Tag Archives: hospital

The NHS revisited

I eulogised recently about the almost impossibly good treatment of my Dad at the Royal Surrey hospital in Guildford.

Over 10 days – initially in A&E and then in a surgical ward – the care and attention lavished on his ailing 87 year old body was remarkable.

But, in view of the explosive population growth – through a combination of increased longevity and net migration – is the NHS sustainable in its current form?

I experienced A&E myself yesterday, at first hand. Well, middle finger.

I managed to slice open a large flap of skin over the knuckle of the third finger on my right hand, courtesy of a shattering cafetiere resisting being wiped up. Feisty things, these coffee making gizmos.

My first instinct was to avoid going to A&E if at all possible, not wanting to waste their valuable resources on a minor domestic injury.

Actually, that’s not true. Before doing anything else I had to enjoy  my freshly baked bread, the crust of which was still warm and oozing with butter, and just crying out for its strong cheddar cheese partner.

A man’s stomach waits for no one. The blood gushing from my wound was temporarily addressed by a rustic dressing of a couple of absorbent sheets ripped from the kitchen roll dispenser.

At 1 pm, I called 111, the NHS non-emergency number, hoping I’d be sent to the GP’s surgery rather than A&E.  15 minutes later, after a thorough series of questions and assessment,  I was sent to A&E.

It was 2:30 by the time I registered with the 3 A&E receptionists. I’d parked at the distant Tesco’s, as the usual Orwellian scenario was unfolding at the vast hospital car park. And I’d stocked up on coffee and a newspaper, in anticipation of the inevitably tortuous afternoon ahead.

“It’s a quiet day, you should only have to wait 30 minutes to be seen.”


“That’s just for the initial assessment.”


Sure enough, I was seeing the triage nurse not much after 3.

“Fingers crossed” – ho ho – “we can get away with sticking a steri-strip on this. Less restricting than stitches”.


All cleaned up and sent back to the A&E waiting room, always an interesting study of humanity.

It was close to 4 by the time I was called through to see a young A&E doctor.

I explained again what had happened.

“Has this been cleaned up?”.

“Yes. And the nurse thinks a steri-strip might be enough. And better than stitches?”

“Hold on. I need to speak with the Consultant.”

5 minutes.

“I think I’ll glue it. But let’s have an X-Ray first, to make sure there’s no glass left in there.”

A 20 minute wait outside the X-Ray cubicles.

15 minutes inside the X-Ray theatre, taking a couple of artfully posed snaps of my offending digit.

Back to the always entertaining A&E waiting room, elevating my wounded finger like an assiduous schoolboy attracting teacher’s attention.

Finally called back to see the young doctor at what must by then have been after 5 pm.

“OK. Good news. No glass in the wound.”


“But let me check something with the Consultant.”


5 minutes listening to my case being discussed on the other side of the curtain.

The Consultant and the young medic return.

“I think that needs a couple of stitches, I’m afraid. Better than gluing.”


I got to know the lovely young doctor as she whacked some local anaesthetic – 4 separate, painful pricks – into the bony top of the finger. She’s hoping to do a year out, in an Australian hospital, before returning to focus on a surgical career back in the UK.

We talked books, as I’d asked the Consultant if it would be ok to have a pint at tonight’s book club meeting in the pub.

After 2 stitches – “I’m a perfectionist” – she called the Consultant back in. The wound was still bleeding – quite a lot – and she didn’t want to sew it up prematurely.

“Squeeze it out, and ask him to elevate the wound before closing up.”

1 final stitch. Bit more chat. Done.

Sent away with a pretty rustic dressing, and a couple of spares, told to keep it dry for 7 days and get the stitches taken out at the GP’s surgery.

Finally home at around 6:30, after a cheeky cappuccino at the hospital’s insanely busy Costa outlet, waiting for some feeling to return to my poor finger before driving home.

Again, what remarkable service. But does it really have to take all that time getting processed through A&E, with highly trained resources who somehow don’t communicate as efficiently as everybody would in any commercial organisation?

I’m incredibly grateful for the thoroughness and professionalism of all the staff, but I ask again….is the NHS sustainable in its current form, free at the point of entry?

I fear not.

By the way, I had a couple of pints at the Olde Ship Inn as we discussed the heart-rending novel The Narrow Road to the Deep North.  For medicinal purposes.






I’ve just experienced an unexpected and intensive 10 days of exposure to some of the inner workings of our remarkable National Health System.

My poor Dad was rushed in, via ambulance, to A&E at the Royal Surrey Hospital late one night and moved through the system thereafter, from A&E to the EAU (Emergency Assessment Unit) and then to the Frensham surgical ward.

We visited every day, and became immersed in the medical processes and jargon, as well as the infrastructure surrounding what is akin to a small city.

We got used to the nuances of the parking options, the Costa coffee queues, M&S snacks and the vagaries of the creaking lifts. We made sure we smothered our secular hands in the anti-bug gel dispensers. We filled out endless menu choices for a disinterested patient. We harassed the nursing staff for updates. We listened to medical advice on Dad’s changing diagnosis. We hoped. We prayed.

With my loving son’s hat on, words can’t adequately describe my gratitude for the care and attention given by everyone at the Royal Surrey. From the paramedics in the ambulance, to the nurses and doctors in A&E and the EAU, to everyone on the ward – the tea-trolley wheeler, the pharmacists, the endlessly patient nursing staff, the young doctors, the consultants, the surgeons, the nutritionists – we thank you all.

But with my ex bean-counter’s hat on, it’s hard to see how a system this professional, caring and so committed to the perfect solution for everyone – free at the point of service – can be sustainable.

Net migration is now running well in excess of 300k every year. The average life expectancy was around 60-65 in the 1940s and 1950s, when the Beveridge Report formed the basis for the current NHS. Today’s average lifespan is closer to 80, and is expected to be close to 90 by 2030.

I don’t know what the solution is, other than forcing those who can afford it to pay for some medical treatment, in order to ensure that it continues to be free for those less well off.

(cartoon courtesy of Gary Barker)

But I do suspect that the current system – and more importantly, its staff – will inevitably buckle with fatigue and stress, if we expect them to continue to provide this level of care and commitment for an ever-increasing and ever-ageing population.

(cartoon by Graham)

In the meantime Dad is back home, with more drugs to get through every day than Amy Winehouse managed in a year, and a series of follow-up appointments to look forward to.

But without the NHS, he would probably have left us many years ago.

Welcome home, Dad. And thank you to Mr Beveridge and the NHS.