Sunday, December 8, 2019
Home News Where the NHS goes wrong, by our man on the front line

Where the NHS goes wrong, by our man on the front line

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I LOVE the NHS: it’s keeping me alive at the moment. It puzzles me why the Left-wing people fantasise about selling it to Donald Trump, but hey ho, what do I know? I’m not a believer in the one true Corbyn, so I can never be ‘passionate’ like they are.

Even though Dad was a GP and Mum was a nurse. They met at Guy’s Hospital, I’m told. Both were equally devoted to the NHS. My older sister is a doctor, one of my younger sisters spent years as an ITU nurse.

As a kid, I was used to sharing my living space with patients, because Dad ran his practice from our house. I was born at home. I’d come in from school, and there would be ‘an aggrievance’ of patients in our front room/their waiting room. When I got into the kitchen and opened the fridge, it wasn’t unusual to see a patient’s urine sample in storage. The upside of all this was I got fantastic herd immunity. I was rarely ill.

The problem with having a doctor as a parent is you never get a day off school. They’ve always seen worse. Dad made us all go to school the day after our mum died. I was ten but my youngest sister was six! I discovered after he died that Sister Mac, the nurse at my dad’s practice, found him crying at his desk that day. I think that’s a common trait among doctors: they are very hard on themselves and never give themselves a break.

So I do love the NHS. Early this year, when my newly fitted PICC line caused blood coagulation and I was in danger of a fatal DVT, I was forced to spend a weekend in Croydon University Hospital. Its original name was Mayday Hospital so everyone calls it the May Die. The nurses kept saying how sorry they were for me to spend the weekend on the wards. But I was ecstatic! One of my best Saturday nights in years. Home from home, loads of nursing assistants, tea ladies and phlebotomists to chat to. There was a lovely Spanish colo-rectal surgeon doing the rounds.

I was back for a week this month when my cancerous bowel and herniated stoma had painful complications. Aside from one obnoxious whinger in the bed opposite and another big bloke who wouldn’t stop belching and farting and talking about his bowel problems, I quite enjoyed my stay. I love the doctors – Dr Alice at Mayday is my new heroine! She looks about 25 but she exudes confidence, and I really need a strong leader to look up to in my current state. (Which is chronic wounds on both legs, herniated stoma and cancer cells in my liver that just won’t die).

Obviously I don’t know as much about the NHS as a Left-wing comic. But anyway, I do think my experiences of hospitals and the way they run might be useful.

Throwing money at anything that’s chaotically run will only exacerbate the problem. When I edited magazines for IT suppliers, they used to say two things about the NHS: if the hospital is badly run, IT only computerises the chaos, and that if you become an NHS supplier, you can charge them six times as much. SIX times! Mind you, the cost of selling to the NHS is massive, as they enjoy making you jump through hoops. Many NHS middle managers love the sense of power they get from organising a meeting. Others are simply lonely and invite suppliers in for a conference as they like meeting people – sometimes they’re looking to jump ship into the private sector.

The NHS wastes an absolute fortune through its management culture. That will take a long time to tackle and it would inevitably be met with resistance. Maybe Donald Trump will be the man to tackle this. I keep reading that Boris Johnson has secret plans to run down the NHS to sell it to the most evil chlorinated chicken-eater he can find. Donald Trump is the current US bogeyman. Mind you, he’s a trader so he might make a buck selling on my precious health service to a Russian oligarch. Or maybe a Mexican drugs cartel or a Malaysian bet-fixing syndicate.

All the Left-wing newspapers are fantasising about this. I say this to you, Owen Jones, Paul Mason and Channel 4 News – be careful what you wish for.

I want our NHS to stay in public ownership. At the risk of upsetting our Left-wing friends, I don’tthink we should turn the Royal Free Hospital into a Trump Tower.

However, I do have some suggestions for money saving. These are simple, practical and achievable improvements.

For example, May Die Hospital summons patients to some appointments using two computer systems. The computer tells you to turn up at 2:15, but another system subsequently sends you a text message telling you to turn up much later. Therefore many people turn up late and the clinic wastes £100 for every patient that doesn’t turn up on time (according to its own figures). Exactly the same happened last year. So for 12 months all they’ve done to tackle the problem is send out letters, at further expense, urging you to ignore any text reminder that they send you by mobile phone.

Nobody will talk to the supplier. So by my calculation that rogue texting machine must have cost the NHS £100 for every botched appointment, which is around £4,000 a week.

If they got rid of that texting system, they could save roughly £200,000 a year! Plus save on whatever ridiculous fees they are paying to this useless bunch of incompetents. Only in the NHS would this be tolerated. The texting firm probably gets around £1million a year, given the gullibility of NHS procurement managers.

Melissa, the lovely clinician who carried out the tests on my legs (when I eventually turned up) said the texting system is run by outside contractors and ‘there’s nothing they can do’. Yes there is. This is where a no-nonsense American comes into his or her own!

When Mr Trump buys May Die Hospital I expect the first thing he’ll do is summon the boss of this unscrupulous service supplier and tell him: You’re fired. There’s a saving of £1.5million, right there. Easy.

However, the crap IT systems and rogue suppliers aren’t even the biggest source of waste. The most expensive mismanagement in the NHS stems from the lack of communication. None of them will talk to each other or tell patients what they need to know. I think this is where the phrase ‘hospital pass’ might have come from. There is an assumption all the way through every stage of the patient’s ‘journey’ that someone else will do the right thing, or give the patient the right directions. But nobody ever does. As they say in the military, assumption is the mother of all cock-ups. It’s the de facto setting in the NHS.

Communication is a massive subject and I have many ideas for improvement. I’ll deliver them all in my next report from the NHS coalface.

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Nick Booth
Nicholas Booth is a freelance technology writer

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