Further to the slow diagnosis and bad communication that my friend Charles* had to endure in his last weeks with terminal cancer – see previous column – two more aspects of his treatment enraged his family.
One was that after a hospital consultation about six weeks before his death, he was sent off to trail along endless corridors to book a CT scan. Then he had to find his way to another department to book another test. And I can tell you, even for somebody relatively fit, the distances in his hospital are immense. I sometimes wonder why they didn't install travelators, as at Heathrow or Gatwick.
Why couldn't these bookings be done from the consultant's surgery? If Choose and Book is supposed to get hospital referrals done remotely from the GP's desktop, why can't an internal hospital system cope with centralised booking of tests? To make terminally ill patients do the booking physically themselves seems a bit 19th century to me.
But what would I know: I am not a hospital administrator or chief information officer. I am just a patient who thanks his lucky stars that he is being treated at a specialist hospital that is small enough not inflict these cruel and unnatural punishments on its inmates.
When the hospital at last realised the seriousness of Charles' condition, the consultant called him in as an emergency admission early one morning. Rather to Charles' surprise, he was asked to present himself not directly to the consultant's ward but to A&E. He arrived there at 10am, passed through endless bureaucratic hoops and finally got a bed in the appropriate ward at tea-time – seven long hours later.
Why couldn't he go straight to the ward? After all, some lord high panjandrum of a consultant had deemed him worthy of an emergency admission. So why did he not receive emergency treatment?
I can hear hospital administrators reading this article, shrugging their shoulders and saying "what a plonker, not to realise that to have two admission streams, A&E and emergencies of existing patients, would cause chaos". Sorry; I insist. Clearly it is administratively easier to have just one admission stream, through A&E. But, is it in the interests of patients like Charles to go through the A&E bureaucracy – for no purpose, and with great distress?
It seems to me that, in the NHS, administrative convenience is still more important than patient care, whatever the rhetoric claims.
Ah, I hear you say, beds are scarce, and Charles should have been content to wait his turn. This is an argument I might accept, except that a week or two later, Charles was left blocking a bed for five days waiting for the cardio-thoracic wing to find a theatre slot to clear fluid from his lungs. In his hospital, the left hand did not appear to know what the right hand was doing. And beds were being blocked for no purpose.
Again, Charles's experience is so different from mine at 'Fastrack Hospital'. At an outpatients' clinic, a few months ago, the doctor reckoned that the wound of my operation had become infected. Within two hours, I was in a hospital bed being pumped full of antibiotic, and stayed there for the following four days until the infection cleared.
What is the difference between Charles' hospital and Fastrack? Size is one thing. Fastrack is small. Charles' is monstrous. Fastrack specialises in one family of diseases, and was only created about 50 years ago. Charles' is general – and has a long history of being one of the premier teaching hospitals in London. Maybe this is a lesson for the NHS as a whole.
* Not his real name
