OPINION
July 31st 2023
In one of my previous letters, I made passing references to the UK NHS system.
It is difficult to believe some of the happenings that occur in the NHS. One has to be careful criticising the NHS in the UK as it has achieved the status of being a national religion and has to be worshipped. If the truth be known, it is a shambolic, bureaucratic mess. Indeed, I asked the classical question beloved by all Marketing Professors “who is your customer?” Unsurprisingly this was met with quizzical looks from both management and clinical staff.
The way the NHS is structured it is in effect its own customer. Everything is focused on meeting the bureaucratic requirements of the NHS in a circular self-satisfying action. Max Weber would be proud.
Drilling down to details of what happens in the NHS, it is typified by the below picture.
In a 6-bed side ward, pressure on beds is so intense they have to squeeze an extra one in. It has no privacy, no screens, limited space for personal items and difficult access for support equipment. Most important of all, it is blocking access to the fire exit! They have obviously learnt from hot bedding as practised in the navy as discharge involves being told that the bed is needed, go to the day room and we will prepare the discharge notes.
There were tales from the unit of cannulae not being flushed for 48 hours and the ward running out of dispersible aspirin.
The NHS is now afflicted with regular strikes from nursing staff. Junior doctors have now initiated strike action this week they are scheduled to strike for 5 days. A junior doctor includes house doctors and registrars, anyone in fact below consultant grade. Even the consultants are now striking. It is difficult to escape the feeling that these strikes are coordinated and politically motivated.
To move on from the dangerous to the ridiculous, the picture below depicts the intrusion by Fallow deer into the neo-natal unit of Derriford Hospital in Plymouth. They were male deer, so it definitely wasn’t an emergency. Seriously though, the whole unit had to undergo deep cleaning.
One of the major issues with the NHS is the presence of bed blockers when the patient should have been transferred to residential care. There are reported cases in the West Country of patients being discharged by ambulance into care homes 35+ miles away. On arrival at the care home, the ambulance crew discovered that the meds hadn’t been sent so the hospital paid for a taxi to take the meds to the home, at a cost of £100+. This is not a one-off.
Then there are cases of the patient arriving at the home without discharge notes and having to be returned to the hospital.
If timed to emphasise the sorry state of the NHS, my little town had a blanket mail shot this week from a private hospital in Plymouth offering surgery at bargain rates. They have a full knee replacement for £12,000 and will even arrange finance over two years if needed. They quote assessment appointments within a few days and then surgery within 4 to 6 weeks. The NHS currently quote the first appointment with an orthopaedic consultant as being 31 weeks after a referral from a GP, with surgery being 18 to 24 months after the consultation with the consultant. If the knee is so bad that it stops the patient from working, then the private operation becomes a very attractive option if it will put the patient back into the workforce.
I could go on about many more instances of incompetence and bureaucratic stupidity, but it would just depress everyone.
In a change of subject, I see that according to scientists in the UK we have just endured the hottest global temperature ever. This puzzles me. Where did they stick the thermometer to measure this? If it was a rectal thermometer my thoughts are that it would have been taken in Wellington, somewhere near the Beehive.