Engleharts Solicitors

DAVID’S SOAPBOX: An Hour can be a Long Time

Posted: Dec. 6, 2010

“What does an hour’s delay matter?”.

The answer “Probably not that much”.

Personal experience has led me to the conclusion that that is not the case where one’s health is concerned.

On February 4th this year I rushed my wife, Angela, into the A&E ward at the Sussex County Hospital. Seventeen hours after arriving at the hospital she was operated on. Four hours later I was told she had a rare infection and that if they had been successful they would not know until the next day when they would be operating again. If they had not removed all of the infection I was told there was every chance that she could lose a leg or die if the infection hit a vital organ.

Neither of these occurred.

Some six plus months on Angela is still in a lot pain. However, thanks to the skills of the burns centre staff (she has no burns but they specialise in skin grafts) at Queen Victoria Hospital, East Grinstead the huge wound she had from the two operations has been repaired by skin grafts. Now all we have to do is patiently await what may well be at least another year of pain control before she is back to anything remotely like herself.

The NHS nursing staff, surgery teams and all the support people involved in looking after Angela at both the Sussex County and the Queen Victoria have our eternal thanks.

The infection Angela had reads like a nightmare and is both rare and often fatal. It eats the body and can destroy an inch an hour.

Neither Angela nor I can still bring ourselves to look at the photos taken of her original wound but the size and what has had to be done since has led me to calculate that at the time of the operation it is likely that she may have had as little as one hour left to live.

So this has brought home to me that when it comes to medical treatment “an hour’s delay is a long time”.

The political parties use scare stories in respect of each other’s supposed stewardship of the NHS. The only consistent theme is that each party try to persuade us that the NHS is safe in their hands.

Labour would throw more money at it.

The Conservatives want to re-organise it and make it more efficient.

According to Vince Cable of the LibDems the NHS should not be exempt from cuts.

So should you be worried or is it safe in their hands?

I believe the answers are “yes and “no”.

I will explain how I have reached these conclusions and why it is that it is that we all need to keep a close eye on what is being done. So long as one is healthy there is a tendency to take the NHS for granted and politicians love nothing more than when the public are apathetic as they can do what they like.

I will highlight a few points and dangers.

1. Cuts to the NHS budget

I mentioned Vince Cable’s comments that the NHS should not be exempt from cuts. I won’t comment any further on that as it is patently wrong. We are becoming an older society so the demands on the NHS are likely to increase.

The Conservatives talk about reducing the number of people employed by the NHS. There is talk of streamlining the administration. I have, however, heard stories of possible substantial front-line staff cuts at NHS hospitals.

Everyone’s perception of life is subjective. Let us assume that front-line staff are reduced then take Angela’s case. They did not know what her infection was until they operated. That she was in extreme pain was evident and that her blood sugar level had rocketed and needed to be brought down was obvious. However, it was not until they opened her to operate that they realised what she had.

Cuts of front-line staff would not only necessarily reduce the front-line staff by only, say, 10%, but could also cause another 5% or 10% reduction because of the difficulty of enticing top-level surgeons and the like to work for the NHS when they could emigrate to a number of quite prosperous English-speaking countries and enjoy a good, well paid lifestyle in a better climate as well as enjoy better job security.

When I was at the Sussex County I did not see any staff doing nothing. So cuts in numbers will surely slow the whole process down.

If we added an additional 10% to the time that Angela waited for her operation I do not think she would have lived.

This could be all our futures. So cuts sound simple but when you or your loved ones’ lives are at stake, think again.

2. 24 hour drinking

I am trying hard not to be political. 24 hour drinking was brought in for several reasons. It was thought that by staggering drinking hours people would spread the drinking over a longer period thereby avoiding binge-drinking. It was also thought that the police would be better able to control situations if the closing hours in city centres were staggered so that everybody did not leave the drinking establishments at or about the same time. It was also thought that by having 24 hour drinking we would end up like the continentals who have the benefits of that but who, by and large as there are exceptions, are not generally such a disruptive, drunken lot as the British. In other words, it would turn us all into nice people. Some hope!

Binge-drinking is still with us and seems to be increasing. The effect of 24 hour drinking means that the police will never know exactly where and when the trouble is going to erupt so instead of being able to contain it within a limited period and area they now have to be on a permanent standby. So that is a waste of police resources and is a huge cost to the tax payer. Last, whoever thought that the English/British were going to become civilised drinkers as a result of being able to drink all day and night? I read recently, I cannot trace it unfortunately so I am unable to give dates or the people involved, that back in the mid-1800’s we were spending just over 40% of our income tax on defence. The idea was to build a series of forts along the south coast in case the French invaded. A better idea was thought of and peace was made with the French including some sort of deal whereby the French could sell cheap wine to the English thereby presumably improving their trade and balance of payments! The footnote was that apparently cheap but good quality wine did nothing to stem the drunkenness and violence of the English people. So what made the Labour government think that anything had changed in 150 years?

The 4th February when Angela was taken in to A&E in the evening was a Thursday, the 5th when Angela’s operation was at approximately 1.00 pm was a Friday. If Angela had been taken in on the evening of the 5th, then as that was the beginning of a weekend I am told that the A&E are substantially busier. The 6th would have been a Saturday when the same would have applied. The 17 hour wait could have turned into a 20 hour wait or longer, as the drunken louts and idiots were brought in, chaos reigns and they are patched up. There would have been no point in the operation by then – she would have died.

We need to get a grip on 24 hour drinking, acknowledge it was and is a disaster, and re-adjust our thinking about alcohol consumption. There seems to be a general consensus against cheap alcohol being available in supermarkets to take away but perhaps an encouragement for people to drink at home rather than out, if they really want to drink to excess, would not be such a bad idea. Sometimes we need to think the unthinkable and then discover how to make it work.

3. The EU

The EU is one of my favourite dislikes. I may have voted for it in the 1975 Referendum but on the basis it was a trading partnership not a super-state. So whatever the result of that Referendum the progression of the EU is no longer what I voted for. I will not get another chance to vote as the politicians well know what the answer is likely to be.

A question: “what on earth has the EU got to do with our NHS”?

The answer is that it will if we allow it to so it must be stopped from directly or indirectly interfering head on and now before it is too late.

First, the EU are saying that they should look at the budgets of all member states before they are passed. Why would they ask to see the budget unless the intention was that they felt they should have some input, initially perhaps advisory and then, by stealth, compulsory? So if someone in the EU decides that we are spending too much on the NHS then one day they may have the power to veto that. We must stop this nonsense and stop it now before it becomes dangerous. Are we a sovereign state or not? Who cares what they think about our budget and what is it to do with them what we spend our money on? It is for us to look after our sick not to have to grovel to an organisation that is alien to us and most of whose members, if not all, would have swastikas hanging up outside their public buildings but for us.

Second this fine institution whose auditors are refusing to sign off the accounts and have done so for the last 15 years, wants the ability to raise direct taxes. The idea is that these taxes are initially to be raised by what look like relatively harmless things such as an airline tax. Presumably even these blood-sucking, non-elected, non-representative people who run the EU have stopped just short of suggesting an actual income tax but they will. In any event we pay a substantial sum to the EU much of which goes to French farmers which if we didn’t would save us an equally substantial sum in direct taxation which we could cut so as to boost spending and create jobs. One favourite argument of the EU grovellers is that were we to leave the EU we would lose several hundred thousand jobs because of all the goods the EU buys from us. This is rubbish. The fact is that the EU buys substantially less from us then we buy from them. So who’s the loser? Turkeys don’t vote for Christmas and even this lot with whom we have little in common aren’t that stupid. We could just as easily enter into a free-trade agreement without being subject to endless interference in our internal affairs. The point is that if the EU raises even more money and takes more tax from the UK there will be less for us to spend on ourselves unless we wish to raise our already excessively high taxes even more. It is every socialist ruler’s dream to have all but virtual control of people’s lives, their money and how they spend it. By and large many EU countries have socialist or left wing governments. The concept of the EU having any say in our budget or raising taxes for themselves could create a situation where we have to take money from the NHS to direct it to the central funds of the EU for them to distribute as they see fit. All of this to an organisation that cannot even balance their own books because of theft, corruption and mis-management. It would be a joke if it wasn’t so serious.

The third concern is the potential for the EU to slap regulations on the NHS directly or indirectly. For example, there is an EU directive that junior doctors whose maximum number of hours per week was 56 must now only work 48 hours. The effect of this has already been for many junior doctors to leave and go to foreign countries because it interferes with their ability to gain experience. Junior doctors are an essential part of the NHS and if they are in short supply the NHS will slow down.

It has taken a number of attempts for me to be remotely happy with this article. In the period of time that has elapsed since I started we now have the first deaths in hospitals that are said to have been caused by the 48 hour EU regulation concerning junior doctors. The regulations were brought in in order to improve the lifestyle of the doctors. They were brought in by virtue of regulations made by an organisation where the vast majority of member countries have different lifestyles and welfare states than us. How dare they tell us when and how to work.

An 18 year old who joined the army in 1940 would now be 88. If he had joined in 1945 he would be now be 83. This was the generation who single-handedly from Western Europe (the Russians fought from the east but only because that idiot Hitler attacked them) fought one of history’s great tyrannies in order to prevent swastikas from hanging outside our parliament and Buckingham Palace. Truly it was a generation who sacrificed lives to enable us to have a land to live in free and fit for heroes. How ironic it would be if yesterday’s surviving heroes died because of pointless and interfering regulations made by the very countries that they fought to free of tyranny. Are we so pathetically weak that we have allowed it to come to that?

4. Immigration

In my many visits over six months to the Sussex County and the Queen Victoria I found that a proportion of the staff were not just non-UK but non-EU. Now it may be that we are taking away qualified staff from other parts of the world who need them more than we do. On a selfish level so what. It does not concern me. What concerns me is that there are sufficient numbers of qualified staff available in the NHS to carry out its prime function which is to deal in an efficient and prompt manner with those problems with which it comes face to face on a daily, or even hourly, basis.

I am a supporter of the argument that we are a small island and that we need to be cautious with regard to over-populating but in specific situations where we need suitably qualified people we should exempt them from any quota. For once Vince Cable may be right.

5. What is the solution?

If I knew that I would hope that the government would employ me at some vast salary to reorganise everything, streamline the administration, cut costs to divert money into front-line services and genuinely create a super 21st century NHS. In fact, on reflection they are welcome to do that anyway if they want to make me an offer!

What I do know is how close I came to losing Angela and how that thought was unbearably and unbelievably painful. The shock was sudden and caused me both physical pain and has left a mental scar since.

It is impossible to thank individuals personally for what happened. There were the people in A&E who rushed Angela through the process and into the ward where she awaited her operation. There were the nurses in that ward. There were the people who subsequently realised that her sugar level was far too high and whilst I sat by her for 17 hours they both kept her pain levels bearable and brought her sugar level down. There was the operating team who upon realising what she had then over a period of many hours, and with the addition of a number of extra people, saved her life. There was the surgeon in charge of the team who had the thankless job of telling me she could die. There were the nurses who then consoled and tried to calm me down. There were the staff in intensive care who looked after her. There were the people in the high-dependency unit who helped nurse her to a state where she could go to a normal ward. There were the people in that ward whose friendliness, attention and support enabled Angela to get fit and strong enough to be moved to the Queen Victoria. I was told that the matron in charge of the ward, I think it was called “The Digestive Disorders Ward” was obsessive about health and cleanliness. I am not sure I ever met her but she has my greatest personal admiration for her cleanliness crusade. At the Queen Victoria there was the constant care and attention at the burns centre, followed then by the expert attention of the operating team who used skin grafts to enable the awful wound to be so expertly closed up so that Angela can, hopefully, one day look forward to an almost normal life. There were the many staff both at the Sussex County and East Grinstead who helped dress the horrendous wound and those who helped manage, and still do, Angela’s pain level. There was the wonderful psychiatrist at Queen Victoria whose services Angela has had no need for. She, nevertheless, saw me on what I think were three occasions and she helped me so I knew how best to assist Angela recover. All of these people have our eternal thanks not to forget the Almighty to whom I prayed for the first time since I was a small child.

However, an hour’s delay, for any one of the above reasons, and I would not be writing this.

It could be caused by any one or more of the above. It could be cuts that have created staff shortages. It could be a sudden influx of drunken louts who are using up scant resources. It could be a bureaucrat in Brussels forcing us to cut our budget and as a result the NHS suffers a drastic reduction in its budget. It could be a general shortage of money as a result of paying extra taxes to feed an ever more bloated EU. It could be new EU regulations which tell us how to run the NHS by people who do not have a comparable service. It could be a shortage of qualified staff due to poorly thought-out immigration restrictions.

So the next time it could be you or a loved one with an hour to live and we all need to be vigilant in safeguarding the NHS, the number of front-line staff and their ability to work swiftly and efficiently.

Remember an hour may not be a long time but it could become a matter of life or death.

© David Englehart 2010

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