Why the imbeciles in hospital management need to change

The other week my father was rushed to a large hospital in Kent with severe stomach pains. The ambulance crew had been great (nearly all my experiences with ambulance crews have been impressive – it seems to be a job that attracts decent, compassionate characters).

I don’t think anyone goes into hospital in this country expecting ceaseless efficiency or a speedy resolution. You know you’ll be tested, in a non-medical way, yet you hope that a serious attempt will be made to diagnose you. The junior doctor that quizzed us in A&E was the worst junior doctor I’ve encountered. A total failure in bedside manner, command of English and ability to digest medical information. I offered her a recent report from a consultant about my father to provide background. It was a mistake. The letter stated there was ‘concern’ about carcinoma.

“There is a malignancy. You have cancer,” she said, adding: “We don’t scan here.” It was hard to figure out what she meant. We’re not willing to give you a scan? We don’t have a scan right here in A&E? Because obviously, in a major hospital, they do scan.

The severe pain didn’t interest them much, but blood and urine tests showed infection and kidney trouble. My father was admitted. For eight days he was passed from ward to ward, where the documentation I thought helpful seemed to irk the doctors since it required them to read something.

Almost nothing my father was told turned out to be true. This ranged from basic promises like “I’ll get you a chicken sandwich” (not got) to weightier matters like “We’ll give you a scan” (cancelled). It looked as if he was a victim of some turf war between the respiratory team and the radiology crew (although, why if you have stomach pains, are you under the respiratory team?). Once admitted he went more than 24 hours without being seen by a doctor, and one only turned up (apologetically, it’s true) because I was jumping up and down in a big way.

I spent at least four hours with my father every day, helping him eat, helping him wash, helping him pee, helping him explain his medical history, Groundhog Day style, to a procession of different doctors (he only saw one doctor twice), helping him get his medication (I had to ask for his morphine three times on one occasion, over an hour). If you’re elderly or seriously ill and you’re in hospital on your own, without family or friends to fight for you, I’d say you’re finished.

Finally, a consultant actually admitted that they weren’t prepared to do anything, so we transferred out to a private hospital. My father was in the Kent hospital for eight days and while he got painkillers, the sole investigation was an x-ray of his stomach. I remembered thinking we might as well have gone to see a shaman, because at least with a shaman, you get a bit of artistry, some showmanship and the diagnosis could not have been any wackier. The consultant had suggested that my father might be suffering from constipation, this despite the fact he had eaten almost nothing for a week and had been pumped full of laxatives. When we reached London Bridge hospital they established in three days it was an aggressive adenocarcinoma. So oddly enough the inept junior doctor turned out to be right.

There’s a big sign outside the Kent hospital, pointing out the staff are there to help and they shouldn’t be subjected to any abuse or harassment. That’s absolutely right. Because there are some good people working there. I could see some of the nurses were embarrassed by the treatment my father got, and there was at least one doctor who was genuinely attentive to my father’s medical history.

And the stupid and the useless? No, they shouldn’t get abuse either. It’s not their fault they’re stupid and useless. It’s not their fault they’re employed in a hospital. That’s the fault of management. The shadowy figures you never see, who are comfortably hidden away from the front line, well away from scrutiny or importuning (try looking up the management of particular hospitals on the internet to see who’s who. M16 has more candour).

I know several senior doctors who have quit the NHS, not because of money, but because they simply can’t bear to deal with the imbeciles who proliferate in management.

I have a solution. The management of a hospital should be working in plain sight, without security, right next to the main entrance of the building, so that everyone passing through could have a chance to express their views directly and ad hoc about the hospital’s performance. Things would improve overnight.