As regular readers will know, both Sue and I myself are prone to 'ooh, that'd be a good idea' moments which then, somehow, often before we've noticed, become a social media campaign. Personally I hold the medication responsible for at least a bit of the inspiration and often wonder why the creative industries don't employ more people on legal opiates to dream up campaigns. Ok, so the potential downsides are things like declaring one's desire to become a duck on twitter, but really that's a small price for any employer to pay.
So, with the #nhssavedmylife trending on twitter I thought it would be an interesting idea to try and live tweet through my bronchoscopy procedure. As many of my ideas do, this had practical downsides and I failed to actually tweet whilst the scope was being used, but it's the intention that counts.It was crap by the way. The bronchoscopy I mean. Definitely not one to put on your bucket list. Surprisingly the having a camera down your trachea bit isn't actually that awful, but the spraying of the local anaesthetic half way down to your lungs would be a worthy replacement for waterboarding, though I doubt Guantanamo would serve it up with a side order of nurses to hold your hands throughout. To be fair unlike torture centres the NHS do also offer a nice, free sedation service for those people not stupid enough to think toughing it out for a few minutes is the way to go. I'm generally a huge fan of floaty sedative drugs so it says a great deal that I chose to reject the free, legally administered by vein drug option.
We've had our problems over the years, me an' the NHS; lack of diagnosis, judgemental clinicians and absence of adequate services to support those with chronic conditions being top of a long list. As someone with a chronic condition falling through every possible gap in NHS provision its all too easy to get caught up in what the NHS doesn't do well and forget to notice all the things it does so brilliantly. NHS reform is undoubtedly needed, but like seemingly most of the legislation this Coalition government is trying to force upon us, there has been so little attention paid to the details that we risk dismantling all the positive parts of our systems whilst leaving the dysfunctional in place.
Yesterday, while waiting in the endoscopy suite I watched the NHS at its best. If I'd remained in the waiting room all I would have experienced was the constant, endlessly ringing phones and the tooth grinding while waiting for them to be answered. I'd have seen the officious reception staff too busy to meet anyone's eyes and the insensitive so and so eating in a waiting room full of people 'nil by mouth'.* I'd have been frustrated at the delays, the loss of my notes and did I mention those endlessly ringing phones already? They were very annoying.
But instead I went through the patient experience. The consent procedure which was repeated as my notes were yet to return from clinic 'just in case'. Even though I had a signed copy with me, it was just in case anything was missed. The repeated measuring of my blood pressure which indicated my fight or flight response was in full swing thank you very much, but despite the desire my ability to turn into a duck and fly far, far away was not.**
As I waited for and recovered from my procedure in the recovery area I saw the part of the NHS most people are never privileged enough to see. Typically an individual uses the health service heavily at the beginning and end of their life, with little contact in between save say the occasional broken bone, or visit to the GP for holiday immunisations. They can be frustrating, misleading experiences which involve lengthy waits or incomprehensible delays. Incomprehensible until you go beyond the surface areas of the NHS and get to see what's happening behind the scenes. There are areas of the NHS that would make you weep with the waste and incompetence, but conversely, an NHS unit which is well funded, staffed and managed is like watching a beautiful ballet performance.
Having experienced health care on both sides of the Atlantic, along with the subsequent bills fought over by hospital and insurance company I wondered how different would this experience be if my experience were in an insurance based co-pay environment. The fear I felt in the waiting room and reluctance to endure and unpleasant procedure would almost certainly have led to me running away and avoiding the test altogether if I had had to contribute towards the financial costs. I would definitely have gone without sedation as having it means losing income not being able to work the following day and adds substantially to the costs. I would almost certainly have refused the 'just in case' venflon put into my arm as an unjustifiable expense, more willing to take the risk of delay during an emergency than spend a few hundred pounds on something that might not need to be used, but that could save my life if it were. Perhaps I would also have felt obligated to go to the cheapest provider of the testing, regardless of whether they were equipped to deal with the kind of complications which can occur in someone with Ehlers Danlos Syndrome. I would certainly have felt a type of stress and fear that most British people raised on the incredible priviledge of the NHS cannot even begin to comprehend.
And that's the utter disaster that is the NHS bill. Its so poorly drafted, so ill defined that it doesn't address the areas of the NHS in need of reform - how we care for those with chronic conditions or the elderly. Instead it attacks the structure, forcing reluctant GP's to become both diagnostician and budget holder seeking the cheapest possible provider not the best. It fails to recognise the complex interactions required in any hospital, focusing entirely on the waiting room experience for the worried well.
It paves paradise and puts up a parking lot.
*Though the insensitive so and so did come with me and is probably not a permanent feature.
** bloody drugs, promise you everything, deliver nothing. Like politicians but without the taxpayer funded duck house.