I dare say our experience was nothing out of the ordinary. But it is not every day that you visit the third circle of hell, and I did, in the space of those eight hours, learn more about the weaknesses of our National Health Service and the patients on whom it is inflicted than I have ever disinterred from a party manifesto. This was not the direst of emergencies. My wife had torn the muscles in the back of her leg and was in considerable pain, but she was able to drive to the A&E department of the Edinburgh Royal Infirmary, where she checked in at 5pm and was told to expect a three-hour wait.
The ERI comes under the auspices of the Scottish Executive, and is, or should be, a standard bearer of devolution. It is, on the other hand, also a product, in almost every respect, of new Labour thinking. A brand new, out-of-town hospital, one of the first in Britain built with the aid of private finance, it is equipped to the highest standards, and boasts the latest in hi-tech medical equipment. What it has not succeeded in doing — at least to judge from our one-night survey — is to meet the needs of its patients. The hospital claims to have reduced its waiting times to an average of 40 minutes. It seems, however, that it does not take very much to tip a fragile service over the edge from accept.able to horrendous.
My limited grasp of how hospitals treat the walking wounded rests mainly on the BBC TV drama, Casualty, where distraught patients are for ever rushing in demanding instant treatment, threatening doctors with violence, or collapsing dramatically as the result of a killer virus with no known cure. A real accident unit is far worse. Nothing ever happens. The drama, if there is any, takes place off-stage. The rest of the cast sits passively, hour after hour, waiting in a Beckett-like state for something to happen. As the night wore on, less and less did. A confused old man wandered in and out, was rounded up by impatient nurses, then finally disappeared, none of us knew where. A boy in a bloody bandage came in accompanied by a policeman, who took some desultory notes, then left. A man with a razor slash down one cheek arrived, looking remarkably cheerful,chatted up an ambulance girl, then departed, leaving his rather more severely wounded companion to wait, along with the rest of us.
There was nothing to read, no catering worth the name, no information available, save for the woman behind the reception desk who could tell us little beyond the fact that the hospital was handling “a lot of resusc cases,” an explanation that turned out to be only partially true. Sustenance came in the form of three vending machines whose offerings ranged from Nescafé to Irn Bru via chocolate and crisps, hardly the healthiest diet for a long Saturday night. We did spot a ham sandwich, but the machine, which accepted our money, failed to deliver it, presumably because the request was so unexpected. There was, we learnet later, a small café attached to the waiting area, but this was shut. It seems that the private contractor to whom it was leased had closed it down because it was unprofitable. So much for private finance.
When my wife’s name was finally called at 1am, the doctor took one look and prescribed painkillers and an elastic bandage. It took just five minutes. What struck me most about our roomful of exhausted sufferers was the way that they accepted it all without complaint. Most people, it seems, simply assume that this is the way the NHS is. My own search for elucidation took me back to the hospital — at its invitation. What I learnt was, if anything, more depressing than the experience itself. The delay had nothing to do with staffing or pressure of patient numbers — both were average for a Saturday night, with a couple of extra doctors brought in because there was a rugby international that day. There had been two serious “resusc” cases (life-saving operations) that night, and six fractures requiring surgery. Neither struck me as an impossible overload. However, just out of our sight was a traffic jam of trolleys — more than 20 of them, bearing patients waiting in corridors and cubicles for beds, tying up space and staff who might otherwise have been available to us.
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The beds were unavailable because patients who were well enough to leave hospital but needed nursing care had nowhere to go. And why did they have nowhere to go? Because the Government has imposed such expensive fire, health and safety regulations on nursing homes that large numbers of them in the area have had to close. With no alternative accommodation, patients are having to stay in hospital instead, blocking their beds to those who really need them. Stretched social services and a lack of funding for home care mean that local authorities have little room for manoeuvre. The hospital, at the delivery end of this broken supply chain, was as frustrated as we were.
So here we have a state-of-the-art hospital — typical of many, I suspect — unable to look after its casualties because red tape has ensured that the community has no provision for those who have been treated and cured. That is not just bad organisation, it is bad government. And so, come May 5, I will seek redress. That is, if I can nurse my wrath that long.