Admin and clerical staff exist in the NHS. Little-known fact. You can read a thousand articles about the NHS and never come across a mention of us. We haven’t had more than a 1% pay-rise since I can’t remember when, either.
Without us hospitals would fall apart instantly, as instantly as if doctors and nurses were removed.
Instantly because there would be no -one to make appointments, no-one to book patients in for diagnostic tests, no-one to book them into out-patient clinics, no-one to send out appointment- letters, no-one to telephone the patients and explain to them where they need to be and when, no-one to answer the telephone and deal with patients’ queries or escalate to clinical staff as required, no-one indeed to chase over-worked clinicians for responses on behalf of the patients, no-one to process queries from GPS or other hospitals, no-one to type the clinic-letters and discharge summaries that convey to patients’ GPs and other doctors engaged in their care the findings and opinions of a particular specialty, no-one to scan or photocopy letters and reports and fax or email them to other hospitals, no-one to get medical records to clinics, no-one indeed to sort out the patients’ diaries and make it all work: when people are very ill, they have multiple appointments and these may be at more than one hospital and in many departments: Neurology, MRI, Oncology, Nuclear Medicine, Thoracic Medicine; when people are very ill, they may be anxious and flustered and not as good at organization as when at their best. When people are very ill, if they are lucky and in my experience most are, most have someone, they have the true unsung unpaid heroes of the NHS to support them, partners and children battling for them. The non-emergency ambulance service may have problems but these are nothing to the problems it would have if all over the country husbands, wives, daughters, nephews, aunts, cousins or just good neighbours weren’t taking the trouble to bring patients to hospital appointments and attend the appointments with them and equally social care problems are nothing to the problems that would exist if all over the country husbands, wives, daughters, nephews, aunts, cousins or just good neighbours weren’t taking the trouble to make sure the patient takes his or her medications at the right time, make sure Pharmacy has handed them the right medications, traipse back up to the hospital to get the right medications in case of error, ring if they’re worried, to wash, dress, launder, deal with the finances and the electricity board.. Then there are the employers of the carers. Employers rarely get a good press, or perhaps it’s just the only press they get is when they’re heartlessly grinding the faces of the workers into dust, but are on the whole human and do understand that your husband is dying, and grant time off work and again of course the cost to the economy in hours lost is minuscule in comparison to the cost to the NHS of providing 24/7 care. The NHS is the people’s NHS not as some trite socialist mantra but because at its best it is the combination of the efforts of all involved, patients and their carers and staff alike; indeed the patients being patients may not be in any fit state to make any efforts.
Thus the view from the top of tree, Cancer Services at UCH, and we have all of us, secretaries, receptionists, nurses, Consultants, heard that it’s not necessarily like that in the lower branches, GPs who are unreachable or roundly described to us as useless, doctors at local hospitals who refuse to talk to you, who sure referred you to us but didn’t even tell you you might have cancer, so you go into a flat spin when you receive an appointment-letter from Cancer Services, doctors who don’t bother to even try to find out what is wrong. Occasionally, usually when a child has died, totally useless doctors hit the headlines, but assuredly there are many more who are merely fairly useless.
There are also of course people who are just not that ill. It’s not just that they don’t have a life-threatening disease, they don’t even have a chronic one. They may waste hours of medical time going from doctor to doctor. Then there are people who have something simple cured not by packing themselves into desperately over-crowded over-worked A+E departments but by a few days in bed. A+E units frantically try to thin the numbers with posters pointing out they are for EMERGENCIES, got that, EMERGENCIES. But when is a non-emergency an emergency, at least from the patient’s point of view, if you are frightened by what is happening to you and know you can’t get a GP appointment for two weeks, by which time you might be dead.
If Labour is to champion the people’s NHS it needs a clear-eyed view of human beings. Not all doctors are saints, not all nurses are angels, not all would-be patients require doctors. And of course that which is in some quarters unsayable: we are each of us responsible for our own health. I do not think the grossly obese, the chain-smoker, the semi-alcoholic should be denied NHS care when it becomes needed. I do think it needs to be said, loudly and often, that there are at base only two kinds of ill-health: that the sufferer can rectify himself or herself and that which requires medical intervention. If you are fat, breathless and running headfirst into heart problems, you may be able to turn yourself around before it’s too late. The reviews of GP practices on NHS Choices are fascinating. They tell you which practices to avoid like the plague. They also indicate there are people whose response to being told by a GP to take more exercise and reform diet is to complain loudly about the GP. Dear Labour, if a person can afford to routinely drink and/or smoke, that person can afford to eat properly and is not desperately poor. I know you hate any suggesting there may be ‘deserving’ and ‘undeserving’, but that is just a particularly tough and possibly even slightly mouldy piece of Cheddar.