By Angela Williams
AN OPEN LETTER TO SUPPORTERS OF THE HEALTH AND SOCIAL CARE BILL
Today I’m marking the first anniversary of a fall which resulted in a broken hip and wrist. I’ve been hearing a lot of optimistic talk about patient choice over the past few weeks – here’s a short guide to how it can work in practice.
- No matter how careful you are, you can’t always choose what happens to you; accidents come out of the blue.
- You can make as many choices as you like, but you’ll still be dependent on other people to carry them through. For instance, you can ask the paramedics responding to your 999 call to take you for X-rays, but if they refuse, you’re stuffed. It’s difficult to be assertive when you’re in pain and someone’s assuring you that a bag of frozen peas and some paracetamol will set you to rights.
- Spending seventy-two hours alone at home with broken bones is grim. You can choose to be stoical but you’ll still be hurting. Nights are the worst – it’s no fun sleeping in a chair with your feet propped on a cardboard box and a pillow wedged under your chin to keep you upright.
- When you finally get admitted to A&E and the doctor starts to talk about your options – your old femur plus some pins, or a total hip replacement – it isn’t easy to concentrate. Lying flat on your back on a trolley wearing a hospital gown is distracting, and also the morphine is a bummer.
- NHS nurses and doctors are accustomed to coping with this and will tell you useful things, like how bone necrosis is a risk because of the time that’s elapsed since the fracture occurred, which means they could pin it but it might not heal. After you’ve thought about that for a while the doctor drops by for another brief chat, and casually indicates what she would do if she was in your place. Nobody talks about money.
- Perhaps you’ve got concerns about snacks, colour schemes, furnishings etc.? The CEO of a private healthcare company currently running an NHS hospital addressed the topic a while back in an article in the Observer. My favourite quote was “a night in a hospital costs more than in a five-star hotel, so why shouldn’t people get a similar experience?” During my four-hour stay in A&E the nurse offered me a cup of tea and a plate of cheese sandwiches, and I was fine with that – grateful, even. A Michelin starred chef wasn’t on my wish list, and I didn’t miss the grand piano either.
- If you find yourself, as I did, in a large acute hospital on a ward that’s overdue for refurbishment, you may assume that an early transfer to a community unit would be a good move. Don’t count on it – better facilities and nicer food can’t compensate for bored and resentful nursing staff.
- Finally, you might suppose that by the time you’re fit to go home the big choices have all been made. But here are a couple more points to consider:
- If you had a good experience with your medical care wouldn’t you want everyone else to have the same?
- If you had a bad experience, wouldn’t you make the effort to improve things for the people who come after you?
- No one can deny that there’s ample scope for improvement within the NHS, but promising increased patient choice as one of the central benefits leaves you wide open to accusations of hypocrisy. Many of us are strongly opposed to the current reforms.
Respect our choice. Drop the Bill.
Guest post © Angela Williams 2012. Available for non-commercial reuse with attribution under an Attribution-NonCommercial-ShareAlike licence.
Why not show the NHS some love and join the UK Uncut protest for mother’s day.