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A stroke in time


We nearly lost one of our founders recently. He's still with us however, for good or ill.

“You will be pleased to hear that Mrs May this morning found an extra £20 billion for the NHS,” said the cheery doctor as he strode into my room, swinging his stethoscope, on the Acute Stroke unit of the hospital at 7.30 am. “Great news” I drooled and spluttered, trying to frame the words I could grip in my head but which slithered off into gobbledegook.

Then I realised the doc wasn’t interested in my political views but was testing my speech. Dysarthria, (try saying that when you have had a stroke), is a speech disorder caused by muscular control problems. Better that than dysphasia – at least I can read and write and make meaningful gestures, although very much slower than usual; poor old dysphasiacs are just faced with a word jumble coming in or going out – or worse still, both ways.

The early symptoms of my stroke were small – I couldn’t press down the X on my keyboard and my left hand declined to do what I wanted. By the time I got to A&E in the early hours of Saturday my blood pressure was 230/170, indicating a “hypertensive crisis”. All kinds of nasties threatened, ranging from permanent organ failure to a severe lack of humour.

The triage nurse skipped me through the assembled social wrecks with busted noses and impaled limbs waiting in A&E and for the next couple of days I got the best the NHS offers – a single room plus bathroom/shower, regular blood pressure and sugar level and other readings, CT scans and an MRI, a heart scan, monitoring by skilled senior staff, experts in their field, enough drugs to kit a pharmacy, consultations by speech therapists and physiotherapists, and much more. I gave up counting the number of times I tracked moving fingers or gave blood for tests. I named as many animals as I could, starting with the letter F, in a minute. I looked at pictures and named the objects. I remembered and recited brief sentences. All this checking, assessing, thinking about me – all done by skilled and trained human beings.

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Even the food tasted good.

What would that little lot have cost me in the USA? Upwards of $50,000 I suspect. Here in the UK for me, a British citizen, it’s ‘free’, although of course it isn’t free at all, but paid for out of your and my taxes. And as I was lying on that gurney being glided around by someone named Oskar I could only think how incredibly lucky I was. I was seriously ill with permanent but recoverable brain damage, but I did not have the extra worry about how I was going to pay for this world-class treatment.

And suddenly I saw it: the miracle of the NHS.

That miracle has many elements but one of them is how the NHS survives, against all the odds; how it attracts and keeps its staff. On my acute stroke unit I learned that the normal staffing level is 24 nurses; the unit currently has 9. The consultant who saw me at the unearthly hour apologised for arriving so early but explained that “I get more done like this.” Turns out, he’s also medical director, an admin job. “Someone has to do it,” he said. I got magnificent care – comfort and support, not just treatment – from a friendly but exhausted nurse at 4 in the morning. Morale was high, or at least seemed to be so – and that helped me be positive.

And of course there were many who cared for me who had no organic connection to either me or this country. The lady who brought my lunch was from Ghana; the young woman who scanned my heart was an exile from Venezuela; the man who wheeled my chair goodness knows where. Poland, Portugal, the Czech Republic…I lost track of where they all came from. Their English was excellent; their skills professional; their personalities charming and kind.

I saw with clarity how our values are totally ridiculous. We think it fine that someone whose job involves sitting in front of several screens watching a series of figures turn from red to green and back again, who occasionally picks up a phone and says ‘buy’ or ‘sell’, gets squillions, while someone who helps save my life gets £25,000. This society does not deserve the NHS.

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Is this just “survivor’s sentimentality”? I had a really good experience while facing a life-threatening calamity, so therefore my addled brain is even more unreliable than normal? I don’t think so. I’m not blinded to all the cock-ups and waste of the NHS – I was asked to wear a pair of green Coco-the-clown-sized linen-like trousers for half an hour while I was in the MRI machine, trousers I was told would be thrown away (“to prevent infection”) rather than washed and re-used.

And the bloated managerial fat is truly appalling. There are more layers in the NHS than in a Patisserie Valerie mille-feuille. One nurse told me of a manager who was recently recruited on a salary of “a quarter of a million” with the task of…seeing how costs could be cut. Even if that story is apocryphal it tells us something of how NHS management is viewed by the nursing and care staff.

No. I am not blind, but have been struck by a bolt of understanding, one in which however Mrs May finds the money to fund the £20 billion extra, I and everyone else will be grateful – so long as it is spent wisely and not wasted (and I know that’s a big ask). The reality is that at some point we are all going to need and want the NHS. It may be when we are 10, or may be when we are 100. You will never know when the disaster is going to happen. When it does you will be glad you live in the UK and not Venezuela – or the USA.