Wait and bleed

One aspect of our fine kingdom that endlessly fascinates me is our National Health Service. Established after World War II, it originally aimed to provide basic (if universal) healthcare, but today, it has grown into the world’s fourth-largest direct employer. In the first full year of its operation, the Government spent £11.4bn on health in the UK (including vast one-off setup costs), whereas last year, it spent £126 billion on an already-established infrastructure. We spend almost as much on the NHS as we do on pensions, and far more than we do on education, yet the health service is constantly being described as under-funded. It has become all-consuming, a ravenous monster that swallows as much money as we can shovel at it, and this poses a simple question – why are our Accident and Emergency wards such shambolic places?

The other day, my dearly beloved managed to twist her ankle. When she tried to stand up, the pain was so severe that she passed out, collapsing face-first onto a metal staircase. Cue an anguished 999 call, a hastily-dispatched ambulance and a race to the A&E ward of our local hospital. So far, so good. Except, once she’d been checked in, she was then left on a hospital trolley, concussed and bleeding from an open wound, for a full three hours before anyone bothered to see her or administer treatment.

Why? There were plenty of (presumably junior) nursing staff, milling around the individual bays that surrounded a central observation desk. The desk itself was piled high with idle computers and flat-screen monitors that endlessly played screensavers. There was, as there always is in hospital, someone incessantly walking back and forth holding a bundle of papers whilst actually doing nothing. Nobody was in a hurry and some of those bays were clearly empty. And yet hours rolled by without a doctor or consultant bothering to inspect someone who had already confirmed her necessity for treatment by being completely unable to walk, arriving in an ambulance, vomiting repeatedly in response to concussion and shock, and bleeding from an open wound for hour after agonising hour.

As a distraught observer, it’s hard to describe the impotent fury you feel in such a situation, although anyone who’s ever experienced a British A&E ward will probably know exactly what I mean. I certainly did, even before this event. Over the last five years, my average visit to A&E has lasted four hours. Once, disgusted at the advertised five-hour waiting time, I simply went home, returning at 5.30am the next morning. Even though there was only one person in the waiting area when I arrived, and three when I left, it still took three and a half hours for me to be seen. On another occasion, having been endlessly passed from one department to another, I abandoned my hard plastic chair and walked out, deciding I could not possibly be worse off in my own bed at home than I was in the supposed sanctuary of a hospital, watching drunks fight and toddlers screaming. Friends tell despairingly of interminable waits with the sick children who supposedly get to queue-jump, while the total absence of comfort, entertainment or basic information updates has driven even patient people to that impotent fury I mentioned a moment ago.

I know the swollen ranks of NHS defenders will be cracking their knuckles here, as they prepare to unleash a tirade of the vitriolic abuse I mentioned in my last post, so let me spike your guns and save you the bother by saying that I have never met an incompetent NHS employee. I’ve known and socialised with many health service staff in my lifetime, from paediatricians and cardiologists to porters and counsellors. Each has been a conscientious and kindly individual, motivated by the desire to help the sick, and they’ve usually been as frustrated by the NHS’s frontline failings as I am.

If you’re in labour, or battling cancer, or in need of expensive medication, the NHS can be almost literally miraculous, and it’s lauded around the world as a pinnacle of how a state should protect the health of its population. I should also point out that the ambulance team on Sunday were brilliant, the consultant who eventually arrived was calm and efficient, and the nurses we saw on our arrival were model professionals. So, back to my original question. If we can get so much of the NHS right, why is its accident and emergency heartland such a consistently inefficient, laborious, frustrating shambles?