It’s always good to reflect. Let the eye take a longer view – Â unconstrained by those ‘here and now‘ sight lines. Â Seeing things for what they really are rather than the jumbled visual puzzle of immediacy. That’s me out of visual metaphors, but I’m bloody glad to have two half decent eyes to at least see what’s being written.
I’ll save you from any further tedious pseudo-medical analysis of the battered eyeball, and instead document my micro slice through the monolith of the NHS. Their ‘first intent‘* is ‘be safe‘ which is interesting in itself. This is less about fixing you and more about doing no further harm. Which makes some sense as the human body is pretty brilliant at fixing itself once you keep it warm, fill it with appropriate fluids and keep it away from infection.
That’s not decrying the capabilities of doctors and nurses Â because we’ve come quite some way since blood letting was the literal cutting edge of the medical profession. The sharp end in our modern world is wielded by highly trained practitioners aided by high tech equipment and rather more traditional values of patient care. And mostly it’s bloody brilliant, especially when you consider the almost uncountable number of services offered free at the point of issue.
The NHS as conceived by the post war labour government was complicated enough. A utopia of medical care born flawed and compromised by bruising disagreements hammered out between the widest range of agendas and perspectives. That in itself was a triumph and unlikely ever to be copied or recreated. Â It’d be too damn expensive and politically impossible to enact in the twenty first century, which should in itself be enough for us to all raise a cheer for getting it over the line in the first place.
But crikey it’s a monster. Impossible to manage supply and demand, unwieldy in the extreme, moribund by creaking systems and rarely helped by technology. Always robbing Peter to pay Paul and increasingly under siege from an expanding population far more needy that those just about surviving a world war. Â My experience was the people within in were universally brilliant but the system of delivery is horribly broken.
Take appointments. Â Pitch up at 9am and be serially allocated an slot based on your place in the line. One go at this and everyone games the system, turning up ever earlier and bagging the seats closest to the reception desk. Which is staffed by lovely if harassed ladies who ignore ringing phones and cast about desperately for dog eared folders where your medical notes may reside. They also reside on about three different IT databases which communicate much in the same manner as a Rumanian and a Frenchman with enough shared vocabulary to sell a camel.**
What’s funny when the clock strikes 9, the massed ranks of the unappointed stagger towards that desk in a manner best described as Zombie Dawn. Half of us are half blind and the other half have around a 50% complement of working limbs. Whoever merged the Osteopath and Eye wards is a funny if evil genius. Anyway on arriving at the desk through the medium of touch, you blurt out name, rank and number, somewhat distracted by swelling knees and stubbed toes, whereupon you’re dispatched to the exact spot from which you started.
Then in some indeterminable time between right then and right before you die before you’re called to another seat which has a different institutional view but the same arse numbing boredom. Amusement can be found watching trolley of notes failing to be steered by busy nurses and crashing into walls, doors and occasionally other patients. Names are called – generally not yours although I always fancied smartly stepping in front of an extremely aged and doddery Mr Phillips who appeared to have all sorts of interesting symptoms I’d have been keen to get a medical opinion on.
Eventually it’s you. Apologies for the delay will be made and more than accepted. Good work in then done if in a somewhat chaotic way as desks are swept of previous notes to create space for your battered diary of NHS life. Â Inevitably you’re asked back for another appointment which you – now a veteran of the system – cleverly schedule for an afternoon where actual times can be provided.
Clever right until you arrive all ready to be seen at 2:30 on the dot. This is of course a fallacy of your own self importance. All you’ve achieved here is chosen a new time to begin queuing. That’s kind of how the NHS seems to work, it’s awesome when it’s doing its stuff, but it’s bloody hard to engage with. Too many hypochondriacs chasing too few doctors. Too many consultants fixing the wrong kind of problems. Too much politics, not enough money.
When I watched a nurse take a handwritten note from my optician, type it into TWO different systems and then print a copy for my file, it became apparent there are some efficiencies to be made here. That’s my kind of vocational bag, but maybe not one I’d like to open in front of the NHS. A colleague of mine did just that – umbrating the doctor who was carrying out his health check with a prioritised list of improvements the surgery should consider in the name of efficiency and patient care.
His reward for such unsolicited advice was an extremely painful examination of his prostrate. At the ripe old age of 28. Â From smartarse to sore-arse in all the time it takes to say ‘Thank you for your concerns, please bend over Mr Martin‘.
Anyway I’ll do my best not to waste anymore of the NHS’s time. They clearly have enough going on without whingy-one-eye pitching up demanding satisfaction. I came away with the greatest respect and admiration for those essentially running ever faster on a burning treadmill . And a final thought that however inefficient, conflicted and underfunded most of the NHS is, we should be immensely proud of it.
I shall attempt to maintain that point of view from an ever receding view in my rear view mirror.
* originally a military term to retain some focus when plans hit reality, but now stolen by the corporate world to define strategy. Most places I have worked the first intent appears to be ‘get your retaliation in first’
** If you ever want a failing IT project, mash up the public sector, politicians with vanity aspirations, 3rd party IT suppliers concerned only with shareholder value and a set of requirements best thought of as a quest. As a man with some experience here, I tell you it’s absolutely impossible to do. You’d be better off stocking up on chisels and slates.