James Delingpole

What I learned while nearly dying

My NHS experience, with a life-threatening problem, was an encouraging one – apart from the other patients

27 February 2016

9:00 AM

27 February 2016

9:00 AM

There’s some journalistic research you’d really never do by choice. Spending four days in an NHS hospital with a life-threatening pulmonary embolism, for example.

Unfortunately it was out of my hands. I fell off a horse, one thing led to another, and suddenly there I was, lying in what I imagine is a reasonably typical NHS ward being tended by all those multi-ethnic nurses and hard-pressed doctors you read about in the newspapers but rarely encounter yourself because in order to do so you have to be quite seriously ill.

So: what have I learned?

First, that it’s not as bad as you’ve long feared, especially not for anyone hardened by the experience of the military, prison or — in my own case — being at an English prep school in the 1970s. Yes, it’s all a bit spartan, but the staff from the porters and cleaners to the consultants were a delight, and I grew very fond of my multinational assortment of nurses from Poland, Zimbabwe, Portugal, Ghana and south India, who couldn’t have been harder-working, jollier, more competent or more caring.

Also, the routine and the retro ambiance can become weirdly seductive: the morning clean-up team who’ll either shave and wash you in bed or give you the towels and shower gel to do it yourself (NHS razors are horribly blunt, though); the jolly dinner-lady type who comes round and round with tea, forgetting every time that you don’t take sugar; the endless blood-pressure and temperature checks; the dispensation of your medicines in those little plastic cups; the school food; the hideous but oh-so-practical, one-size-fits-all pyjamas. If you were healthy you’d be appalled by everything: the noise, the light, the smell, the Soviet basicness. But when you’re ill, there’s almost nowhere you’d rather be and you feel in very safe hands.

That’s the good side. Now the bad — and it’s so bad I’m surprised it isn’t more of a national scandal. We read a lot about a service stretched to breaking point but what few of us grasp — I didn’t until I saw it myself — is perhaps the main contributory factor to this: bed after bed occupied by elderly, often Alzheimer’s-afflicted patients who simply don’t belong in wards designed to treat acute, short-term conditions.

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I don’t mean to be heartless here. Clearly we need to find some way of ensuring that our elderly, especially those with no family to care for them, live out their twilight years free from misery and discomfort. But the place for these people is a dedicated home run by carers, not an expensive-to-run NHS ward with highly trained staff and valuable equipment designed primarily for emergencies.

A pulmonary embolism isn’t the worst thing that can happen to you but it’s pretty bad. On my first night, as I lay wracked with pain that sometimes penetrated even my morphine delirium, I could not but be conscious of the skeletal, rambling old geezer opposite me spraying his entire bed area in explosive diarrhoea.

Bright lights on for at least an hour. A team of three night nurses or primary care assistants heroically, uncomplainingly clearing up the mess. No gratitude at any point from this bloke, who may have been suffering dementia or may possibly just have been paranoid and suicidal. A hideous stench. Do you really need this kind of shit when you’re quite seriously ill? I don’t think so.

Each day, all day, the man lay quietly, doing nothing more annoying than turning on his TV/radio so that pop music came out really loud. Only towards midnight, just as you were drifting to sleep, did he become hyperactive. The paranoid burbling started. He decided that people were trying to murder him and he kept trying to escape from his bed, detaching himself from his drip and falling heavily, with the result that he had repeatedly to be checked by anxious medical teams worried that he’d broken something.

I saw this happening a lot: old people who’d been admitted for acute problems (e.g. cutting their feet on some glass) very quickly becoming long-term cases as, in hospital, they let down their guard, gave up on their last vestiges of self-sufficiency, and succumbed to a series of subsidiary problems — constipation so bad that it threatened to require surgery, say; or injuries sustained from falls while trying to get up, confused, in the night.

This is what is meant by ‘bed-blockers’. They were only expected to stay a couple of nights; instead they become semi-permanent because the NHS, being in the business of caring, cannot bring itself to chuck out people who aren’t sufficiently fit and well.

Again, let me stress, I’m not saying our system shouldn’t look after these people. Of course it should. But it should formally acknowledge their existence and deal with them sensibly, not let them fester on acute NHS wards, taking up specialist time, helping to breed MRSAs.

It’s not just me. My sister-in-law had a similar experience when she had a pin put in for a broken leg. The whole night, an Alzheimer’s woman in the bed opposite screamed the most foul-mouthed racist abuse at her two black carers.

You leave an NHS ward (I did anyway) full of affection and admiration for the staff: those diarrhoea cleaners; the Filipino who had to sit patiently by the skeletal man’s bed through the night, talking him out of his attempts to escape. But is this really the best use of their reserves of strength and skills: babysitting the demented? Cleaning up shit?

Is this how you imagine it being, all those of you out there who believe that if something bad happens to you — a car accident; a fall from a horse; a heart attack; whatever — the NHS will be there to pick up the pieces and dedicate its fullest professional attention to your injuries?

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Show comments
  • bufo75

    This is not a new problem but thank you James for highlighting it.

    • Shinsei1967

      Surely they’d be funded from the resources freed up from not looking after them in expensive hospitals.

      • Mary Ann

        That requires joined up thinking and one budget for both.

    • Mary Ann

      How about raising the income tax, the government won’t do that, while we all want more money spent on the NHS, (apart from the rich) we don’t want it to be us who pay for it, but the NHS is a lot cheaper than the private systems that generate so much paperwork and good health care is so important for improving happiness.

      • Tamerlane

        And build more beds to be filled by more bed blockers?

      • William Brown

        You could throw as much money as you want at the NHS as it is – it still wouldn’t be enough.

        Unfortunately, the left believe (because it’s easy and lazy thinking), that it just needs money. Progress is often hobbled by intransigent medical consultants, who roam God-like around the wards, alongside bureaucratic managers who are either too scared to question the orthodoxy, or happy to take home a six figure salary.

        The real workers – nurses, porters, hospital doctors, admin staff, etc., are underpaid, undervalued and overworked and just doing their best to get through their over-long shifts day after, day, night after night. Frankly, I don’t know how they do it.

        If you didn’t watch it at the time of broadcasting, watch this series Mary Ann – it just shows what could be done. https://www.youtube.com/watch?v=YIl0b7dWHHY

    • Flintshire Ian

      Maybe with some of the post EU savings?

  • camjan2

    Elective work is being postponed weekly by this huge problem, well highlighted in this article. Can you imagine how doing elective work over the weekend as the Government wishes, would compound this failure. Mr Hunt the system is barely coping with elective work over 5 days. Adding 2 more days is barking.

    • JimHHalpert

      I don’t think you quite understand. It’s the same amount of work being spread over 7 days instead of 5. I – and the general public when they’re asked – want a 7-day-a-week NHS, not something run for the convenience of the producers.

      • camjan2

        That is extremely expensive. It requires departmental secretaries to be in , all X Ray staff, the lab staff, porters full complement, nursery staff to look after staff children on weekends…most hospitals have a children nursery nearby . The parking and maintenance people and I Twill have to be in hospital

  • dramocles

    Some years ago, when my mum was rehabilitating in hospital after a broken hip – in a ward full of old people, my sister and I decided the best place for her was for us to care for her at home. The doctors demurred and tried to resist discharging her. Fortunately we were sufficiently experienced to overcome these objections and – somewhat reluctantly – they allowed us to leave (I have no doubt that they believed they had my mother’s best interests at heart).

    As we left, a senior nurse came over and confided “it’s really nice to see someone get out of here alive…” It was chilling.

    My mother made a complete and happy recovery.

    • Sarony

      Our biggest regret is that we didn’t do exactly the same for our mother. She died in agony from CD (we think) five days after discharge following treatment for pneumonia in a ward beset by explosive diarrhoea. The doctors had confidently expected her to be as right as rain.

  • MikeH

    Last year a close friend suffered a stroke and was initially admitted to the ICU, then onto a stroke ward. This particular ward was made up of three separate bays of around ten beds, two all male and one female-only. The thing that struck me was the demographic makeup of these wards; nearly all elderly British, with one Irish chap. The initial thought on seeing this was ‘here’s the frequently reported bed-blockers’

    Each evening’s visiting session started with a floor wide search for seating, often poaching the ward’s computer seat, duly returning it at the visit’s end.

    One particular evening after a fruitless search for seating around these three sections, one rambled a little further, through two swing doors towards a hitherto unseen separate entry / exit and took a wrong turn into a huge, filled to capacity five bay ward; this ward’s beds were completely full with elderly Asian folk, in various states of indisposition and in glorious segregation from the natives’ ward.

    That experience revealed real bed-blocking and showed the root cause of NHS issues: the keenness to import and then fawn over the world’s poor and sick in the most misguided, deleterious ideology without planning or provision.

  • nouveaulite

    I always felt you looked overworked JD. Get well soon.

  • William Brown

    You’re right, there is a huge problem with care for the elderly. It is so often very, and I mean very, poor and ridiculously expensive, with private care homes demanding whatever they want, in terms of price. It is noticeable that many care homes are often owned by a kind of ‘buy to let’ investor, who has, at best, a passing interest in providing a service, but are mainly concerned with lining their own pockets handsomely, while employing cheap, untrained and frankly incapable staff.

  • davidshort10

    Probably not typical because this fellow was probably in hospital in London.

  • http://www.facebook.com/nigelbryancook Nige Cook

    Dementia can now be prevented by giving bexarotene to worms (or to old folk): http://nhv.us/content/16024316-experiment-worms-against-alzheimers-disease-proves-promising There are 850,000 in the UK with dementia so this is a costly problem that needs preventing. Unfortunately, the people in medical science are very slow and conservative because of laws due to past mistakes like thalidomide.

  • http://www.facebook.com/nigelbryancook Nige Cook

    Was the horse OK?

    • SICK OF THE IDIOTS

      Was the fox OK????

  • seangrainger

    A long time ago I went to the clinic in Davos with some minor skiing scrape. Thereafter I fancifully suggested any Swiss nurse could sort out any UK. hospital. Last year my friend and neighbour in Munich took me to visit his friend and former neighbour Volcker who retired from running a 600 bed hospital in the Bavarian capital. Volcker ,,, not fancifully ,,, could run the NHS blindfold. We taxpayers should import proper management to replace the tossers allowed to coin it in our Trusts.

  • http://www.twitter.com/edzeteito Eddie

    Steady on. I’m related to a Primary Care Trust manager.

  • T Gould

    The NHS is so adept at turning anyone who criticises it into a pariah nothing will be done. Sorry.

  • Jacobi

    My experience was slightly different. Pneumonia. Out after five days of protest at being detained. But two patients both young , retained and
    apparently willingly so because they had infected pinkies, you know, little finger. I kid you not!

    The nurses were great. Mean that not just saying it. The doctors were not. Not just saying it. An impression reinforced by the recent unprofessional strike shambles.

    • jamesdelingpole

      I found that some of the doctors lacked people skills and were rather brusque. Gave the impression that patients were a slight impediment to the running of the ward.

      • jamesdelingpole

        I also think I was lucky in my hospital – a teaching hospital outside London. I gather that nurses aren’t great everywhere.

      • Jacobi

        I have a very specific example. Someone in about the same time. His consultant (and accompanying junior doctors) assured relatives he was effectively dead and discontinued treatment. The ward nurse waited till they had gone, quietly replace the device and within 3 hours consciousness had returned. He is running around today, fit as a fiddle, admittedly a somewhat aged fiddle.

  • TruckinMack

    Let me help. When the elderly arrive in pain, if they are given a variety of pain medications, they will become constipated, often severely so and with more severe complications.

    The NHS needs to stop handing out life threatening pain meds because they don’t know what else to do. (I’ve seen more than a few patients degrade seriously because of problems with pain med management.)

    • Ed The Duck

      Regarding degrading as you put it, allow me to add from my own observations that as the staff – overstretched to start with – don’t have the time to assist the elderly with simple things let eating and drinking, they go downhill and get worse, not better. Usually without the staff noticing or understanding what’s happening.

      During a couple of NHS stays of my own, I saw exactly the sort of thing James describes and two old gents probably dying or getting very close basically due to dehydration because staff didn’t see they weren’t actually drinking or able to manage holding a cup. Classic cases of 3 day “oh, didn’t you want your tea, dear?” syndrome because no one joined the dots.

      Advice to those with elderly relatives going in: get them put on a drip regardless so that you know they’re hydrated.

  • Burt

    Do hospitals no longer have geriatric wards for such patients?

    • Ed The Duck

      Sadly, no they don’t. Some years back, no doubt in cost-saving mode, a government axed long-term or specialist geriatric wards in favour of treating the aged on standard wards. With the consequences JD describes.

      • Burt

        Grim. 🙁

  • http://www.herkinderkin.com/ Herkinderkin

    Lucky escape, James. My wife was recently hospitalised for angioplasty and observation after a frightening bout of atrial fibrillation – luckily, she was given a clean bill of health. I hope you likewise are now hale. The NZ public hospital system hasn’t deteriorated as far as your NHS, thankfully. My wife was in a specialist heart ward.

  • Jon Hagger

    Simple James. Get PRIVATE health insurance. Private ward. Nicer nurses and attendants. Your mates visiting you, WITH BOOZE, at virtually any hour. Your specialist dropping by each morning: “when would you like to go home? Tomorrow? Really? Ah…stay another couple days…you’ll be right”. And you know what? You usually are. Not ideal places to be, but you have your own TV (it’s not an extra), so you can sit up at all hours watching endless reruns of Jeremy Clarkson’s Top Gear, etc. etc. etc.
    So if you are crook, why slum it? Really!

  • Matthew

    Who gives a toss “James”…

    Heard your interview about this on bbc2 Radio earlier today. When asked the question of how you fell off a horse and what were you doing, and asked were you hunting, you avoided answering…

    He fell off that horse because he was hunting, everyone.

    Coward.

    • alfred5

      It’s a pity he wasn’t hunting you , you twerp

      • Matthew

        Its a pity you’re a t**t.

  • Mark B

    Not fit enough to go anywhere with your own power so you have to annoy a horse? Guess the horse thought the same way we do.

    • Matthew

      Love it. 🙂

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