After my daughter and my grandchildren the best thing ever to happen to me in my 71 years has been the NHS. Had my parents still had to pay for the doctor to call, how I would have survived severe measles at 4 is hard to judge, and perhaps it should be “whether” instead of “how”. Tonsils, pleurisy, concussion, fractures, replacement knee, mental health…and much more, the NHS has always been a phone call away, a so so comforting nanny just down the road to make it all better. And usually it’s done so, with a little help from me as is only fair. The idea of monthly prepaid (therefore much cheaper) prescriptions was also a masterstroke, since lots of us find we need lots of them as we advance in years. Visits from midwives, doctors, counsellors, district nurses (on bikes) … the staff, the services are legion. When it works it’s a glorious humane enviable set-up.
On the medical side I still defend the NHS staunchly. The doctors and nurses, especially the former, tired and over-worked (and I can see this, I don’t need them to tell me – my practice has been two doctors short for years), are without fail supportive, kind, knowledgeable and informative. On my visits to Airedale the same fatigue is evident in the eyes, in a loss of vitality , which can only be threatening for patients. We’re told the country is short of doctors, nurses, midwives, A&E staff, ambulance crews; and that even if we start training now the shortfall won’t come close to being made up for years yet.
But given that this constantly publicised problem is due solely to the immediacy of lack of human resources, the answer can’t simply be to keep throwing money at the Service, like some monetary sticking plaster? Nobody seems concerned that the amount of wastage and profligacy of equipment and time in any hospital, if you trouble to observe, is utterly hair-raising. I’ve just had a simple wrist incision operation. This was then bandaged in (and I measured it later) seven feet of cotton wool bandage and fourteen (yes,14) feet of crepe bandage. For safety yes, but overkill in an daft,excessive, expensive way. Cost that, multiply it per CTS op. per annum at that hospital, then times it by all the other hospitals. It gets to be a big big figure. Just on some crepe bandage in one theatre. I lay down for the op on a kind of lightweight surfboard, which was replaced when I was done. I gather it wasn’t reused – sterilised, it could and should have been. A bandage with a pair of cheap scissors came in a sealed packet …..whose scissors, and I deliberately asked this, were then disposed of, not sterilised and reused. And these examples of heedless, needless waste were clear in this smallest of fifteen minute operations.
And it seems that the Service has no central ordering system for its drugs or supplies, with some hospitals and practices paying far more for a drug or piece of equipment than others buying elsewhere. Frankly I’m baffled by this fact and have wondered for years why this hasn’t been resolved within a year by an overlord of a logical business mind as it could be. Some hospitals, at ward changeover time, have new on-duty staff laboriously copy out on paper the latter entries of the staff whom they’re relieving, as though the technology age stopped with the pencil; whereas other hospitals have scrapped all paper where possible and have saved tens of thousands of staff hours and drug costs (and paper!) by investing heavily in IT and databases. So – why not all? And how is just slinging another £3b going to improve this poles-apart state of affairs unless somebody kicks ass and insists that these things will happen and that new cost-saving methods and new technology for systems, never mind the medical operations, must be standardised and put in place all across the land at all levels – or no more bloody money?
Sadly nobody in the Service has time to do more than paddle furiously to keep his own patient list treated or her own ward afloat. The fatigued, glaze-eyed staff themselves would be the worst to handle such a rationalisation. And unfortunately (the understatement of 2017) no government has yet cottoned on (dared to admit?) that the NHS is collapsing (now visibly) and that a politically independent bit of a bully-boy needs to be put in charge of curing the mismatching, misordering, misapplying illogicality within systems that’s genuinely as much a cause of patient dissatisfaction as any medical problems.