It was Aneurin Bevan who, in 1948, said of the NHS: ”We never shall have all we need. Expectation will always exceed capacity.” How true that is, as much now as it was then.
On this occasion our capacity was particularly inadequate: the NHS allowed our patient’s fishfingers to defrost. It would never happen in the private sector.
Our patient turned up on our same-day admissions unit, built in a desperate attempt to reduce our length-of-stay, along with five bulging carrier bags of shopping. She casually asked sister to put the frozen food in the freezer while she underwent surgery. Her argument was quite logical, if you’ve actually lost touched with reality some time previously.
“The doctor told me I wouldn’t be able to go out of the house for two weeks”, she explained - the possibility of doing the shopping on the day prior to admission evidently not having occurred to her. And why stop there, perhaps she’d like us to pop round and spruce up her cushions or walk the dog while she’s in recovery?
I must suggest it to our PR department: it might give us the edge over the opposition on Choose and Book. But, back in the real world, our theatre fridge was already full of rather more important materials such as drugs, blood and my sandwiches (only joking), so we were unable to satisfy her request. It resulted in the ’bad outcome’ of defrosted food which probably merited an adverse incident form.
I can feel the complaint winging it’s way towards us as I write. No doubt I shall be instructed to alter our patient information sheet to include the words: “Please do not stop off at ASDA on the way to the hospital to do the next month’s shopping”.
Of course, patients, or consumers as they should now be called, have been allowed to think that healthcare is a commodity like any other, which they have a right to demand whenever and wherever they like, preferably online and with a home-delivery service. The sad truth is that no health care service in the world can ever deliver such a service to everyone - not the NHS, and certainly not the American system where you’re at the mercy of your insurance company, should you be lucky enough to have one.
Even France, with whose health system we are always unfavourably compared, has recently been reducing the range of services covered by it’s social insurance system because it’s become so expensive. Some one up there in Whitehall needs to have the courage to stand up and tell it like it is - although, come to think of it, any politician who told such an unpalatable truth just before a general election would have about as much chance of being elected as one of my patient’s soggy fish…
Tags: Patients
There’s no doubt that the government’s encouragement of patients to become more aggressive consumers will have consequences that medical staff will have to bear.
Rising expectations aren’t a bad thing in themselves as long as they really don’t expect us to start walking their dogs…
Personalisation of services, ratings websites, personal budgets - the public are going to be expecting more than just the NHS’s compliance in keeping their fish fozen in a couple of years.
No doubt in reply to the complaint we will write to the patient and apologize and tell her about the lessons learnt and how we’ll try to avoid it next time.