Although I’d never stayed in hospital before and only ever had a passing need for their services, I’d always admired and supported the NHS and everything it stands for. Stupidly, I’d always imagined a hospital ward to be a Holby City-esque world of chatting nurses, bowls of grapes and happy endings. I didn’t imagine that my experience of our health service would be such a humbling and life changing experience.
My stay in the Respiratory Department was only for three days, but long enough to meet some incredibly dedicated people, and witness some amazing scenes of compassion and decency in amongst what often seemed like organised chaos.
From what I can gather hospitals are essentially run by nurses and junior doctors in the same way that the Army is run buy Non Commissioned and Warrant officers, the lower ranks. The self important TV Interviews will be carried out by a media savvy Senior Manager or Consultant, but behind the scenes the daily running of the place will be the responsibility of the working staff, mostly nurses.
I’d always known that nursing work was challenging but I’d never realised it was quite so physically demanding and sometimes, for people like me at least, unimaginably disgusting. Lifting, persuading, consoling, cleaning and the almost continuous writing in colour coded files and folders. This work is not quantifiable by gazing at pie charts and talk of ROI, it’s the same slog it’s always been, however we try and shape it.
I ask a nurse checking my blood pressure how long she’s been in the job, and whether she’s still enjoying it. Sadly not. She talks of being treated badly, like a resource, and how the focus on efficiency and targets impacts the quality of care and service. There’s a general unhappiness about how ideals on which the service were founded have been hijacked for electioneering and then betrayed in equal measure. Her jaw tightens as she turns away, and there’s a a hint of fluid on a bottom eyelid.
“I’m hoping to go home today”, I tell one of the many polish nurses. “I don’t want to be a malinger, next thing we know I’ll be named and shamed in the Daily Mail”. She gives me a knowing smile, “Well, it’ll make a change from shaming us”.
In amongst the dying and distress there are moments of laughter and compassion as the staff exercise unimaginable patience. There’s also the little snippets of conversation that offer a snapshot into the lives of the other patients. One of the men on the ward was so old he was born when the last series of Downton Abbey was set, he’d have come home from hospital as a baby in a horse and trap. Another elderly patient lives in Corsham and worries his West Highland Terrier will think he’s not coming back for her. I talk with a volunteer from the chaplains department for the best part of an hour. He was in the Royal Green jackets and knew a soldier from my own regiment back in the 70s, “A tall chap called Quinn”. We discuss our country’s failed exploits in Iraq and Afghanistan and the demonisation of Iran, before moving onto software development and his love of light aircraft. Before he leaves I agree to a small prayer, and although I don’t believe in God it doesn’t hurt him thinking he’s doing some good, which he is anyway.
The workload for the nurses doesn’t seem to abate during the night when there is less staff on hand but the needs of the patients somehow increase.
On one gloomy night shift I watch nurses run from ward to ward dealing with distressed and dying patients, making on the spot decisions well above their grade simply because there is nobody else available. A patient refuses to keep his oxygen mask on so the nurses have to continuously put it back on for what sees like hours, I am amazed by their patience and kindness. At one point he rips the pipe out of the wall and they struggle to reattach it only to end up charging around locating bottles and masks. It becomes too much, the young staff nurse in charge can’t hold the tears back, has her head in her hands and is consoled by an older colleague.
The young Doctors try to figure out what’s wrong with me. They are interested in my medical history and spend what time they have running through different scenarios, sending me for tests and performing a process of elimination. I never believed that such caution would be exercised, and that me wanting to be out of their hair would be enough to see me out of the door. She kneels down when talking to patients so not to appear condescending, and wears running shoes with her ridiculous frog green uniform for a reason. I watch them make life changing decisions and wish at least part of me could be like that.
These are Sound Bite Cameron’s real ‘Hard Working Families,’ now having to work even harder to fulfil his party’s ridiculous fantasy, where caring for our ill and most vulnerable can be turned into a portfolio of entrepreneurial business ventures. The tough choices, the strutting public schoolboys of key markets and the chopping motion of management.
I struggle to understand why the NHS has become the tabloid whipping boy of choice. Why the gutter press choose to ignore the dedication and backbreaking work and choose instead to impress their Prime Minister with sycophantic reportage and tell tale sensationalism. And how they champion a selfish Royal Family who’s own healthcare arrangements sit, unquestioned, on a stratospherically different level, paid for by the ‘Hard working families’, making ‘Tough choices’ whilst cleaning shit from the floor of this very hospital. You couldn’t write the irony any better.
It’s not perfect, there are obvious issues with interdepartmental communication and getting patients from one place to another on time. Many people don’t get the service they think they deserve and have a right to complain. However this does pose a question of where we make our expectations of that service, and how our self importance and experience with rampant consumerism does little to help.
The future of the NHS lies in how we perceive it, and what we want it to be.
We could allow huge corporations to cherry pick the easiest and most valuable work for their own profit, and allow them to dump it back on ‘Hard Working Families’ if the returns don’t point in right direction at the shareholders meeting. An American model of successful greed on one side of the tracks, and of hopeless despair and failure on the other.
On the other hand we could accept that it’s integral role in our society is worth the cost and the investment, and leave us with an example of social care to be proud of. This is how we look after the sick and vulnerable here, so what if it’s a cash hole, so what? Better that than lost wars and failed banks.
We play with the NHS and toy with the legacy of Bevan at our peril.
Once it’s gone, it’s gone.