Proud of the NHS?

I have witnessed many instances of fantastic care, both as a doctor and as a family member. I can also think of instances of care that was not so good but they have been minor and small in number. Until now.

I am passionate about the NHS, so very proud that my country provides healthcare free at the point of delivery and regardless of means. I admit there are some loose definitions of ‘free’ but relatively speaking. I often find myself defending the NHS with friends who prefer to have health insurance or with Americans and others who do not believe it can deliver good quality care.

So I write this piece with a heavy heart. As Robert Francis and many commentators have said, we must own up to the NHS’s failings when things do not go well.

My daughter’s partner has just experienced the sort of care that is unacceptable. Poor communication, poor organisation, rude and unhelpful staff, promises of phone calls that never happen, conflicting advice. As a 27 year old with a fracture sustained playing football, he does not generate the same sympathy as the elderly person living alone. He recognises that he is lower priority than others. But he is still a citizen with a nasty injury in severe pain. He is self employed and uncertain about his ability to work. The disturbing thing is that my daughter is an experienced case worker for London MPs so just the sort of calm and resourceful person you want to have help you when the bailiffs arrive at your door or you are about to forcibly repatriated or you have a dispute with a neighbour that is turning nasty. Yet even she was unable to unblock the blocks and ended up dispirited and frustrated at how incredibly insensitive everyone was. People would not give names or phone numbers to contact, no-one took responsibility. There were a couple of staff who were pleasant and apologetic, but they too seemed caught up in the apathy or impossibility of trying to provide anything like a reasonable experience.

In my work in clinical settings I witnessed the ease with which some people can lapse into a bubble of their own world and lose sight of the needs or impressions of those around them. No one is immune; we all occasionally succumb to the conversation around the nursing station about the gossip of last night, forgetting we are in earshot of families with sick children. One regret I have about my years in practice is not about any clinical action or inaction, it is a casual, flippant comment I made to a mother whose baby died later that day.

However, even though I recognise that we can all lapse, I have never been aware of such systemic lack of thought, lack of consideration for a person’s physical or emotional wellbeing. It was not about integrated care between organisations or sectors, it all happened within the same organisation. I am sure there was no one person to blame, no one thing that could have been put right. It was many small things that led to a whole experience that have left a young couple without confidence in their care or those supposed to provide it. In the NHS. That is what is so profoundly depressing.

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