Jeremy Laurance: My niece had world-class emergency care – but now what?

Medical Life

Friday 18 September, a warm, dry afternoon and a motorcyclist is cruising down the M3 at 70mph. Her name is Cathy, she is wearing a full-face helmet and expensive black leathers and she happens to be my niece. Then – bam – a car slams into her from behind and she is tumbling and rolling down the tarmac at 65mph. Seconds later she comes to rest against the central reservation and her bike slides in neatly beside her.

The first motorists on the scene ask what they can do. Cathy, fully conscious, takes charge. She has lost her gloves, her hands are covered in blood and her right leg is twisted under her. "Move that leg," she commands, an act which, she learns later, may have saved it from amputation by restoring the circulation.

Next, paramedics are taking scissors to her leathers – they need access to her chest in case she goes into cardiac arrest – and a helicopter is circling overhead. An argument ensues – the police are refusing to close the motorway because it's rush-hour. The emergency doctor lets them have it – and wins. The traffic stops, the helicopter lands and Cathy is scooped up. The doctor briefs the paramedics on how to lift her over the central reservation and slide her into the helicopter. "Don't go near that propeller or it will be very messy," he orders. The rescue is immaculate. Just before they arrive at Basingstoke A&E, she is briefed. "This will be overwhelming, there will be dozens of people waiting to help you. Be prepared." What a wonderful institution is the NHS.

Two weeks later, two major operations down and at least one to go, she is discharged from hospital. The medical care up to this point has been the equal of any in the world. But now her problems begin. She cannot go home because she and her partner happen to have the builders in and the place is uninhabitable. She stays with a friend three miles away – but this is outside her local GP's area. She needs transport to get to an outpatient appointment and, critically, she needs physiotherapy on her damaged hand and badly broken thumb. She cannot get either. As a design and technology teacher, she is more worried about her thumb than her leg. She says: "I can hobble around but if I can't hold a piece of wood, how will I work?" What a bureaucratic, inflexible, frustrating institution is the NHS.

I listened to her story on Saturday as she lay in the front room of her house – she is back home now – her leg strapped into a heavy metal brace, while outside in the fading light chattering pedestrians passed the window. It reminded me of a remark a senior doctor made to me years ago about the NHS. That the care it delivers is mostly first class – but too often there is a catch somewhere along the line. A small problem – a lack of physiotherapy – can negate all the good care, the world-beating surgery, already delivered. And destroy a young woman's dreams.

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