but I’m fed up with it now, so I’m retiring early”. He is 50. His reasons were the ones we hear time and time again: overworked, very stressed, not paid enough, those doing the same job in the private sector being paid much more. I expressed my gratitude to him for his help, his kindness and his skill in fixing me up and said I was sorry to hear of his disillusionment. What was he planning to do with his time? I asked as we parted. “Travel” he said, “I’ve been to all four corners of the earth, but there are many more places I want to see”.
I found myself thinking, yes, why wouldn’t you, if you able to do so? And not for the first time, I marvelled that there are people who devote their lives to caring for others, to the detriment of pretty much everything else in their lives. I felt immensely grateful that there are such dedicated people who choose this path and also extremely worried about what we might do as more and more of them fail to get job satisfaction and choose not to do it any longer
10 days ago, much sooner than I might have expected, I had another brush with the NHS which only added to my concern. It was a Monday night. My husband and I had just eaten dinner. We sat down to watch TV and he began complaining of a pain in his shoulder spreading up through his neck and head. His left arm had pins and needles. This is a man who is extremely robust health-wise and never ill with anything more than a cold, so this kind of grumbling was unusual . After an hour with no improvement, I decided to ring 111. Having worked my way through lengthy recorded messages, mostly about Covid, I still hadn’t talked to an actual person and when he was sitting with his head hung low and telling me the pain had moved to his chest, I put the phone down and told him to get in the car, we were going to A&E.
The cacophony of noise when we walked in to the hospital was extraordinary: there were people of every shape, size, age and colour everywhere – I’m guessing about 100 of them. There were no seats left, so standing people lined the walls. Babies wailed, elderly patients moaned and people shouted. One frustrated mother was in tears, appealing to the beleaguered woman behind the screen at the desk, saying she had been there for five hours, her toddler had an abscess that had burst and no-one was doing anything about it. A teenager in a wheelchair was doubled up in pain as his mother kept politely pointing out to the same receptionist that he had severe appendicitis and needed to be seen urgently. Because my husband of 63 had presented with chest pain he was “fast tracked” but we still waited for 2 hours and I had to keep asking at the desk when he might be seen. This was before the extreme weather we’ve had recently, but it was hellishly hot in the waiting area and we were all having to wear masks.
While we waited, I looked around at people’s faces, which variously registered pain, desperation, frustration and resignation. Next to me sat a woman who had kindly moved seats so my husband and I could sit next to one another when some chairs became free. She looked tired and drawn. She had a cannula in her arm “Have you been seen already?” I asked her. “Yes”, she said “they’ve assessed me, but they’ve sent me back out here to wait as there are no beds. I’ve been here since six o’clock this evening”. It was now well past midnight. She gestured around the area where we were sitting, to five other people, all with cannulas “They are all waiting too”. It was hard to compute. This felt like watching a news report from a developing country.
Finally, my husband’s name was called and I was allowed to accompany him to a cubicle in the assessment area where he had blood pressure and bloods taken and was given intravenous painkillers. He was informed he was to have a CT scan. I was impressed. From what I know, CT scans are expensive and therefore they don’t take the decision to do them lightly. We waited. The nurse looking after us was completely stressed out and couldn’t find my husband’s notes but she was brisk and efficient and did what she could. We waited. Several others were being admitted and there was a lot of noise and bustling activity. We waited.
After the scan, a doctor came by to talk to us briefly and said he was confident all would be ok, but he would be back later. We waited. I fell asleep in a chair. I woke up when the doctor came back and said “The good news is your heart and aorta are fine. The less good news is that we’ve discovered a totally unrelated issue that is concerning us and we want to admit you, but we don’t have any beds at the moment so you’ll have to stay here”.
It was now four o’clock in the morning. I spread my cardigan out on the floor, used my bag as a pillow and fell into a fitful doze. In my half sleep I could hear people shouting and lots of coming and going. My husband told me later that two woman had been brought in accompanied by police. Clearly domestic violence and drugs were involved but it was all so confused he couldn’t tell what else was going on. Meanwhile an elderly Sikh gentleman who had arrived in a wheelchair pushed by his son, and who was very dehydrated and ailing in a number of other ways, “escaped”. A search of the car park and surrounding areas ensued. He was found later lying on the floor in one of the hospital toilets and brought back for treatment. Another man was shouting abuse at the nurses and refused to be helped in any way.
“It was like” my husband told me “I was watching some awful documentary on TV”. Remember, this was a Monday night, not Friday or Saturday, when the NHS staff have the added pressure of dealing with numerous drunks and ne’er-do -wells. This was probably all in a night’s work for the NHS staff. To us it was shocking.
By five o’clock in the morning, when we were still there, waiting to find out what was going to happen next, my husband suggested I go home and try to get some sleep and see to the dog who had been left wondering what on earth was going on, as we dashed from the house some seven hours before. I walked out into the dawn, negotiated the car park payment system and drove home in the early morning light just as most people were waking up to start their day.
A bed was eventually found for my husband almost 24 hours after we had arrived at the hospital. He was lucky to get one. The only space they had was in an orthopaedic ward with five very elderly men who had all had falls resulting in broken hips and legs. One was bad tempered, objectional and racist, constantly complaining that the nurses were pushing him around and telling him what to do. He was so disruptive, they eventually brought in an agency nurse to be permanently stationed by his bed to stop him from continually getting out of it.
Another was insisting he wanted to go home. His sister was visiting and explained he couldn’t do that “You’ll have no one to care for you” she told him. Even though carers could be provided to go in to see him four times a day, it wasn’t going to be enough to look after him sufficiently. So, he was continuing to occupy a much-needed bed, because there was no-where else for him to go. It was depressing, distressing and a real eye opener for we who are not used to life at the sharp end.
I am happy to say that, after being kept in for four days for tests and observation, my husband is back home and going to have further tests as an outpatient. He is not by any means out of the woods yet, but we have decided there is no point in worrying until we know more.
Aware of the pressures on the NHS medical teams and the likelihood that this might mean things don’t happen very quickly, we did consider him being seem by a private consultant. This immediately presented us with a dilemma: is it good to pay for private treatment if one is able, to free up a badly needed NHS slot for someone who cannot afford it? Or is this exacerbating the problem of private versus NHS and widening the gap between the haves and have-nots?
As it happens, the NHS have been relatively quick off the mark and have set up appointments for the various scans and tests that are required in the coming weeks. In addition, the private consultant we spoke to briefly, advised that the experts in the NHS multi-disciplinary team that is dealing with my husband’s case, are the best people to take this forward, so it seems we are on the right track.
We are left reeling with emotions: shock at the whole experience of attending A&E, admiration for the patience, fortitude and dedication of those in the medical profession, gratitude to them for helping us when we needed it and dismay at seeing how some patients treat these same staff.
But most of all, we are left with an ongoing concern about the future of the NHS and what life would be like for us in Britain if we lose it altogether or it becomes so strapped for cash, beds and trained staff that it can no longer function and care for us.
I find myself recalling a quote from Nye Bevan just after the NHS was launched in 1948, “No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means”. We owe it to our forefathers and our children, to make sure this never happens.
What are your experiences of the NHS? I’d like to know, especially if you are or have been, an NHS worker. Leave a comment by clicking the button below and I shall respond
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Thankyou Susie , my father worked proudly for the NHS from its start for 50 years and held it in high esteem. He was horrified when a nurse roughly removed a cannula after successful heart valve replacement. One of the first signs he’d seen of nurses pressured by time. He lost the use of his finger dexterity and independence from then. A year later, after a fall, he ended up on a geriatric ward- there were no physios on that floor but if your bed was upstairs you were lucky to get one. He spent hours just staring into space and would relay the whole experience when we visited.
For us, the same hospital that Dad had worked at saved our son who suffered a major head injury aged 14 when he bullseyed a car. Transported by blue light from Torbay Devon to Frenchay Bristol for the only paediatric intensive care neuro bed available . The care was amazing in the hospital - the aftercare at home was not there and I was left with decisions about when he could return to school and to navigate a Brian injured child’s return . Ending up at Torbay when Joe fell down stairs in those early days , led us to a support worker who was fantastic and became the voice for us that allowed readers and time for exams and allowed him to drop subjects that were impossible with a safe place for rest breaks. Our GP has always been fantastic.
When Beth had suspected Quinzy we were seen at our local minor injuries with prompt emergency referral . I ended up in Aand E similar to what you describe . I left her alone at 11pm with a cannula in still sitting in A and E - waiting for beds to be delivered ! She ended up in an office. She phoned me at 6am . No one had been to see her and she didn’t know where a toilet was. They had literally forgotten she was there . That was our worst experience and I wrote to our MP.
Two weeks ago I needed an X-ray on my foot. I tried Kingsbridge minor injuries - queue of three - in and out in an hour . No break . Then last Sunday a phone call - Consultant says there is a fracture . By now I’m just going to see how it goes but I may have a fracture clinic referral if I need it . They were amazing .
It is scary - when we really need it they have always been there but I wonder for how long. It’s not easy to even see a GP and our dentist has left to go private and has not been replaced. It all feels a bit alarming .
What a scary experience for you both. I share your fears about the future of the NHS and what would happen if we had the US system. I am also appalled about care homes and the low wages carers are paid while the owners have made vast profits during and since the pandemic.