Bedlam, Charity and the NHS

Recently I was unfortunate enough to have to use the emergency services after an accident.  Let me say at the outset, that I am very grateful for the NHS and all that it attempts to achieve.  However, my experience was nothing short of horrific.

Indeed, I am so shocked at how chaotic the hospital system works I am driven to avoid any further contact with my local health board hospitals if at all possible, and this includes life and death situations. ‘Desperate claims’ you might say.  Well, they maybe desperate but believe me that is precisely the way I feel.

There has to be a better way.  Firstly, hospitals must be run more efficiently.  It is apparent that the institution where I was admitted is not.  Why do I say this? Basically because my treatment/diagnosis  from accident to admission took eleven hours when it could and should have taken no more than two hours.  If only a proportion of patients were treated in a timely manner with a view to getting them back on the street it would make an enormous difference.  If however the charitable instinct dominate then there will remain a drive to care even when it is not strictly the need. The consequence will be to add to the overcapacity crisis. In any enterprise there must be some objective definition of corporate goals.  In the NHS it is too broadly set as ‘free care for all’ even the word ‘necessary’ would help, with all the attendant issues of definition that are implied.

The aim must surely be to define the service more clearly. Whilst recognising the ideals of the original concept we have to realise that we cannot exponentially increase care.  There have to be limits.  The NHS cannot succeed trying to be the carer for the whole of British society.  All these lovely employees dashing around doing their best to achieve unachievable goals has to be modified.  Not letting people in to hospital is just as important as getting them out of hospital.

Everyone I’m sure is aware of the issues of the National Health Service; the pressure of exponential demand and of course hapless social care support.  This means that a high percentage of beds are unavoidably blocked unless there is a fundamental change of budget planning at national level.  The prospects of the integration of health and social care is abominably complex especially if the NHS continues as a gargantuan national enterprise. The prospect of it getting even more massive is very challenging and maybe someone at Government or  parliamentary level ought to start thinking more radically and not exclude the idea of regional or even sub regional organisation (s).

Back to our city hospital.  My impression was that the system is not ‘joined up’.  I mean by that there is no discernible system at work. It is as if those who are in charge have surrendered to ‘what is, must be’ system.  An entirely reactionary system which responds without structure or organisation.  One can easily see that this comes about because of idealism rather than practicality. I.e. ‘we must be flexible and ready for anything’ an attitude which lets us become undisciplined and unfocussed.  In turn this leads to counterproductive mini groups who see themselves as the pivotal centre of necessity.

These, so called, teams become more inward looking than collegiate, fighting for their own mini kingdoms rather than looking after the efficient running of the institution as a whole.  Clearly there are issues of life and death, challenges and choices of the gravest nature.  Under these stresses, it is imperative that the institution as a whole runs much more efficiently.

Add to this, the sheer chaos of night time where bedlam is nearer the reality than we would be ready to admit.  The simple idea of peace and quiet has long been lost to the idea that ‘respond at all costs, and ‘what is, must be’ attitudes.  The night staff have an often impossible task of integrating disturbed mental health patients, restraining screaming drunks and drug addicts, as against managing the rest and quiet reqired by those recovering from injury or surgery.   Quiet places and not so quiet places and the management thereof, should not be beyond the wit of man or manager. No one is saying this is easy, buildings are often ancient and inappropriate  but these issues can be managed more effectively.

Despite my cynicism, I know there is much to be cherished about the NHS, but please, please, will someone understand that this is not some charity run by volunteers but a national enterprise run for the benefit of all patients.  Let’s not pass the buck, yes, there are huge problems but at least manage the manageable and give our much vaunted NHS the chance it deserves.

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