Saturday, 16 March 2013

Some Words in Praise of the NHS
  and the Gift of Choice

At time of writing there has been widely reported ‘bad news’ in the British press and broadcast media concerning the NHS (National Health Service). A government adviser has pointed out that there have been 20,000 avoidable deaths in certain poorly performing hospitals over the last decade. Needless to say, this is scandalous. But my intention here is not to condemn the NHS, despite some very serious failings in some areas of the country.

Those who have read some of my previous blog entries will know that I have often touched upon a particular issue that, by implication, incorporates criticism of the NHS. That issue is the historic abuse or inappropriate treatment of people – especially children and young people – within mental healthcare settings (and one setting in particular).

Indeed, as a result of my book Delivered Unto Lions I occasionally hear from people with their own horror stories related to past mental health treatment within the NHS. And I am also aware of one or two horror stories relating to recent or current treatment. It should be emphasised, however, that such things are not confined to the NHS. Bad things happen in the private healthcare sector too. And in any case, I’ve also heard of examples of excellent mental health treatment within the NHS.

Negative attitudes and maltreatment in mental health settings were, of course, deeply entrenched long before the creation of the NHS – if anything, such things have improved (though not nearly enough) since the 1940s when British government minister Aneurin Bevan set in motion the events that led to the creation of this system of healthcare.

One of Bevan’s assumptions was that free healthcare available to all (funded through taxation) would lead to (a) an improvement in the health of the nation, which would in turn lead to (b) the NHS being able to ‘pay for itself’ as better health led to a more efficient economy (healthy workers better contributing to a healthy economy). Needless to say, this didn’t quite happen. The health of the nation certainly improved, but the NHS did not ‘pay for itself’ – as Geoffrey Wheatcroft, a columnist for The Guardian, recently pointed out.

But whatever deficiencies may exist within the NHS, I want to say something positive about my own recent experience of treatment. This experience has included the very welcome opportunity making my own choice with regard to treatment. This isn’t a completely positive story, but it is a substantially positive story.

One of the reasons why I’ve been silent on my blog during the early part of this year is because I was given some unexpected news on the final day of last year.

On 31 December 2012 I had an appointment with a urology consultant at Worthing Hospital in West Sussex. I was expecting some ‘inconvenient’ news, but not anything especially bad. However, the consultant told me that I had cancer. It was prostate cancer. At the time I was surprised rather than shocked – not having yet hit 50 I thought I was a bit too youthful for that sort of thing! The fact that I didn’t react with panic on that occasion may have something to do with the consultant’s rather quaint and reassuring turn of phrase. That’s a good thing!

Over the following weeks I had various scans and tests before learning that my best option was surgery, which in this case meant radical prostatectomy (surgical removal of the prostate).

Less than a month after I was given my cancer diagnosis I met my prospective surgeon. He carefully described the procedure and what I should expect in terms of recovery, and then he patiently answered all my questions.

Since the beginning of this year, every one of the staff members I’ve encountered at Worthing Hospital – consultants, registrar, surgeon, specialist urology nurse, other nurses, counsellor, etc. – has treated me with professionalism and courtesy. I have experienced care of the highest standard.

Unfortunately, the surgery I need is not undertaken at Worthing. I was told I would have to go to another hospital, some 50 miles away, for the actual procedure. I won’t name the hospital where the surgery was to take place because it does not come up to the same high standard I’ve witnessed at Worthing (I’ve already said that this is a substantially positive story, not a completely positive one).

I attended a preoperative assessment at the hospital in question. I won’t go into too many of the unpleasant or off-putting details, but I will just say that I never expected to be sent home with a blank consent form to sign! (That’s the yellow CON 1 form for anyone who’s interested.) Needless to say, I came away determined that I would not sign away my consent on a form which had not been filled in. In fact, I was determined not to be operated on at that particular hospital.

The following day I did a bit of hasty research (clearly this is something that I should have done earlier!) and identified another hospital and surgeon, both with excellent reputations (not that I had any objection to my original surgeon). I then tried to see if my own GP (General Practitioner) would be willing to refer me to the hospital and surgeon of my choice. That referral has now been made with no difficulty whatsoever.

At present this story doesn’t have an end. But it does have a message. The NHS provides free treatment to UK citizens at the point of delivery. In many countries a cancer patient would be reliant on private insurance to pay for a radical prostatectomy. With the best surgeons at the best hospitals charging thousands more than their less experienced and less well-regarded counterparts, it’s easy to see where many insurance providers would steer their policy holders.

Like any very large institution, the NHS it has its dark corners. But there is also light. This will be no comfort for those who have not received the best treatment, those who have lost loved ones to poor treatment, and especially to those who have done so without realising there was a possibility of choice (at least in some cases). But for those yet to need treatment, this could well be an encouragement.

While my operation will now be delayed a little – due to my ‘eleventh hour’ exercise of choice – I now know that I will undergo the procedure at a centre of excellence performed by one of the best surgeons. This is a true privilege for which I am very grateful.

Delivered Unto Lions by David Austin is published by CheckPoint Press
ISBN 978-1-906628-21-5

For more information visit

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