The
National Health Service was established in 1948 as a result of
legislation passed two years earlier. It was founded on the
humanitarian principles that healthcare should meet the needs of
everyone, should be free at the point of delivery, and should be
based on clinical need rather than the ability to pay. It is a
perennially over-stretched service and the target of frequent
criticism, which is often justified. Occasionally things go seriously
wrong and there are scandals. However, without it, a large section of
the population of the UK would have either intermittent access, or no
access at all, to quality healthcare.
As of April 1st, 2013, the NHS will cease
to be an organisation whose sole purpose is to tend to the needs of
the sick and disabled. Instead it will effectively become a brand
name, under which a raft of private companies will cherry pick those
parts of the service that make money and then run them for a profit.
Naturally there are concerns about the conflicts that might arise
between quality of care and the need to provide a return on
shareholders' investments.
The short piece of fiction below is written in the style of the
incident reports that I seemed to spend half my life writing when I
was employed by the NHS. It is somewhat flippant, and yet no less
absurd than the situations that those who work for NHS hospitals may
find themselves in, over the coming months and years.
A Period of
Readjustment
By Mark Sadler
Last Monday our hospital was paid an
unannounced visit by a senior figure from the Department of Health.
While I ushered the gentlemen into my office and made him coffee, my
colleagues scrambled to alert the wards and departments that a
dignitary was in the building, and that we should at least try to put
on a united front, and give the impression that we all knew what we
were doing.
Of particular concern was the
possibility, however slim, that our distinguished guest might run
into the disembodied spirit of Mr Wheeler, who had died the previous
evening on the respiratory ward and had returned as a
poltergeist. The member of the chaplaincy who normally deals with
patient hauntings was away on annual leave. My secretary had spent
the morning phoning around the usual temping agencies in an
unsuccessful search for a qualified individual who would be able to
deal with the problem. In the interim, a suggestion made to Mr
Wheeler's spectre by a member of the nursing staff to “go towards the
light” had resulted in him rapidly circling a strip lamp in one of
the delivery suites on the maternity ward, like an over-excited moth.
As it turned out, our visitor expressed
no desire to see the hospital and became openly hostile when I
suggested a tour of the new Linda Mountjoy Diabetes Unit, which had
been opened the previous month by Wagner – a former contestant on X
Factor.
“Driving here was depressing
enough...” he yawned boorishly. “...Tell me, do you actually live
in the area or do you commute in?”
“Well, I live in Thorpe Bay. There's
some quite nice houses there and the schools are improving. There's a
lovely new swimm...”
“Do you know what: I was just making
conversation. I don't actually give a shit.”
The gentleman went on to apprise me of
the singular purpose of his visit, which was to deliver a special
package direct from Number Ten Downing Street. This turned out to
resemble a round hat box. When I opened it I was somewhat surprised
to discover that it contained a top hat.
After I had signed for the package, the
very important man from the Department of Health informed me that, as
of 9 o'clock this morning, the government had unceremoniously cut all
funding for our healthcare trust. As a substitute for this abrupt
100% loss of income, we had been provided with a high-quality,
magical top hat. Whatever we were able to conjure from it we would be
allowed to keep and use to run the hospital.
“I would ask it for sensible things
such as a kidney dialysis machine, rather than a million pounds, in
case it decides that you're a fucking piss-taking cunt and stops
working for you,” he advised me.
My immediate response was to ask him
how the top hat functioned and whether he could perhaps give me a
demonstration. He reluctantly agreed to my request. After about ten
minutes of rummaging around inside, interspersed by occasional light
taps on the brim with a pencil, which he brandished theatrically like
a wand, he managed to produce a very wet and surprised looking
sardine from the silken void.
“Do you want this?” he enquired,
dangling the wriggling fish above the upturned hat by its tail.
“No. Thank you very much for asking.”
“I'll fucking throw it back then.”
The fish disappeared into the hat with
a faint splash. My visitor turned his attention to his coffee which
he predictably described as “tasting like it had shot out of a
C-diff patient's arse”. I assured him that this was not the case
and offered to his address his concerns by sending a sample to the
pathology lab where it could be tested for the presence of faecal
matter. This seemed to calm him down. After the sample had been sent,
he filled me in on some of blue-sky thinking that lay behind the
government's Top Hat Initiative:
“The firm that won the bidding process
provides transport for prisoner transfers and security at live music
and sport events, so basically they don't know what the fuck they're
doing. They had the hats knocked out in a factory in Jakarta. We
think part of the problem is that the pixie inside, or whatever the
fuck it is that does all the magic, either doesn't understand English
or is ideologically opposed to western culture and the concept of
socialised medicine. If you have a member of staff who can speak
Indonesian it might be worth letting them have a go at it. Also if
you sort of wave your hands above it like you're casting a spell,
that sometimes works.
“There's one other thing: We're not
entirely sure whether the hats are bringing objects into existence or
teleporting them in from elsewhere. If it turns out to be the latter
then, technically, every time you use it, you're committing theft. If
you ever get anything that looks like it's come from another
hospital, make sure that you peel off any incriminating labels and
file down the serial numbers.”
After he left, my colleagues and I
spent a fruitless afternoon attempting to conjure something from the
hat. The following Tuesday was equally barren. On Wednesday one of
the Heart and Chest consultants managed to coax a wheel of smoked
Bavarian cheese from it. Later that day a couple of nurses emailed me
and made it known that they were willing to accept this as part
payment of their salaries.
On Friday I accidentally knocked the
hat over. Somehow this jolt caused it to expel a quantity of uncut
cocaine with a street value of around £5million, all over my desk
and the floor of my office. We are currently engaged in high level
discussions, exploring whether, given the circumstances, we might be
able to legally sell it or, alternatively, whether the government
would be willing to take it off our hands and then financially
reimburse us for it.
The papers, of course, have been full
of stories about the hats. Of all the hospitals involved in the
program, Basildon has made the easiest transition, after they hired a
stage magician and his assistant to oversee the magical procurement
process. The hat at Queens hospital in Romford has gone berserk. The
only thing that staff are able to pull out of it are bewildered
patients from other hospitals, who have had to be returned to their
point of origin by ambulance. One poor man has apparently made the
round trip three times.
As is always the case with any new
initiative, there is a period of readjustment before things settle
down and get back to normal.