Who can fail to be angered by the appalling death of young cancer patient Kane Gorney, aged 22. Originally treated for a brain tumour, the treatment he had affected his bones so that he needed a hip replacement. This was performed at St Georges in Tooting, but died three days after the operation. What killed him was not a complication of the surgery but a simple lack of water. He needed to be kept hydrated at all times, which is what the doctors instructed, but nursing staff ignored him and he died a slow and agonising death of dehydration. Even now, writing these few lines, I can't help but get furious over this.
In the last few years I've had a lot of direct personal experience of hospitals, including spending several long periods in St Georges looking after my son. I've had experience of a number of hospitals in the UK, some NHS and some private, plus hospital treatments abroad. I've seen more medical treatments than most will see in a life-time. My conclusions from this? We've been sold a massive lie in the UK. The NHS is a second rate service in many respects, but no politician has the guts to say so. And most people will never see up close how it compares to treatment in Germany for example, or even to see the difference in treatment between the NHS and a private hospital in the UK (and thankfully, having a job that includes private health insurance allowed me to see it for the first time too).
When it comes to St Georges we got to see what's best and what's worst in the NHS. The good included fantastic doctors, particularly oncologists and surgeons, and excellent facilities in operating theatres and ICU. The absolute worst was experiencing nursing "care" by nurses who really didn't give a shit about patients. Dealing with a Soviet-style bureaucracy and layers of administration that seemed to drive everybody mad, from patients to doctors. Not all the nurses were crap. But there were enough of them to make the overall level of nursing care abysmal. And this wasn't just one isolated incident. This happened again and again over a number of years and a number of different wards and treatments.
This poor level of treatment was not limited to St Georges. We had similar experiences at UCH in London. Again, good facilities, good doctoring, but a feeling that many of the nurses just weren't interested. Again, let me be clear, it wasn't every nurse, but the good were crowded out by the bad, and in fact the good seemed to spend a lot of their time chasing after the bad or correcting their mistake.
By contrast, nursing care at our local hospital or at the Royal Marsden was excellent. It was excellent in every private hospital we went too and in the hospital abroad.
Why is this?
You'll hear all kinds of lame excuses about 'systemic failures' and 'learning from mistakes', but the fact is that the NHS is a lumbering beast and like a dinosaur doesn't seem to be very responsive. It's a bloody scandal that a 22-year lad has to be dialling 999 in a vain attempt to get a drink of water before he dies. If this had happened in a prison there'd be a huge outcry. Heads would roll. What's happened here? A half-arse apology from the hospital and that's it.
Fucking outrageous.
The real problem is that St Georges and UCH are both too big. They're huge lumbering giants and impervious to change, just as the nurses were impervious to a dying lad asking for water. St Georges is a merger of many smaller hospitals, all consolidated onto a massive single site. A feature of all huge bureaucracies is a culture of neglect, incompetence and self-protection.
The answer to the problem is the same as the answer to the many of the other problems in the NHS. Break it up. The Soviet-era NHS system doesn't work. Other countries manage socialised medical systems without having a single bureaucratic structure like the NHS. It's what we need. Unfortunately, trying to talk about real structural change in the NHS is all but impossible in the UK. Every discussion is framed as a simple NHS versus the US system - as though there's nothing in between.
Poor Kane Gorney, at the very least his death is manslaughter, but he isn't the first, nor will he be the last person to be killed by a system that's too big too care.
