“Can’t you at least get my mum a bloody pillow? Is even that too much to ask?” I shuffled awkwardly in my hospital scrubs, cheeks burning with shame. Because in this supposed centre of hospital excellence, in the world’s sixth richest country, I knew that pillows were like gold dust and – just like the non-existent beds in the A&E where I worked – there were absolutely none to be found. My patient, 86-year-old Mavis, lay curled into a ball, hands hiding her face, under a thin cotton sheet on a trolley. Beneath the strip lights in the open corridor, she looked frail and insubstantial. Amid all the drunks, the clamour, the abuse, the shrieking of A&E on a Friday night, we couldn’t even offer a screen to protect her basic dignity.
This is the human cost of a “trolley wait”. A cowering, fearful octogenarian whose distress and bewilderment would shame anyone who saw it. And right now, all over England, more grandmothers and grandfathers are languishing on trolleys in corridors because, statistically, it is our elders who most often need hospital care.
Was it any wonder that her daughter was livid? Would you want your loved one fully exposed to A&E carnage at their most vulnerable moments in hospital? I apologised profusely, attempted to coax my patient out from her cheap cotton sheets, and wondered for the thousandth time how a country that can afford a £42bn new train track could simultaneously subject its most vulnerable citizens to such abject inhumanity.
Mavis was comparatively lucky. She didn’t die on her trolley and made it – eventually – to a ward. But last week, we discovered that in the first few days of 2017, NHS patients were stranded for so long on trolleys in corridors they did indeed end up dying there, one from a heart attack and another from bleeding. And those are only the confirmed cases.
The responses from on high could not have been more different. Mike Adamson, the chief executive of the British Red Cross, condemned current conditions in NHS hospitals as a “humanitarian crisis”. Yet the Secretary of State for Health, Jeremy Hunt, roundly dismissed that description, claiming that only “one or two” hospitals were in trouble, with the “vast majority” actually coping better this winter.
The trouble for Hunt is that the statistics say wholly otherwise. Vast numbers of NHS patients – more than 18,000 of them last week alone – endured trolley waits of over four hours; 485 patients waited more than 12 hours, treble the number seen during the whole of January last year. First-hand testimony from frontline doctors backs up the scale of the crisis, depicting almost unimaginable conditions of squalor and indignity up and down the country. “It’s an absolute war zone” said one junior doctor, “completely out of control” said another. Hunt’s denial of frontline reality has left doctors like me feeling utterly terrified for our patients. Two deaths on trolleys are two too many. Just how many more are required before the Government acts?
We have been here once before. But after the horrors of Mid-Staffs, where thousands of patients were subjected to untold cruelty, the Government promised that never again in the NHS would finances be put before safety. Hunt condemned the “times when it might feel easier to conceal mistakes, to deny that things have gone wrong and to slide into postures of institutional defensiveness”, vowing instead to foster “a climate of openness, where staff are supported to do the right thing and where we put people first at all times.”
So why, at this time of crisis for NHS patients, has the Government spin machine cranked into overdrive, denying the seriousness of doctors’ concerns and promising the public that all is well? That is the precise opposite of what the nation was promised.
Everyone who works in the NHS has a duty of candour, and no Health Secretary should be exempt from that. If Hunt really cares about patients, then when frontline staff are clamouring to warn of crisis conditions that we know are costing lives, he owes it to patients to listen.
The more he downplays, dismisses and denies, the greater our fears of another Mid-Staffs – only this one is being played out nationwide.
Rachel Clarke is a junior doctor in Oxford. All patient names have been changed
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