Where were you when you heard the news that Theresa May had called a general election? On 18 April, I was in a London hospital sitting by my father’s bed, trying to distract him from his hunger and thirst. He was waiting for his elective knee replacement operation – and “nil by mouth” until the surgeon’s knife had done its work. Due to other health problems – severe asthma and heart failure – we already knew that he was going to need a high dependency bed post-op.
Morning stretched into lunchtime and my father’s stomach growled like an angry bear. Close to running out of distractions, help came from the most unlikely of places. The breaking news ticker announced a snap election. A whole hour was dedicated to politics after that – enough to take anyone’s mind off food.
I contemplated my own exhaustion. The day before I had been doing my job as A&E registrar in North Wales. After my shift, I caught the train to London, arriving at my family’s home after 1am. I got my dad to the orthopaedic unit six hours later. Through closing eyes, I was told how the Prime Minister and her husband had been walking in Snowdonia when she had made the decision to call an election. During that period I was on shift in the local hospital caring for both the indigenous population and visitors. A poignant synchronicity.
By 3.30 pm, after 15 hours of no food or drink for my father, the orthopaedic surgeon arrived with “that look”. I know it because I’ve worn it too, having to break similar news to patients who have waited for me all day.
“I’m so sorry to be the bearer of bad news…” he began. The operation was not going to happen. No high dependency unit bed was available.
On the day Theresa May announced her snap election, my father’s much-anticipated operation was cancelled – an operation for which a whole machinery of preparation had taken place. Numerous outpatient clinic appointments, logistical drug planning and the final green light from three separate specialities at consultant level to say it was safe to proceed. I had negotiated time off from my own NHS shift. It’s never “just” a cancelled operation for patients. The orthopaedic surgeon walked away, shoulders drooping in commiseration and frustration. He had spent most of the day, between other operations, fighting for a bed that didn’t exist – an increasingly common pursuit happening across the NHS especially in high dependency units and intensive care.
My father will hopefully have his op another day. But what about 20-month-old Kayden Bancroft who developed a hernia after a fall? His operation was cancelled numerous times over a week at the Royal Manchester Children’s Hospital due to a variety of reasons – one of them a lack of ITU beds. His condition deteriorated and he died. According to news reports, the hospital’s management was approached by Kayden’s surgical team, who asked if the operation could take place ahead of elective operations. But the idea was vetoed. Waiting lists are ballooning, after all.
Central Manchester University Hospitals Trust’s own investigation revealed “significant problems” with Kayden’s care, which was “not timely and resulted in his death”, the BBC reported. The trust stated that it “would like to make it clear that at no time has it directed clinical staff to prioritise elective over non-elective care”.
We all feel for the family of the baby – the anxiety caused by the wait and then the ultimate tragedy. I empathise with the staff too; understanding their anguish in the knowledge that they could have saved Kayden, if not obstructed by delays. Non-clinical managers move chess pieces on the medical board as they try to make a hospital function, under increasing pressure to work within ever-decreasing budgets imposed by this and the previous coalition government.
What does the election mean for the NHS – a political football being booted between the parties – and ultimately our health? The recent Tory track record of refusing to provide more funding, where there is a reported £22bn deficit by 2020; their attack on junior doctors; and the removal of nursing bursaries. None of these fills me with reassurance. Under Tony Blair, Labour inflicted PFI initiatives on trusts which have left hospitals in crippling debt. Last year Virgin Care was awarded 200 NHS contracts worth £700m. What next? The Virgin and NHS logo merged and red scrubs for doctors and nurses?
Sitting there by my father’s hospital bed, absorbing the news of a cancelled operation, made me think deeply about the future of the NHS. Before May’s election announcement, the recurring message from the Department of Health to the NHS was that there was no more money beyond what was already allocated. That was precisely what the Secretary of State for Health told senior managers at the NHS providers’ conference last November. Ironically, I was there as a guest speaker, talking about resilience at a challenging time within the NHS. But how much resilience can you muster up when the financial challenges are so grave?
All parties are screaming out promises for the NHS because politicians know voters care about it. The prime minister pledges an additional £10bn by 2020 and wants to force junior doctors to work for four years in the NHS after graduation. Release some of that £10bn now – we need it today, not over three years. And the “conscription”? It’s immoral and indecent, and would be applied by those who have little grasp of what is involved in being a junior doctor, as proven by the new contract imposition. Three junior doctors have committed suicide since last year.
The public must consider the NHS when they vote. In the future, more of them might find themselves, like me, waiting by a loved one’s bed – in a manner similar to what I’ve seen in less developed countries while working on humanitarian missions. Another four years of this and worse? My advice – look after yourselves very well so you limit your risk of needing the NHS. It might not be well enough to look after you.
Saleyha Ahsan is a doctor working in the NHS.
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