Friday, 31 May 2013

A deep malaise at the heart of the NHS

Readers of this blog will know that I have been very unwell. I have already recounted some of my experiences as an NHS patient. I am slowly recovering and I have had several days now free from pain. In my journey through hospital and after care I found plenty of examples of compassionate and caring medical practice, but caring can break down if stretched to limits through insufficient resources.

This much I found in the care of the district nurses. One night when I was in severe pain I called to get attention. They were very busy covering a whole county but would try to get to me later. They kept me informed as the night progressed and in the early hours of the morning called to say they would be with me soon. Two nurses arrived. They had worked solidly through the night. Nevertheless they came with smiles and comfort. Sadly they couldn't do much to help me. It struck me how little information they had about my history. I was barely on their radar, and they had not the authority to do much to help me. That did not stop me getting a call from them later to find out how I was.

In desperation I contacted my GP. How could weeks have gone by since being discharged from hospital without any contact? All I had been told by the hospital was that I would receive a visit from the district nurse to remove a catheter. That happened two weeks later. By that time I was in considerable pain and infection had taken hold. My GP told me he knew nothing of my history. He had received nothing from the hospital. He had been unaware of my condition. He acted with efficiency and with care. He telephoned a couple of day later to ask how I was and to put me on another course of antibiotics. I had now lived with weeks of pain and painkillers that were slowly losing their effect. I felt isolated, the more so since I discovered I was not on anyone's radar. I only got attention if I called for it, and on each occasion I had to repeat my history because they had not received notes from the hospital.

These problems are not the result of a lack of compassion. They don't stem from inefficiency of staff. It is systemic. There is a deep malaise at the heart of the NHS. It results from underfunding and a reorganisation that has produce chaos and a lack of joined up care. It results in large part from savage cuts that have impacted dramatically on front line care. It will take this government no time at all to destroy the NHS; it will take decades or more to rebuild it.


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