One thing I haven't done before is blog directly about my individual experiences. I don't like to give too much extra credibility to something purely because "I was there". You don't see much of the world just through your own eyes.
But my two week hospital stay courtesy of the NHS gave me a little view on Britain as seen from one of its most contentious institutions.
I entered hospital for the first time as an adult because a GP who had never seen me before said "I didn't look well", correctly ignoring my flu like symptoms. 72 hours later I was waking from a life saving operation. Along with the various tubes attached to me, I was wheeled back to my ward to start recovering.
As a patient, your bed is an island within the sea of chaos that is the hospital ward. Nurses maintain a vigil, day and night, checking your vital signs as well as dispensing pain relief. Orderlies support the nurses with the more physical duties like giving a patient a shave. Porters steam in, pick up patients and steam off to get an x-ray. Cleaners float about scrubbing and mopping any exposed surface. Junior doctors follow senior consultants like ducklings as they do their rounds. Phlebs surface from the depths and take more blood. Food and refreshments arrive on a large trolley. And all this happens with no apparent orchestration.
The sense of hierarchy and purpose in a hospital feels timeless. I suspect Florence Nightingale would be quite at home on a ward today. But because everyone is always needed, there is no obvious tension between the staff roles. For instance, with the fear of MRSA, a cleaner is not seen as lowly - rather a vital defender of holy cleanliness. Everyone scrupulously cleans their hands coming in and out of a ward.
The ethnic mix working in this outer London hospital is familiar and updated. The bulk of nurses are Irish and Caribbean, with a good few Filipinos and the occasional Australian accent. The junior doctors are mainly Asian - Indian or Chinese. (There are too few consultants to make any type of generalisation.) Orderlies and Porters are often East European. Indigenous Brits seem most evident in support medical staff - physios, councillors, admin etc. This is just a rough sketch of course; I asked one junior doctor where she came from, and she replied Mauritius. It could be that a flood of immigrants have rushed to take all available NHS work - but the truth is almost certainly that well off Brits just don't see themselves working long term in the caring profession.
This mix of backgrounds encourages a functional spoken English, free from the bureaucratic corpspeak found in most NHS written communication. Yes, there are the obvious cultural nuances that can clearly cause problems. For example, there is no point asking the older generation of British men if they are "ok" - they will demurely respond with a polite "yes, thank you". Even if they are in fact about to expire.
The octogenarian opposite me was told that he could go home the next day. During a care worker interview he made it clear he had no regular help, but blithely stated he would be fine. But I knew he frequently forgot where and when he was, and had difficulty getting to the chair next to his bed without assistance. Fortunately a second set of care workers were more assiduous and delayed his release.
The food really wasn't that bad - it naturally has to be biased towards being appetizing to the largest audience. This probably edges out healthier, but less familiar food. It is true that there seems little observation as to whether a patient is eating or not.
One of the bigger questions facing the NHS is how it can successfully accept IT. Something in the DNA of the service makes it immune to government initiatives, especially the
large ambitious sort.
I was certainly asked the exact same questions by different staff about
six or seven times. Even taking into account that asking questions is
often a ploy to check the patients state of mind, it became obvious that
data once given was
not necessarily recorded. My immediate thoughts were "give everyone a bloody iPad".
A week or so after leaving, I was back, waiting for an outpatient appointment. I saw a man pushing a trolley full of fraying yellow folders, each stuffed with patient records - usually hand written notes. The trolley was being pushed around to distribute these patient files. It is hard to imagine such a disrespect for information.
Actually, I didn't have to imagine. Sitting behind his desk, my appointed doctor noticed that the folder with my name on the cover actually contained someone else's files. He said to the nurse "this isn't good". No sir, it was not. The correct folder was found ten minutes later - but the appointment was cancelled anyway because there was no report available for a scan I had only taken the day before.
So, hurrah for the NHS. There is no doubt that the system that brought together a set of professionals with minimal information on a Sunday in order to operate on me definitely works. It probably does not work in a way that a management consultant would appreciate, but a little like many institutions, it works around it's own shortcomings. When we decide what modern Britain should look like, perhaps it can be coaxed to fit in.
But if you do find yourself having to stay for a couple of weeks in hospital, I have only one bit of advice - bring a Kindle.