Could Hospital’s horror stories help cure the NHS?
14:27 24 January 2017
The powerful television show that might just make a difference
After three weeks in the Albert Ward recovering from a broken ankle, redoubtable 91-year-old Dolly Jackson is ready to be transferred.
The good news is that following a search lasting several days, relieved staff have found her somewhere to go. The bad news is… there’s no transport. Just another drama in the constant chaos of a frantically busy London hospital.
A model of stoic cheerfulness, Dolly sighs: “The problem of getting a place in a care home has been solved. But now I’ve got to get there. You don’t know whether you’re coming or going. I might have to stay here all night again. It’s a farce really. It could be made into a comedy.”
But the increasingly critical situation at St Mary’s Hospital, central London, isn’t funny. It’s tragic. Sometimes literally. Every moment of every day the battle of the beds rages with such ferocity that doctors, nurses and managers are forced to make life or death decisions while desperately sick patients become pawns in a grim game of chance.
If, like me, you hadn’t quite comprehended the scale of the escalating troubles facing the NHS, watch BBC2’s Hospital. This six-part series should be required viewing for Theresa May and her Health Minister Jeremy Hunt. Here, in one of the most harrowing programmes I have ever seen, the extent of the crisis is laid heartbreakingly bare.
Even as a mere viewer these extraordinary documentaries take you on a rollercoaster ride of uncomfortable emotions. In the first episode, cancer sufferer Simon was waiting for an operation to remove a tumour from his oesophagus. But a woman called Janice with a ruptured aneurism was being rushed from Norwich for emergency surgery. Unless she perished on the journey, there would be no bed for Simon.
To root for this poor man was effectively to wish for the death of another human being. A macabre nuance that wasn’t lost on Simon. “How does it make me feel?” he enquired, his eyes filling with tears. “Guilty”. In the end, Janice arrived safely and a dejected Simon trudged home. It was the second time his operation had been called off at the 11th hour.
Once again, a surgeon, nurses and a theatre were all available. But in the absence of any beds, all they could do was pray for a miracle. To no avail.
With 297 beds, St Mary’s treats thousands of patients each week. As 150 cases a day pile into A&E, the entire building is packed to capacity. “The walls are not elastic,” says Sister Anna Markay. “It’s all about beds, beds and more beds.”
In charge of the eternal hunt for space, site manager Lesley Powls adds: “We’ve got lots of patients competing for an unknown number of beds.” In short, they’re at breaking point.
For retired software engineer Peter Lai, 60, his big day had been two months in the making. In a triumph of coordination, a huge (and hugely expensive) team was on hand to remove an aortic aneurism that was in imminent danger of bursting.
Four consultant vascular surgeons, one cardiac surgeon, two perfusionists, three anaesthetists, one general surgeon and several expert nurses were all assembled and raring to go. “I think we might be lucky,” said head honcho Colin Bicknell. But they weren’t. Suddenly, a guy with a serious brain injury required the one remaining intensive care bed and Peter was out of luck. No room at the inn.
A portrait of restrained exasperation, Bicknell said: “It’s unreal isn’t it? The last minute. Yes and then no. It always feels like the worst thing in the world.” And with that, Peter’s ordeal continued.
His story is one of many sagas of despair that unfold at hard-pressed hospitals that are quite simply chronically over-subscribed. As the population grows so does the demand for free healthcare. It may not quite be – as the Red Cross suggested – a humanitarian crisis, but before long it seems certain that something’s got to give.
In my capacity as a television critic I can’t remember a more powerful programme than Hospital. In a quiet and unsensational way, this compelling production objectively chronicles the struggle of a beleaguered NHS that is on the cusp of not working.
We’re used to the rows about underfunding, understaffing, overworking and overcrowding. We’re used to the attrition between junior doctors and their hated nemesis, the cruelly mispronounced Hunt. But these are dry statistics and black and white headlines. Here on television are the stark realities of Britain’s medical frontline in gruesome technicolour.
As he pronounced the intensive care unit to be “completely full to the rafters”, stressed consultant anaesthetist Helgi Johannsson revealed: “There are times when I think that if another thing happened the system would break.”
Keyhole surgeon George Hanna added: “It’s rare to be actually allowed to go ahead with an operation.”
Far from shrugging their shoulders, the dedicated professionals cannot hide their simmering frustrations. They want to help. All too often, they can’t.
The pressure to downgrade intensive care patients to the high dependency unit is intense. At the other end of the treatment scale, the need to discharge the less critically ill as swiftly as humanly possible is also crucial to the bizarre bed-juggling that never stops.
A formidable woman who shuffles the space for the five inner city hospitals of the Imperial College Healthcare Trust, the remarkably resilient Lesley Powls handles the adversity with admirable calm. “It’s not like I don’t go home some days, walk through the front door and start crying,” she admits. “Because I do. I never do it at the office, I’ll always wait until I get home. Sometimes I think, that was the day from hell.”
To add to the poignancy of these tales of NHS woe, Simon and Peter finally underwent the operations they so urgently needed. The sight of their devoted wives Patricia and Diana caught on camera anxiously hoping for the best was deeply moving. Sadly, despite the best efforts of the St Mary’s staff, Simon and Peter subsequently died.
On a lighter note, they found an ambulance to take old Dolly to the care home and three weeks later she returned to her husband Peter as right as rain. A small victory and a happy ending for a lovely lady. She’s a television natural.
So who or what is to blame for this lamentable state of affairs? Is it an uncaring Tory government starving the NHS of the money to do the job? Is it chief executive Simon Stevens and his highly-paid cohorts failing to run a vast and unruly organisation cost-efficiently? Or is it simply that there are too many people in the UK and not enough hospitals? Whatever the answer, the consensus among the medical fraternity is that things can only get worse.
After more than 10 years watching all the rubbish the television industry can throw at me, I can tell you that very few programmes come close to making a difference.
But such has been the strength of the response from a horrified public, Hospital might just help to bring about the necessary changes to cure our ailing NHS. Before it’s too late.
Kevin O’Sullivan was television reviewer for the Sunday Mirror for 10 years, is resident critic for The Wright Stuff, and features on Radio 5’s Afternoon Edition Television Club. He also reviews at tvkev.co.uk