Part 5(A): In Sickness & In Health; Until Death Us Do Part

London’s NHS: A Personal Experience - Max gets uncharacteristically verbose on a hot topic, in the run-up to the UK General Election

I recently got up close & personal with the current state of the National Health Service. Something most of us would normally prefer not to have to do. At least it provided an excuse for me to look at another aspect of London life, for you.

A rogue set of step ladders derailed me - and all my best-laid plans – by giving an unexpected, but very passable, impression of a bucking bronco, whilst I was about 4 feet up in the air, treating a garden fence. The result? “A non-displaced (pretty much the only 'good' piece of news) spiral fracture to the neck of the right foot’s 5th metatarsal”. No weight-bearing for 4-6 weeks. Brilliant! I would just have to face up to the consequences; like a man.

Since 9th December 2013, those consequences have become more complicated than previously. That's the date, etched in local infamy, when my local hospital's 24-hour A&E department was closed, to be replaced by a 12-hour Urgent Care unit. Even basic maths suggests it's only going to be half as good. The background to that change involves Tory politics, deceit, bullying (or am I just repeating myself?) and more besides. From 2004, the local constituency's prospective Conservative parliamentary candidate, Nick De Bois, led the “Hands Off Our Hospital” campaign, against proposed Blair-Brown Labour changes to services at Chase Farm Hospital. Under those proposals, our local hospital would be decimated, in order to fund the provision of better services at the two nearest other major hospital sites: Barnet and North Middlesex. The proposed cuts were a key local issue at the 2010 general election, and a contributing factor to why 'White-Knight' De Bois won the local seat, based upon his opposition. He even brought David Cameron along; who made a personal pledge to keep our A&E open. Hooray! Of course, we've all found out since then how little a personal David Cameron promise is actually worth. After their election victory, all the proposed, swingeing service cuts were then implemented, anyway - by the Tories. Was anybody really surprised? Not only was A&E axed; but so was the Maternity unit and other services. Enfield's pregnant women apparently enjoy spending an extra half hour stuck in North London's snarled-up traffic, to go several miles further away from their homes, friends and families. [Chase Farm Hospital, incidentally, isn't famous for very much; but its A&E did help save many lives after the carnage of the Potters Bar train crash - and its maternity services did give us Amy Jade Winehouse, back in September, 1983.]

The stated intention of these deceitfully-implemented cuts was “to maximise clinical effectiveness, given limited human and financial resources”. That's right: to reduce services, so as to improve them - and no, we locals weren't convinced by that argument, either. The cuts were also predicated on substantial incremental investment in local community health provision; which, of course, never materialised. One could go on at length on the subject; there's the astonishing story, for instance, of David Burrowes, Mr. De Bois’s Tory MP colleague, from next-door constituency, Enfield South. Burrowes hit the local headlines when he had the misfortune of spending many hours on a trolley, in a corridor, at the supposedly vastly-improved North Middlesex A&E, without pain-killers, whilst crippled with a bout of appendicitis. That A&E unit has since "been threatened with closure on safety grounds … the first time in the NHS’s history, amid fears that its 500 patients a day are at “serious risk” of suffering harm ... what one local MP described as 'a catalogue of failings'.” I think I can guess which “local MP”. And this, apparently, was the improved level of care for which my own local A&E department had been undemocratically and dishonestly sacrificed?(https://www.theguardian.com/society/2016/jun/14/north-middlesex-hospital-ae-faces-closure-on-safety-grounds). 

Local protests ensured the quality of local services were maintained - NOT!

In addition to such structural turmoil and failure, the NHS has found itself increasingly privatising its services out to the for-profit/corporate greed sector; and, of course, has recently been caught out in a massive, ransom-ware-driven IT mismanagement scandal. It was against THIS backdrop that I picked myself up, dusted myself off and started out for my first ever visit to Chase Farm’s "Urgent Care" (sic!) unit; limping along with aid of an old hiker’s stick. Having had the Lady Bracknell-esque "misfortune"* of breaking a metatarsal in my other foot four years earlier, almost to the day, I had a fairly good idea of the prognosis awaiting me, any way.

After about an hour of very uncomfortable waiting, I finally saw a nurse - for about 60 seconds. Though not before I’d also walked several hundred yards on my broken foot, to the most distant possible consultation room; through a veritable warren of doors and corridors. At one point, said nurse retraced their footsteps to check where the heck I had got to – and gave me ‘the eyebrow’. Clearly I wasn’t sprinting along fast enough behind them, on my broken foot. Those 60 seconds of nurse consultation were, you'll already have guessed, enough to confirm that an X-ray was required. After a further 30 minutes or so waiting for the radiography technician to turn up, a few minutes of X-raying was also enough to confirm the presence of a fracture. To break a second metatarsal in four years begins to "look like carelessness"*. Finally, after a brief additional wait, a few minutes in the plaster room were sufficient to equip me with a pair of crutches, a padded boot and a leaflet explaining the new “virtual fracture clinic” procedure; and I was out just in time for staff to start closing up the unit behind me. So, that was roughly two hours in Urgent Care for just a few minutes of contact time; which felt neither very Urgent, nor very Caring. And while I realise one can easily wait far longer than this to be seen in a 'proper' A&E department, in the absence of any emergency ambulance arrivals, there's a very strict (and very slow) take-your-turn system in operation in 'Urgent Care'. To the 'layman', it's very clear that something is not at all right in the processes that manage and dictate our interaction with our NHS; the principles of which most of us support heartily - and for which we have all paid royally. Yes, something appears to have gone very wrong indeed.

That Tory Manifesto Pledge, in Full

I reviewed the leaflet I'd been given. Apparently, if 'virtual' fracture experts decided circumstances required it, I would have to get myself along to the North Middlesex (errrm, no thanks! - see above) or Barnet Hospital Fracture Clinic, "within 3-5 days". Oh yes; that’s right. Did I not mention this? Along with our A&E service, Enfield has also, rather carelessly, lost its Fracture Clinic facility. A schoolboy error, surely - and one with obvious transport and access implications!

To Be Continued ...

Let's talk about this again here soon.

Your Addicted London Buddy,

Max ("F-H-W")

Footnotes:

* from "The Importance of Being Earnest, A Trivial Comedy for Serious People" by Oscar Wilde. First performed 14th February, 1895 - St. Valentine's Day!