Outlandish horror stories have become common. Here are some I heard personally over the holiday period about our No Hope Service. A charming GP from Kent, whom I met at a party, said his 70-something neighbor recently presented with slurred speech, almost certainly the sign of a stroke. He was unable to give her an MRI at any of the nearby hospitals and according to him the conditions at A&E would have killed the poor lady. In desperation, after two days without answering phone calls, the doctor advised the family to take the alleged stroke victim to London and drop her off at the door of the Urgent Care Center at Princess Grace private hospital. That hospital immediately performed an examination, but precious time had been lost between the heart attack and the start of treatment. Left behind in Kent, that woman could easily have been one of the preventable deaths.
On another Christmas day, I had a chat with an impressive young doctor who works in the A&E resuscitation unit of a major London hospital. Pale and shaken after consecutive 18-hour shifts, he told me how he and his colleagues spend their time trying (and all too often failing) to revive patients “who should have been with us hours, if not days, before.” Ambulances just weren’t getting patients on time, mostly heart attacks, strokes and “an unusual number of late-stage cancers.”
I noticed the young doctor had a dark, wry laugh, too old for his age. He said he spent all the breaks he could snatch googling for jobs in Australia. A country with world-class healthcare (a combined state and private system) where I could “practice the medicine I thought I was going to practice and do some good, instead of watching all these people die helplessly.” Conditions at A&E, the doctor said, were “much like what I imagine the Somme would be like.”
“Third world” is how Lottie, the mother of an eight-year-old girl with a terribly high temperature, described the scene that greeted them in the pediatric ER 10 nights ago. Families with children covered the entire area of the floor – small children vomiting into paper cups, puddles of urine, babies crying uncontrollably. You hit the jackpot if you bagged one of the hard plastic seats to sleep upright in for six hours, nursing your restless, feverish child. “It’s unreal,” Lottie said, shaking her head. “How can we call ourselves a civilized country?”
A very good question. So you may well ask, where are all the highly paid NHS managers offering answers to this dire crisis? Why the hell isn’t Amanda Pritchard the £255,000 per year CEO of NHS England, and your team being dragged over the coals? They are the ones in charge. Not that you know. Shyer than the African anteater, and even harder to spot, the NHS top manager has perfected such effective camouflage that it’s impossible to tell if he bears any NHS responsibility. We give them over £150bn a year to provide a healthcare service that preferably doesn’t kill people, but there’s no liability. Like Jeremy Corbyn at the funeral of a Palestinian terrorist, NHS administrators are mysteriously “present but not involved”.
I think the British public is being misled by these non-administrative managers of the NHS. It’s all our fault, you see. Over the Christmas period, NHS trusts had the nerve to issue press releases urging “self care” rather than assist A&E. “Get away from us with your dreadful diseases! Do not go running in case you fall or have a heart attack. Avoid alcohol. No thoughtless consumption of sherry trifles! Hold perfectly still, everyone, just for a few months until the winter crisis has passed and please do your best to avoid becoming a burden to your local hospital because we won’t send an ambulance to look for you selfish sponges.”
That was basically the gist. What is really remarkable is how unremarkable someone thinks this attitude is. Last week, dozens of NHS trusts declared critical incidents because they “can no longer provide safe levels of care”. They make it seem as if this is an act of God rather than a perfectly predictable consequence of not having enough care beds to discharge thousands of recovered patients. No board of any major company could get away with a “nothing to do with us, government” attitude to corporate negligence.
“Unprecedented pressures caused by flu and covid!” shout managers like Chris Hopson, director of strategy for England’s NHS. I heard Hopson on Radio 4’s World at One on Monday and quickly went into possible cardiac arrest. Confronted with the story of a 90-year-old woman with a suspected hip fracture who had waited more than 27 hours for an ambulance, he said “everyone in the NHS works to provide the best possible quality of care, blah blah… ” but “we triage based on clinical priority.” If she doesn’t have a “life-threatening” condition, if she’s just a scared nonagenarian in excruciating pain, well, tough.