Operation Hit & Miss: a tale of two different NHS experiences

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all dressed up and ready to go. . . but an emergency left my friend under anaesthetic with no hope of her operation

This column comes with a health warning. My narrative is based largely on my own recent (good) experience of the National Health Service and partly on hearsay: the reported testimony of a close mutual friend’s comparatively poor treatment in the care of our 70-year-old national treasure.

Identities have been changed, names of hospitals and geographical details omitted in order not to detract from the disturbing message contained herein. Fuller facts can be made available, particularly  to any of the 650 Westminster MPs, all of whom claim to care for the NHS as the cornerstone of the UK’s social contract.

THERE ARE TWO WAYS to measure the success or otherwise of our troubled society: by wealth and by health. Both require constant attention, both require investment.

Wealth can be the product of hard work and talent or simple good fortune; the nation’s health demands the devotion of hundreds of thousands of well-trained individuals (including both indigenous and immigrant recruits) working within a system requiring an unstinting and constant proportion of national resources which increases in real terms year upon year to attend the needs of an ageing population.

My health over the past twenty years has not been good. Leukaemia, meningitis and glandular fever have been my ‘headline’ conditions but a number of lesser problems – loss of an eye, dizziness, a variety of spectacular falls – have made resultant contributions to my general decline over recent decades. Through it all, the National Health Service has been my lifeline.

With an important contribution from a company private health plan (which diagnosed and treated my leukaemia for a dozen or more years) the safety net of the NHS has twice saved my life and continues to provide succour and security since I abandoned the costly umbrella protection of private treatment.

It came up trumps again this week when, days after being sent to A&E with chronic back pain following a heavy fall in my bathroom, I was recalled to the hospital’s orthopaedic clinic to be told that what a duty doctor had earlier identified as a ‘damaged’ vertebrae showed, on specialist examination, that I had fractured a bone in my back. Reassured to learn that the break was healing, I left happy that I required no treatment beyond rest and painkillers.

But who had referred me? Had it been my GP or the Macmillan nurses who monitor my latest chemotherapy or even the haematologist who is treating my leukaemia? I asked.

“None of them,” said the orthopaedic specialist. “Your x-ray from A&E was automatically referred to us for monitoring and I could see the crack in your vertebrae.” In other words, once again the national treasure that is the NHS working perfectly, unprompted, in the interests of the population it protects.

I arrived home relieved, impressed and buoyed by yet another NHS success story; until, that is, I took a phone call from my daughter regarding a mutual friend who had experienced the reverse side of a flip of the health service coin.

Four years ago a mutual friend had a serious stroke, leaving her partially paralysed. In layman’s terms, the stroke emanated from a bleed in a ‘blister’ at the back of the brain which is still there; after years of monitoring surgeons concluded that there was risk of a further aneurism which might prove fatal but that they could not operate directly through the skull.

A procedure was agreed whereby they would pass a fine tube from the groin via an artery up into the area at the back of her brain in order to  – I told you these were layman’s terms – encase the ‘blister’ in a surgical superglue that would prevent further leakage. The operation has an 80 per cent success rate with a five per cent risk to the patient’s life.

Although nervous, the patient agreed to the terms: arrive at a major city hospital having consumed no food or fluids since 6am, procedure at 9am following a general anaesthetic then home (unbelievably) either later that same day or the following morning.

Things started to go awry quite early in the day: a permission sheet signed upon arrival at 8am went missing, the procedure was delayed while fresh forms were completed, the delays grew until at almost 2pm when, five hours later than planned and rapidly dehydrating, the patient was given a general anaesthetic and took a tearful departure of her husband and son before leaving for the operating theatre.

Some hours later she revived, immediately relieved to have survived. . . only to be told that the surgery had NOT taken place. An emergency case had arrived shortly after she ‘went under’, her surgeon told her apologetically. His team had to switch to the life-or-death surgery and worked tirelessly for some hours; he was now unwilling to allow them to take part in the delicate surgery that she required.

My friend has now been told that her surgery has been rescheduled to a date in January (life-or-death cases permitting) giving her some more weeks to fret over its outcome.

How can a big city hospital’s surgical service be derailed by the arrival of a single emergency case, leaving a woman’s life in the balance and an already nervous family to ponder her fate? Compare that with my treatment at a large but rural hospital – on the Scottish side of the border, incidentally – serving a wide catchment area where I was once again treated royally.

On a day when the Queen’s Speech pledged increases in NHS spending which seem largely obligatory – and no better than Theresa May’s pledge of two Queen’s Speeches past without allowing for inflation –  and the head of the Nuffield Trust comments that the increases are unlikely to make a dent in the critical need for 40,000 more nurses the government is still playing fast and loose with figures at the expense of the nation’s health.

Either that or this government – like Trump’s America – believes that only wealth can safeguard health.

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