Andy McSmith: Flat on your back in a mixed ward, you see another side to the NHS

I have discovered a quick route into hospital. All you need to do is to ring up and say you're having chest pains.

Share
Related Topics

Last Monday night, I experienced a mildly uncomfortable stabbing sensation in the lower left rib-cage. When I woke and found the pain was still with me, I thought I had better make a doctor's appointment to have it diagnosed. I did not anticipate that, within an hour of making the call, I would be in the casualty ward of Lewisham hospital in south-east London, bearing a doctor's letter.

Over the next two days, I was penetrated with needles in arms and stomach, separated from a phial of blood which went off for a laboratory test, wired up to strange bits of equipment, put through a fitness test, until I emerged, dazed by the sunlight on Thursday morning, feeling a bit sheepish. All I had was a mild case of angina. I now hold a piece of paper which proves that I am not due for a heart attack for at least a year.

In autumn 1999, Alan Milburn, the new Secretary of State for Health, decided to ease up on Labour's silly election pledge about waiting lists, and told the NHS to put heart conditions at the top of its priorities, a decision which obviously had an effect on me.

It makes medical sense, because even people in their twenties can die of heart attacks. While I was wired up on the ward, my wife was at a dinner party where there was a guest who had had a triple heart by-pass at the age of 45. But like anything else to do with NHS, this sensible medical priority – for which I am deeply grateful – has its political side. Heart disease, like cancer, is an ailment from which middle-class people cannot escape, and the NHS desperately needs its middle-class customers.

It is easy to mock the immense bureaucracy necessary to run an organisation as big as the NHS. From my own brief experience, I do not think it is inefficient at the micro level, but if it was managed like Microsoft, I doubt whether the well-off could be persuaded to use it.

The basic organisational unit is the ward, and the three wards I saw were tightly run operations where every patient and every task is somebody's responsibility. The problems seem to begin when one ward must speak to another. I was dealt with quickly by casualty, but ceased to be their patient when assigned to the medical admissions ward.

Unfortunately, that was full, so for seven or eight hours I was nobody's responsibility, waiting, bored stiff, on a trolley until a houseman and a porter arrived to hold a rather bad-tempered conversation about whose fault it was that I was still there. Yet I was lucky, because a rowdy night in the pubs can push waiting times to 11 or 12 hours.

The following day, when I was settled in a ward, a doctor insisted I had my heart rate measured while I was on an exercise machine. The treadmill was somewhere else, and the rules did not allow me to walk to it. It had to be brought to me. So I was kept in for two nights when I should have been for only one, and for all I know, someone in a worse state was waiting for my bed.

I suspect the untold reason the well-off will always opt for private care is that in a public health service, hell is other patients. The service throws the self-sufficient and curable into the same room as the terminally ill.

In casualty, I spent hours beside an old man, certainly lonely and possibly with mental problems, and who had come in complaining of phlegm in his chest. The staff did not see this as an emergency, but could not bring themselves to turn him out. The result was a confrontation lasting hours. When food was served, he refused to eat but kept coughing to prove he was ill. Later, he wanted to urinate but refused to walk to the lavatory and stood by his trolley, demanding help. This drama was interrupted by another, when staff battled in vain to save the life of an 87-year-old-woman.

One night an elderly woman kept up a monotonous moan, accusing staff of maltreating her and claiming she was dying. A grumpy old man in a bed near mine rolled over and shouted: "Fucking well die then!", for which he was told off by the night sister. I should add that I came in close proximity to at least 40 patients, of whom there were about four who created trouble.

Labour has spent five years trying to prevent the flight of the middle-classes into private care, fearing the NHS will be left as a graveyard for the incurable. Government strategy is to make sure the public service is as well funded and efficient as any private hospital can be. But the NHS can never compete with private hospitals' freedom to hand-pick patients, and in our spoilt consumer culture, those who use money to shield themselves from life's unpleasantness when they are well will feel entitled to do the same when they are sick.

Maybe, instead of all those glossy photographs we see of smart, smiling nurses with happy patients, we need to be reminded more often that hospitals are places where there is sickness, sadness, suffering and death. They also alleviate pain and save lives.

Andy McSmith's novel 'Innocent in the House' is published by Verso at £7

React Now

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

Recruitment Genius: Bookkeeper / Office Co-ordinator

£9 per hour: Recruitment Genius: This role is based within a small family run ...

Recruitment Genius: Designer - Print & Digital

£28000 - £32000 per annum: Recruitment Genius: This Design and marketing agenc...

Recruitment Genius: Quantity Surveyor

£46000 per annum: Recruitment Genius: This property investment firm are lookin...

Recruitment Genius: Telesales / Telemarketing Executive - OTE £30k / £35k plus

£18000 - £35000 per annum: Recruitment Genius: This company specialises provid...

Day In a Page

Read Next
 

Errors & Omissions: When is a baroness not a baroness? Titles still cause confusion

Guy Keleny
 

CPAC 2015: What I learnt from the US — and what the US could learn from Ukip

Nigel Farage
War with Isis: Fears that the looming battle for Mosul will unleash 'a million refugees'

The battle for Mosul will unleash 'a million refugees'

Aid agencies prepare for vast exodus following planned Iraqi offensive against the Isis-held city, reports Patrick Cockburn
Yvette Cooper: We can't lose the election. There's too much on the line

Yvette Cooper: We can't lose the election. There's too much on the line

The shadow Home Secretary on fighting radical Islam, protecting children, and why anyone in Labour who's thinking beyond May must 'sort themselves out'
A bad week for the Greens: Leader Natalie Bennett's 'car crash' radio interview is followed by Brighton council's failure to set a budget due to infighting

It's not easy being Green

After a bad week in which its leader had a public meltdown and its only city council couldn't agree on a budget vote, what next for the alternative party? It's over to Caroline Lucas to find out
Gorillas nearly missed: BBC producers didn't want to broadcast Sir David Attenborough's famed Rwandan encounter

Gorillas nearly missed

BBC producers didn't want to broadcast Sir David Attenborough's famed Rwandan encounter
Downton Abbey effect sees impoverished Italian nobles inspired to open their doors to paying guests for up to €650 a night

The Downton Abbey effect

Impoverished Italian nobles are opening their doors to paying guests, inspired by the TV drama
China's wild panda numbers have increased by 17% since 2003, new census reveals

China's wild panda numbers on the up

New census reveals 17% since 2003
Barbara Woodward: Britain's first female ambassador to China intends to forge strong links with the growing economic superpower

Our woman in Beijing builds a new relationship

Britain's first female ambassador to China intends to forge strong links with growing economic power
Courage is rare. True humility is even rarer. But the only British soldier to be awarded the Victoria Cross in Afghanistan has both

Courage is rare. True humility is even rarer

Beware of imitations, but the words of the soldier awarded the Victoria Cross were the real thing, says DJ Taylor
Alexander McQueen: The catwalk was a stage for the designer's astonishing and troubling vision

Alexander McQueen's astonishing vision

Ahead of a major retrospective, Alexander Fury talks to the collaborators who helped create the late designer's notorious spectacle
New BBC series savours half a century of food in Britain, from Vesta curries to nouvelle cuisine

Dinner through the decades

A new BBC series challenged Brandon Robshaw and his family to eat their way from the 1950s to the 1990s
Philippa Perry interview: The psychotherapist on McDonald's, fancy specs and meeting Grayson Perry on an evening course

Philippa Perry interview

The psychotherapist on McDonald's, fancy specs and meeting Grayson Perry on an evening course
Bill Granger recipes: Our chef recreates the exoticism of the Indonesian stir-fry

Bill Granger's Indonesian stir-fry recipes

Our chef was inspired by the south-east Asian cuisine he encountered as a teenager
Chelsea vs Tottenham: Harry Kane was at Wembley to see Spurs beat the Blues and win the Capital One Cup - now he's their great hope

Harry Kane interview

The striker was at Wembley to see Spurs beat the Blues and win the Capital One Cup - now he's their great hope
The Last Word: For the good of the game: why on earth don’t we leave Fifa?

Michael Calvin's Last Word

For the good of the game: why on earth don’t we leave Fifa?
HIV pill: Scientists hail discovery of 'game-changer' that cuts the risk of infection among gay men by 86%

Scientists hail daily pill that protects against HIV infection

Breakthrough in battle against global scourge – but will the NHS pay for it?