The hell that is A&E

At the weekend I spent far too long in an A&E department. Now my story is nothing special and it could be repeated by thousands of people around the country. The worrying thing is precisely that – my experience is now normal, rather than exceptional.

It was my husband Ian who needed medical care, complicated by the fact that he is 79, has some disability and uses a wheelchair outside our home. We didn’t think we needed to go to A&E but phoned 111 on Sunday afternoon for some advice. They sent us to the out-of-hours GP unit at a renowned teaching hospital some 40 minutes drive away. The GP there thought he needed to be seen by hospital staff, and possibly admitted, so sent him down the corridor to A&E.

We probably arrived at a bad time. Not only was it the weekend but junior doctors had been on strike earlier in the week so no doubt some people had held off until the Sunday evening. First we joined the queue to see the triage nurse, alongside a police officer with a prisoner. The small waiting room was already packed with around 50 people, at least half of whom were in some kind of distress, the others anxiously concerned about them.  These were in addition to the patients arriving by ambulance through a separate entrance. It was surprisingly quiet – each person silent in their own island of pain and worry.

We were sent straightaway to the Urgent Treatment Centre, which implied (correctly) that our need was actually less urgent than others. This waiting room was less packed and indeed some people were sitting outside the door in the cool of the garden area. The notice board announced a wait for adults of a rather precise 174 minutes. A vending machine dispensed chocolate bars and drinks, but all the catering facilities in the hospital were closed. We were grateful that we had eaten a meal before we left home.

The woman sitting next to me was clearly in a lot of pain, apparently from a broken arm. She was whimpering and praying with every breath. There was nothing I could do to help her, apart from offer to get her a cup of water. Over 3 hours later she was called in and I felt her relief. Eventually just Ian and one other patient were waiting to be seen. It was well after midnight when a nurse said the unit was closing and took us back to the main A&E waiting room. I was worried that we would have to start the wait period all over again, but was reassured that it wouldn’t be long.

A&E was just as overcrowded as when we had first arrived. Some people had to sit on the floor. One man was stretched out fast asleep under a chair – we realised that he was drunk when he tried to attack a nurse who attempted to move him. The door of the disabled loo had been vandalised and was unusable.

At last, over five hours after the appointment in the GP unit we were taken through to see an A&E doctor who was amazingly cheerful and reassuring. She decided Ian didn’t need to be admitted after all, and sorted him out with medication and a follow-up appointment. We finally left the hospital at 2am.

The staff were extraordinary. They were courteous and calm throughout and I admire their resilience. I’m sure I would be a quivering wreck at the end of a shift in A&E. But they must have shared the patients’ frustration at the suffering caused by the long waiting times. Patients and staff all deserve better than this.

This is, of course, just one snapshot of one segment of the NHS. Similar stories can be written about many other aspects of the NHS which are not functioning as intended, from ambulance wait times to waiting times for treatments for cancer and other conditions. These are never the fault of the practitioners – medical and other staff – but result from chronic underfunding over a long period of time. Let’s do something about it.

* Mary Reid is a contributing editor on Lib Dem Voice. She was a councillor in Kingston upon Thames, where she is still very active with the local party, and is the Hon President of Kingston Lib Dems.

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  • Was the police officer and prisoner given any priority, in order to get the officer back on duty in the community outside of the hospital?

  • @theakes – I don’t know as we were moved to the Urgent Treatment Centre.

  • I was very sorry to read about your experience,Mary.

    I underwent a transplant operation at the excellent Edinburgh Royal Infirmary back in 2011, and naturally have had a continuing close relationship with them ever since, with, fortunately, none of the stuff you mention. My only observation is that the Langley 2012 Health and Social Care Act (which many of us unsuccessfully tried to oppose at the 2011 Gateshead Liberal Democrat Assembly) has not helped. It has made things worse.

    Lib Dems need to work up a detailed costed coherent sensible humanitarian policy for the NHS and Social Care to repair the damage if they ever have a sniff of power again. Social Care, as well as the NHS, is in a terrible crisis especially in the English bit of the NHS.

  • GWYN Williams 23rd Jun '23 - 11:27am

    I had a very similar experience last month when I took my son to A&E at 10 pm with suspected appendicitis. Over the next 7 hours until a bed was found, it felt as if every social problem passed through the Hospital’s doors. Two policemen brought in a man with a cut on his head about the time we arrived. A homeless man received his medication and then bedded down for the night on the bench next to me. He was still there when I left at 5am. One man was having a heart attack and despite our best efforts to attract a member of staff we failed to get any help. The lady sitting behind me found a chair and placed it in front of the receptionist where the now very distressed man was sat down until he was seen.
    Although there are huge issues with waiting lists, the funding and organisation of the NHS we will never resolve its problems if there is nowhere else for the homeless, the mentally ill and the inebriated to receive care.

  • Predictive text. Should be Lansley Act 2012.

  • Robin Stafford 23rd Jun '23 - 2:29pm

    As the party of Beveridge we should be unequivocal in our commitment to effective health and social care. This needs proposed actions on resources and funding, not just words. As one of the parties of the Coalition, the party still has the albatross of austerity around its neck. Osborne’s brazen denials of the literally fatal consequences of austerity have come as a reminder to the public of how disastrous it was. Unless you were a bailed out banker with your bonuses protected, all funded by the state.
    Until the party makes it clear that it will rebuild those services that have been so damaged by austerity, and that its priorities once again reflect those of Beveridge, it will be wide open to attack by its opponents on the centre and left.

  • David Garlick 23rd Jun '23 - 7:32pm

    I fear that the conservative plan is to dismantle the NHS in all but name.
    Failure to fund it, ever inceasing contracts with the private sector, Failure to train enough doctors or nurses and paying them too little. A recipe for disaster. If another pandemic hits or the existing ones explode again I can’t imagine how this ‘never prepared’ Govt will cope.

  • Ruth Bright 24th Jun '23 - 8:53am

    Mary. A Henry Mayhewish snapshot of the state of the nation as it really is. Wow. Salutary.

  • The health system in Japan seems to be remarkably efficient compared with that on offer from NHS. A longtime friend has just moved there from the UK. On arrival in Japan he got a health insurance card and gets 70% off all treatment. He says its a great system. As a regular imbiber of alcohol he has not taken the best of care of his health. He has already had 5 blood tests for diabetes, fatty liver and heart palpitations. He says there is no messing around, they just do whatever is necessary. After a few days of treatment and abstention from alcohol, he is feeling heathier now than he has done for years.
    Although healthcare is universal in Japan, there is a co-payment system that seems to work well enough both in Japan and Germany I expect this is probably where we are heading with the NHS as the baby boom generation ages. If a Labour government comes to power next year, they will inherit a healthcare system barely coping and stretched public finances that leave little room for big spending commitments outside of longer-term infrastructure projects like new hospitals. They will need to choose between carrying on as we are or injecting sufficient funding into the NHS to bring back the system back to an acceptable level of care.

  • Peter Martin 24th Jun '23 - 4:19pm

    @ Joe,

    The amount spent by Japan as a % of GDP is slightly lower than in the UK. You’re probably right that the Japanese health service functions as well as you suggest. The level of infant mortality per 1000 live births is a good indicator. Japan has 2.3 deaths. We have 4.2. Incidentally, the USA has 6.1. However, you’re probably wrong with your unstated assumption that it is primarily about systems.

    We could copy their system and we’d still have the same problems as we do now. Your friend, “a regular imbiber of alcohol (who) has not taken the best of care of his health” is probably far more typical of the UK population than the Japanese. I’m not sure if its a racial characteristic, or if it’s cultural and dietary, but it’s very noticeable how they are much slimmer than we are!

    What’s the correlation between life expectancy, general health and levels of obesity? I don’t know but I would expect it to be very high. The obesity issue needs to be given a much higher political priority.

    In other words, even if we were to totally swap systems with the Japanese they’d still do much better than us!

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