Tuesday, 11 October 2016

Dodging The Grim Reaper

More on personal NHS experiences from regular commenter Wiggia.


Little did I realise after my shortish piece on the current state of the NHS that shortly afterwards I would become a victim of the best and worst that the NHS has to offer. I don't want to dwell on my personal problems within this story but a short resume of the events leading up to my hospitalisation will be no shock to many who have had to go through similar trauma, if that is not too strong a word for what transpired.

Dodging The Grim Reaper
About six weeks ago I started to get a shortness of breath. As an asthmatic this is not unusual at certain times of the year depending on pollen and other agitators, but this soon went further and breathing after any exercise as simple as walking created a problem. After about four weeks and my wife telling me to make a doctor’s appointment it magically subsided and I put it all down to a severe asthma effect, not an attack but very uncomfortable.

After a couple of weeks the symptoms returned and got steadily worse, I was reluctant to contact the surgery as getting an appointment like so many others is a nightmare, but the situation developed to the point of no choice.

The initial call resulted in the usual nothing available for three weeks despite my pushing the issue, so I struggled on in increasing trouble, then phoned again, still no joy even when explaining in full what was going on and believing an asthma attack was imminent, the best they could offer was to turn up on Monday morning and try for an appointment that day. A rubbish solution but needs must, the problem being it was Friday so a couple of days to go.

In a worsening state I got up on Monday washed and started to feel unwell sat on the edge of the bed struggling to breath and feeling awful I then briefly passed out, my wife called the surgery, not the ambulance as we should have not wanting to load the A&E up with another patient. The locum diagnosed well, it was nothing to do with the asthma and got me into the acute ward post with, and the end of all the tests, x-rays and a scan it transpired I had large blood clots in both lungs and the arteries, without admittance the consultant openly admitted any more delay and I could have easily been dead.

A Lot To Be Thankful For
All is now I hope going well and my hospital treatment and the people involved at all levels were top class despite the pressures they are under, so I have a lot to be thankful for. With that out of the way I can relate the marked differences that are now the norm in the NHS. The old GP surgery where you could walk in on the day or phone and turn up is almost completely gone. Three to four weeks for an appointment is considered normal and even in urgent situations unless you make a big fuss in person little is different. It is a total failure at the first line of health defence and with other factors puts ever more pressure on hospitals to take up the slack.

Overloaded GP Surgeries
Even my old surgery that was excellent has fallen to the new low level as my adjacent patient in the ward who uses it related. 1500 new houses gone up there and no extra doctors, all the old ones retired or gone elsewhere and evermore female doctors with families, working part time, a story repeated throughout the country.

My current surgery has an extra two housing estates being completed over the road from it and is still taking new patients despite no increase in doctors to cope, so soon three week appointments will be four weeks, or perhaps next year who knows any more. It would be easy to fill pages with anecdotal stories like mine from almost everywhere and it has been done to death, we are all aware of the shortcomings.

More Openness In Hospitals
What I found different when in hospital on this occasion was the attitude of staff at all levels to these problems. Not many years back getting anyone to agree with an opinion about the NHS that was not congratulatory was met with a blank, it could not be criticised. That from this short stay is something that dramatically changed; staff at all levels were prepared to talk about the problems in a constructive manner and roundly condemned what was happening at GP surgeries.

From the moment I was put in the ambulance and an ECG was instigated, the crew after asking what had happened openly told me to ignore my GP surgery in cases like this and simply phone for an ambulance. They themselves had surgeries where appointments could not be had in similar circumstances. A senior nurse in charge of a hospital unit readily revealed she had had enough of her surgery and was at that moment about to change, though she admitted she was lucky that she had somewhere to change to and that the change would not guarantee all would stay well in the future.

Everyone will have their own vision of how the NHS should move forward, and reams could be filled with all the suggestions, but what did emerge was a consensus from the small sample of professionals for change in certain areas.

The NHS - A Very Different Animal
As with all things in this consumer based society money is at the heart of the problem, we spend less on health care in GDP than our contemporaries, the NHS is a very different animal to that started in '47 and expectations as to what it should provide have soared along with the bill to do so. From what I gathered another level of funding in the form of insurance as in France Australia and many other countries is inevitable, whatever form it takes. But all governments have for the simple reason of votes to stay in power put off ever doing anything meaningful in that area for fear of the backlash, but they and us can't have it both ways. It needs the courage to instigate change at the earliest opportunity in a new parliament so that the mud-slinging and recriminations can be weathered and the change accepted by the public and the vested interests can be held at bay,

PFI has been a disaster yet is still being used under the guise of a new deal. When money is at an all time low in borrowing terms there is no excuse for PFI simply to keep debt off government books. “Never again”, should be the mantra there.

Despite "official" pronouncements that health tourism is not a major drain on NHS resources it is none the less a bigger drain than admitted. It is difficult to believe official figures when there is a refusal to collect data on this at the coal face. The same goes for the non contributors who arrive here knowing they will be treated without even being asked for their details.

Again the government and the NHS themselves refuse to admit the scale that this activity has on resources and how much extra money the taxpayer is footing the bill. Going by figures released from countries not so coy on releasing these statistics the figure no doubt is enormous, with illegal migrants getting into the country at over 100k a year, all of whom can simply walk into a hospital and get care for nothing whatever their problem.

This has to be a major drain on resources especially in places like London. As someone said not long ago - "you can have unlimited immigration but you can't have welfare" as it will become unsustainable. Those who come here are fully aware of our NHS hierarchy’s opinion that all the world should be accommodated at the taxpayer’s expense and will continue to arrive ad infinitum, Whilst this attitude prevails, some drastic curtailing of moral principles at other peoples expense is called for.

At a lower level the usage of the NHS for trivia should be charged for. An example is the Friday Saturday night drunk fest. I was told this activity has reached the stage where those to pissed to get home now phone for an ambulance so that they can sleep it off in the comfort of a hospital bed, and that this is not an isolated practice. This and other similar wastes of public money should be charged for. Nowhere else can you get that sort of treatment, it simply is not available. Insurance could of course cover such activities, but opinion again is divided on whether or what insurance should cover.

The question of imported staff is another area of a short cut that is a Ponzi scheme, attracting nursing staff and doctors from third world countries. It is not difficult as the money they can earn here far outstrips what they could earn back home, yet many of these people trained here to be able to go home and make a difference. Morally the bribing of them to return here to fill vacancies we should be filling from our own people is not only wrong but a cheapskate solution. The cutting of training funds is one of the seriously stupid decisions made by any government and the recent announcement of more funding in that area will not scratch the surface as a solution to the shortfall.

Accountability, waste in the public arena is legend, other people’s money, and the ability to waste it is an art form for some individuals and organisations. I had a classic example shown to me during my visit. This it must be remembered is in a hospital that because of PFI is losing money at the rate of around 30 million a year. A new bar code portable scanner is being used that simply doesn't work properly, the old laser scanner was I am told quick efficient and always worked, but someone decided a new form of scanner was needed. A trial under perfect conditions was run and hey presto £800,000 is spent on something not needed and that doesn't work in a day to day environment. Next ! is all you will hear about it.

The drugs bill is stratospheric. Seeing what is dished out in hospital these days is mind blowing , yet despite never ending cases of the NHS trusts being ripped off for millions nobody is ever held to account and the same companies continue to supply. One cannot help but believe that as in football management and council contracts brown envelopes are involved. Our money once again fills the boots of the recipients.

A Lighter Side Of Hospital
But enough of the doom and gloom, what I have written here has been in various forms been written before with little effect, change will come but will probably be a forced change. Hospital is a world in a ward, the constant ebb and flow of humanity is and can be an eye opener, especially if you have not had the "pleasure" of being interned lately.

I was at first put in the acute ward, most stay only up to 24hrs for assessment before being moved to a more specific ward but I was there for two nights plus most of the next day so had a constant change of scenery. The staff on this ward were noticeably different, the variety of health problems and injuries etc attracts those who need more variety in their day to day work.

On the only full day I was there my companions consisted of a young chef who had not eaten for four days after ingesting something in Germany that made him vomit continuously, a thirty stone night club owner who had become ill with the same problem as myself and was also a diabetic, a young lad who was waiting for a liver transplant and was in the process of setting up a private ambulance business!, an old neighbour of mine from my last house that I never met who said very little but in the silence that occasionally broke out in the night would loudly say FO in his sleep? and a man who told jokes but one could never understand a word he said because of the awful rasping chest condition he had. One just laughed anyway and nodded, he seemed happy with that, bit like Dickens 'aged parent'.

Our main topic of conversation apart from the obvious what are you here for was the food. For reasons I have not fathomed the food in the acute ward was terrible compared with half decent in the rest of the hospital. Dishes such as sausage and mash should be and were avoided, the sausages I named Colditz sausages, ersatz is the German word that best describes them. 90% sawdust, no sign that a pig had ever been involved in the making.

The next up was anything with vegetables, all were stewed to an in inch of their life, and the petite carrots as my night club friend called them were obviously the minute thinnings from a carrot harvest. This awful vegetable pottage that it had almost become permeated with its smell everything near. The apple pie I had as dessert was the first I have ever had that smelt and tasted of broccoli. This was only surpassed by the rice pudding that was best described by someone else as "interesting".

On duty on the full day and later whilst in the acute ward was a wonderful Jamaican nursing assistant called Godfrey who got into the swing of things straight, in these PC days it is not on to describe him as a perfect stand in for Jack Benny’s butler but he was. The meal ordering followed a Michelin star restaurant mode when he came around with the 'menu' with requests for a half bottle of Chianti with the shepherd’s pie and 'can I see the à la carte' becoming the norm. He also had a little admirer which we cottoned onto, but all was taken with a laugh and good spirit.

Our very large night club owner had no night clothes as none would fit so went to the bathroom in his designer underpants and a towel that covered little. When half jokingly stopped by a nurse saying he couldn't go out like that he replied he had no choice and was only going out to get a quote for materials anyway, time flew in that ward and it was soon time to be moved after my scan upstairs.

But not before the first of several good doppelgangers appeared, the first being my consultant, an elegant in style Frenchman who was a slightly younger version of Sir Ian McKellan, he even spoke like him. So at 11 in the evening I was moved upstairs to cheering from those left behind.

The ward I was moved to was for chest cases. Not a lot funny in there at first as the patient beside me was not going anywhere but further upstairs soon and his neighbour had the misfortune to contract asbestosis when as an engineer pipe lagging was removed on a job he was working on years ago. No one should have to suffer like that on a continuous basis. His relief in hospital was marginal and he would be back soon and forever as the cure does not exist.

On the opposite side were two patients with respiratory problems whom I got to know quite well and the resident loony for whom no bed could be found elsewhere, apart from standing at the bottom of the beds with eyes like Jack Nicholson in the Shining and going walk about with his frame. He was harmless though not so sure about the one we had barnstorming the acute ward earlier. He burst through the closed doors in a surgical gown all beard and mad eyes with half of a roll up hanging from his lips. After a couple of circuits looking like he had escaped from the set of The Life of Brian he tried to open the window at the far end, I presume looking for another exit. Cries from my unsympathetic companions of ‘open the window’ (we were two floors up) went unheeded and he was ushered away by several nurses handlers and security men. Never a dull moment on that ward.

The forced visit finished with another couple of doppelgangers. The male doctor who came round with the consultant was George Chakiris. I fully expected a rendition of Everyone's Come To America to be burst into at any moment, and a nurse who was the spitting image from all angles of Suranne Jones the ex Coronation St actress, but the piece de resistance of the visit was the Nigerian nurse who looked like a black roly poly and sang for a large part of the time. I questioned her about her singing and she said she is a member of the Pentecostal church and during a rare lull in proceedings gave us a full of Don't Worry be Happy  with all the moves down the centre of the ward to much applause. She said she believed in the power of prayer, who was I to argue otherwise? When she had such an uplifting effect on all around her, perhaps, just perhaps that is the answer.

What the hell is going on at GP level?
That should have been it, but this morning I returned to the hospital for a blood test. Whilst there the senior nurse phoned my surgery to arrange the next tests to be done there. Having no hotline she had to wait as everyone else does for the phone to be answered, an appalling waste of very busy peoples’ time. Once through the receptionist had no idea what she was talking about and said we are not equipped, for a single finger prick, she then passed someone else to the phone who after being told what was required said that I could not be accommodated. My nurse replied that she the answer unacceptable, that it was appalling and she had never heard anything like it before and would be complaining to the appropriate authority. A minute later the appointment was made. What the hell is going on at GP level?

I don't believe this snapshot of my stay is anything out of the ordinary. The fact it is now almost normal re GPs is more than worrying it is scandalous that the first line of defence for peoples’ health is now almost certainly killing people.

Miranda Hart

Just as an aside - when I went back to the hospital I saw the senior nurse who is changing her doctor again as she is head of the coagulation unit, lovely lady in the true sense. What I failed to mention was that she was the spitting image of Miranda Hart. I can't help myself with doubles they fascinate me and in so many cases the physical similarities obviously have an effect on the voice which often follows in its similarity with the original. Keeps me amused.


Sam Vega said...

Laughing and crying throughout this, Wiggia. An excellent piece. I'm wishing you all the best for a full and speedy recovery.

Henry Kaye said...

I am sure that many others reading this posting have had their share of questionable experiences with GPs and the NHS. I lived in Bermuda for 30 years and medical care there was available through private insurance. I had very few needs most of the time that I was there but I did eventually suffer a couple of heart attacks. The local medicos immediately arranged for me to be flown to Baltimore for the necessary treatment. I went that night and was greeted at the other end by staff ready to deal with me. The trip was successful and I was soon back to work in Bermuda. My son-in-law (also in Bermuda) was seriously ill for several years and was flown to the States for treatment many times. The treatment was seemingly efficient but, sadly, did not save his life. The point about it all was that I and my family had excellent and immediate medical care in an insurance based medical scheme.
Later, back in the UK, I suffered some illness which was eventually identified as an overactive Thyroid. The symptoms had been there for several weeks but the problem was only identified when I attended a routine blood test in connection with my diabetes. I saw a GP immediately who said that no further treatment was necessary. Not satisfied with this I requested seeing an endocrinologist. This took a further two months but I was immediately put on medication which dealt with the problem. When I questioned my GP asking why he had not put me on medication or immediately referred me to a specialist, his reply was that if he referred all of his patients with my problem, the Specialist would not be able to cope!!! In the meantime he was content for me to continue in ill health!! My experience here and in Bermuda made me feel that private health insurance offers a better deal.

Sackerson said...

Excellent! And worrying.

James Higham said...

Oh dear, I lost Wiggia but good to see him popping up elsewhere.

A K Haart said...

Sam - on Wiggia's behalf, thanks.

Henry - yet the NHS is virtually untouchable mainly thanks to the Labour party. My treatment has been good but a family member has received hopeless treatment for a serious condition. Happens too often as you found.

Sackers - yes both.

James - isn't he popping up at yours too?

CherryPie said...

I too am of the opinion that these days it is necessary to call an ambulance when there is an acute condition such as you mention.

Many years ago I moved medical practices because it was not providing my needs. Since then all the silly rules have come in and the practice I left is one of those that can't get an appointment unless you book in advance! As if we can book are illnesses to suite the surgery :-O

The practice I have moved to has not yet gone down that route and on the one occasion when I have had an emergency problem they were able to find a solution so I could be seen the same day. I was booked in to see the locum who had a bad dismissive attitude when I arrived, I suspected he had been dealing with a lot of time wasters before I arrived. His attitude changed when I told him I had a problem with my eye. It had suddenly become bloodshot and puffed up for no reason... He looked at my eye and did the obligatory temperature test via a new fangled device in my ear. He then phoned the emergency eye clinic and booked me an appointment later that day and informed me that I was not allowed to drive. The problem was driving home after the potential treatment.

When I have minor problems, there is a way to get appointments within a few days. My mother still attends the surgery I left. She can't get an appointment unless she books in advance.

I love your tales of the people you met during your stay in hospital :-)

A K Haart said...

Cherry - our practice is okay so far, it is possible to get a quick appointment one way or another. The one we left is not so good though.