Friday, 16 November 2007

Daily drip, drip, drip of uselessness

I realise this story may hardly compare with Maidstone and Tunbridge Wells NHS Trust's managing to kill 90 of its patients after infecting them Clostridium difficile. But it nonetheless seems to me a precise example of the daily drip, drip, drip of NHS incompetence. This is it.

My son, Theo, 14, broke his collarbone over the summer. It was a perfectly ordinary accident. He was playing with some chums and he fell over. We were in England at the time, in Kent, about 10 miles from Canterbury.

So, off to Canterbury hospital we went. I had vaguely heard, or so I thought, that the A&E department there had been downgraded, so I was accordingly reassured to see, as reached the ringroad, a series of signs with a large red H on them, with underneath, also in red, the letters A&E.

Ominously, however, on arrival, the A&E department turned out to be something called a Minor Injuries Unit. On the other hand, a broken collarbone sounded like a pretty minor injury to me, nasty of course but hardly life threatening. Plus perhaps Minor Injuries Unit was just another example of pointless rebranding. Perhaps this was what all A&E departments were now called? Christ, we had been in France for the last seven years. Who knew might have been happening in the meantime?

First impressions were pretty encouraging, however. We were able to register more or less at once and within about five minutes Theo was on his way to be X-rayed. This, too, was pretty speedy so that within about 30 minutes of arriving an X-ray had been done and the broken bone clearly confirmed.

This is when it started to go wrong.

I should stress that this was mid-afternoon on a weekday, so hardly the busiest of times. Nonetheless, we then had to wait fully two and a half hours before Theo got to see the doctor. Except that it wasn't a doctor. It was a Practice Nurse.

Because this was a Minor Injuries Unit and they don't have doctors there. No, they have Practice Nurses. And our Practice Nurse, who I should say could hardly have been kinder or more helpful, could only frown, look serious and say that Theo had to see an orthopedic specialist.

'Ok, yes, good. That's why we're here,' I said. 'When can we see him?'

'You'll have to go to casualty in Ashford', she said. 'There isn't one here.'

In other words, not only did Canterbury, a city of 40,000 people, have no A&E department, its hospital, which to my untrained eye was pretty enormous, had no orthopedic department.

Put it another way, we had to wait over three hours to be told what we could have been told when we arrived or, at worst, once the X-ray had been done.

Further, it takes a good half hour to drive from Canterbury to Ashford, meaning that by the time we got there it would have been close on five hours since Theo had broken his collarbone and he still wouldn't have seen a doctor. Plus, who was to say how long we would have to wait once in Ashford before he could see one?

On this point at least the Practice Nurse could reassure us. 'Don't worry. They know you are coming. They'll be expecting you.'

Except of course that they weren't.

We arrived at about 8 in the evening. If mid-afternoon in Canterbury Minor Injuries Unit is quiet, 8pm in Ashford's A&E department is anything but. In fact, it was a seething mass. As I subsequently discovered, one reason for this is that those who might once have gone to their nearest hospital, Canterbury for example, now all had to go to Ashford, which is accordingly swamped. In fact, if our experience is even remotely typical, scarcely able to cope at all.

So we waited. And we waited. And we waited some more. Three hours in total, my increasingly exasperated attempts to explain that we were apparently expected and that it was now six hours, then seven hours, then eight hours since Theo had broken his collarbone and he STILL hadn't seen a doctor having exactly no effect at all.

Eventually, at 11, he did see a doctor. He, too, could hardly have been nicer. But he could recommend only that Theo be kept in overnight to see the specialist in the morning. Which is what happened.

In short, though in neither case was the government target of all patients being seen within four hours broken, it had nonetheless taken eight hours before Theo was actually seen by a doctor. And this in southeast England, one of the most affluent and supposedly civilised areas of the world.

I know I am biased, but the contrast with France could hardly be more stark. Where we live, in deepest southwest France, the local hospital is about 20 minutes away. It serves a town, Jonzac for those who are interested, with a population of slightly less than 2,000. We have probably had to go to the A&E department there – and, yes, there is one, a real one, known as Urgences in French – perhaps half a dozen times. And we have never once had to wait more than five minutes. Seriously. And guess what? They have doctors, too. Real ones.

As a final little twist to this tale, when the next morning Theo did see the specialist, he told us Theo would have to come back in a month for a check-up. All perfectly routine.

'Not a problem,' I said. 'Expect that we have to go back to France on September 1. The appointment will have to be before that.'

'Of course, of course,' came the reply.

A few days later a card arrived with the date of Theo's appointment. It was for September 3.


Mark Wadsworth said...


I have added this to my occasional series on 'NHS Fuckwittery'.

The Creator said...

You are a gent Wadsworth. Grateful!

Peter Horne (Saltburn Subversives) said...

A grimly comic tale, Thomas.I have one or two of my own - well quite a few but I won't bore you with them all.

A few months ago I developed a severe pain in my left foot making me unable to walk or stand for any length of time. After a couple of months I got to see a specialist who diagnosed the problem and a couple of months later had an operation to remove a "neuroma".

I went happily back to work but found that the pain soon returned. When I eventually got to see the specialist again he said and I quote

"Oh, I never thought it was a neuroma. We never were really sure what it was."

Good eh?

So now I have a foot which is half numb, due to removal of some nerves when the operation took place, and still as painful as ever and they still don't know what it is. Good thing we have good mortgage and income protection insurance otherwise we'd be totally fucked.

In addition my wife has early-onset dementia - probably Alzheimer's. Just to give you a flavour of what this is like...

We once received a telephone call from the hospital demanding to know why Valerie had not attended an appointment that day. I told them because we knew nothing about it. The woman replied,

"But I telephoned last week and told your wife all about it."


Even better eh?

This week we had to go to the 'memory clinic' at Guisborough General Hospital. Pointless waste of time and money but they are the only people who will prescribe the drugs she needs. Unfortunately someone forgot to unlock the doors and we couldn't get in. I know this sounds unbelievable, but we banged on the door for some time without effect. The car park was full bur there was no one about and the entrance was in darkness. My wife was distressed so I took her home.

It just gets better!!

The Creator said...

Jesus, and I thought we had it bad.

That's seriously not funny.

You have my sympathy.

Henry North London said...

It doesn't get better does it?

I remember vividly tripping over a pavement slab and injuring myself in 2001

At the time I was on my way to visit someone in St Thomas's Hospital so I asked the sister on the ward what the prospects of being seen urgently as I was part of the NHS back then.

Oh dont go there you'll be waiting for 6 hours plus

I got back to my car drove to Ashford the same A&E that you describe and waited for two hours and was seen.

Sorted in the same time that I would have been still waiting at Tommy's

Of course I remember when Canterbury still had an A&E dept

It would have been faster possibly to have taken him straight to the QEQM hospital in Margate.

woman on a raft said...

Judging by the length of time it took, Henry, it might have been quicker to get on the Eurostar and go to the first Urgences in France.

I wonder if there are people in Folkstone who already do that?

Henry North London said...

actually WOAR thats an excellent suggestion

It only takes 2h15 minutes now...
to Paris and even less to Lille

Henry North London said...

I have indeed been blessed and have added you to my blogroll aswell

May we both prosper...

Au revoir