Do not cry for us: But do something to fix the NHS

Rajan Madhok

You would not wish it on your worst enemy, let alone your friends or fellow human beings. Yet, it goes on, and it is ‘normal’. Let me explain.

I took my friend for an urgent CT scan to the local hospital on 29 Sep where the radiologist found something which required immediate assessment and asked us to take him to the A & E department (around 4 pm) since the radiologist could not send him to the medical team, or better yet the oncology team, given the underlying problem of cancer.

Four hours later, the assessment was done and as predicted my friend needed admission and treatment from the medical team. And then the wait began; sat in a wheel chair, since he could not walk, in a crowded room, with a monitor showing around 2 hours wait and 108 patients when we arrived there – not correct since patients had been waiting for over 12 hours, and the numbers kept going up.

Knowing that he was being admitted, and had not come prepared for this development, I first went to the local Co-op to get some food for both of us- the vending machine had very limited offerings which were unhealthy and expensive anyway, and then went to his house – a 40 minutes’ drive each way, and brought back some essentials.

At midnight he had not been seen, and it took some sleuthing to ensure that he had been referred to the medical team, not an easy thing to find out, and after some ‘stalking and pleading of the harassed staff’ to ensure he was looked after, I came back home to get some sleep.

A & E

Unable to do so, I drove back to the A & E around 7 am next morning to find that he had just been assessed by the medical doctor, after sitting there overnight, and the doctor would come back in 20 minutes with an update.

After an hour I again went on the prowl trying to find someone to talk to, and hit the handover time – “we have just come on”, and then safety huddles, but managed to speak to someone, and long story short saw him to a cubicle, and a trolley bed, in the ‘Majors’ at 10am.

Oh, by the way he had been given the medicine for his immediate medical issue – one tablet, but when we pointed out that the doctor had said two tablets, the nurse initially dismissed it but then came back a few minutes later with another tablet.

On the positive side the CT scan was done on time and the radiologist acted promptly, the A & E assessment was also done efficiently- indeed both doctors were very good.

Again, on the positive side, next morning when my friend had finally got to the cubicle in the Majors, I had a meeting with the Matron, who was very professional, sympathetic, and honest and could not apologise enough for the failings in my friend’s care.

But there was nothing positive about the rest of our experience, and to explain this further here is some background.

My friend had lost his wife last month due to cancer, and her care had been not been satisfactory (another horror story, she suffered a Never Event as well, but for another time, as has been his story that led to the urgent CT scan), and he himself had just been told that he had advanced stage cancer.

Counselling

At a time when he should have been given counselling to take in this news, he was sent to A & E, to sit in an uncomfortable chair all night, mostly alone (since I could not stay all night).

His loving children, who lived some distance away, were working and had already spent quite some time with their ailing mother, and that is where I (and other neighbours) was stepping in to help, just as he and his late wife used to do in the neighbourhood.

Except, I had also just lost my partner, and was on my own. Friends were telling us to take our time, to grieve our losses, and praying for strength for us to bear them.

For sure we needed the strength, not just physical – both of us are not young, but mentally to cope with the A & E. And not just for our experience but to see all the other patients in the crammed department, many sitting/lying on floors, a situation which was inhuman and cruel, as staff, when they were seen, were oblivious to this scene.

Patients and their attendants, those who had them, were trying to comfort and help others, and the only sign of humanity I saw from a staff member (maybe there were others) was the next morning when I saw a man, official looking, who as he was walking through the entry door to the assessment area, looked at the old man lying on the floor there, gave a nod of his head, and five minutes later two staff came to talk to the man on the floor.

I do not know how many senior managers or politicians have ever spent time in the A & E, but I challenge anyone who has done so, and tell me that what was happening was acceptable – that we are a civilised society and not a Third World country (By the way, another patient in the department commented that the so called Third World is in many ways better), and we should celebrate and be grateful for the NHS. And if they have not spent a night in an A & E observing, why not?

Distressed

Can you see this scene, two old men, an Indian and a White, united across all divides by common humanity, grieving for their personal losses, surrounded by other distressed patients, lying on floors sometimes, in a crammed department, waiting and waiting? Indulge me, try it, close your eyes, and imagine the scene. And how do you feel? If this (and such stories, as I am aware that our experience is not unique) do not move you then you must look into yourself and ask whether you have a heart, and if they do not move you and you are in a position to do something about and do not do it, then ask yourself how you can live with it.

Worst of all, this was avoidable – he could have been sent home with the two tablets and asked to see the right specialist next morning. Just the kind of thing that the Matron wants to see happen.

This experience has been more upsetting because I had previously highlighted these problems last year, and my friend Julie whose story I had shared had then spent months trying to help, engaging with the leaders at the Health Board, the National Team and the politicians, without any success. And to top it all, the Matron was clear that the service was not acceptable, and things were the way they were because no one was taking responsibility to sort them out – “it is a broken system, we know what needs to be done, but it is not being done.”

Shortcomings

Why am I writing about it? Afterall, since last year I have written many articles, tried to engage with the system leaders and politicians. I have not just pointed out shortcomings I have complemented when the service was good, and most importantly I, and my friends, have offered to help, but all to little avail. Instead, I am told (talked at) about major reports, working parties, new leadership, more funding, and nowadays with a looming election, political sloganeering and peddling of the same old solutions; we are living in parallel universes, a world of politicians and management and another world of harassed staff and patients.  And never the twain shall meet? Well, they have not met yet, but maybe they will – or rather I hope they do. Especially as we head into another winter.

I write because that is all I can do now, and that is what my partner, Helen, and Val, my friend’s partner, would have wanted us to do. Stories (can) matter.

Do not cry for us – though my friend and I are grateful for the support we are getting, but try and do something, whatever and how small, to restore some basic human values, compassion, kindness, and empathy, and create a better NHS.

Rajan Madhok is a retired Public Health Doctor.

This article is written in my personal capacity. More details of my work are available at www.ramareflections.com

NOTE: I have taken the permission of my friends for sharing their experiences and had informed the Matron that I will be writing this article, and am sorry if this causes a problem for her. As far as I am concerned, she, and some others I have come across, should be given medals. Since last year I have relied on (and am grateful to) Nation Cymru to disseminate my messages, as I found that trying to work directly with system leaders and politicians does not work.