However good the NHS is, it is not a lot of things; it isn’t social care, it isn’t a hotel and it most certainly isn’t a miracle worker. I work as an emergency care assistant on ambulances at the weekend. I can see the amazing things the health service does, but also why it sometimes appears to be falling apart at the seams. The NHS is stretched to breaking point every day. There are a lot of reasons for this and some of them are easy to see.
I’ve lost count of the number of times I have been called to patients who aren’t really patients at all. They are desperately in need of help, but not medical help. They need social care. Or social housing. They need their basic needs to be met, but not an ambulance crew. It’s just that there is no one else who they can call on a Sunday afternoon when, for example, they are at the end of their tether. When the loneliness hits hard, the prospect of not seeing a friendly face for another week is more than they can bear.
In the past this would have been dealt with by ringing another family member, or by a carer or a respite centre to give the family a break. These days, though, families are spread far apart and cuts to local authority budgets mean social care has been decimated. There is no one to call. There is no relief or respite in sight for a lot of these people and so, in desperation, they call an ambulance.
In turn, because the ambulance crew can see that the family cannot cope, that it’s just too much, we have no choice. We take them to hospital in the hope that given a few hours of space the family feels better, more able to continue in the thankless task of caring. We put a plaster over society’s failure.
And so there goes a hospital bed. A nurse, a doctor, all of whose time is taken up, instead of looking after the sick. There goes the protected NHS budget – the one that the government has pledged to increase. Only it’s not really an increase or protected at all, because now, instead of the money being spent on social care, and coming out of local authority budgets, it is coming out of the NHS one.
Then there are the lost souls. Those who drift, who sofa surf or sleep on park benches. Many of them mentally unwell but not acutely so. They don’t need a hospital, they just need somewhere warm and safe. It takes a cold-hearted person to leave someone on a park bench when you know they have nowhere else to go and it is -3C outside. Yet again we, the ambulance crew, paid for by the NHS, spend our time and your money phoning around charities, forgotten contacts in our patient’s phone, in the hope that we can find them a warm bed for the night. If not, due to cuts in social housing, there being no easy access hostels, we take them to the warm waiting room of the hospital. As we sit there sticking plasters on the plight of the homeless, another cardiac arrest call goes unanswered. Another person dies.
Other patients are just too old; their bodies far too weak. Sometimes it happens slowly, other times it is quick. I recently went to a patient who was in his 90s and barely lucid. His daughter insisted he had been fine until he got pneumonia and was taken into hospital for a month.
There was no point telling her that maybe it was just his time to go. That he had lived longer than most people, that the hospital she was blaming for the state of her father was probably to blame, only not in the way that she thought. Years ago, her dad wouldn’t have been taken to hospital to be treated for the pneumonia that nearly killed him. He would likely have just died at home. Instead we dragged him off to A&E for more interventions. When he isn’t restored back to full health, no doubt his daughter will claim that the hospital killed him. Blame, it would seem, is easier than the truth. Sometimes we just need to allow people to die and not play God and attempt miracles.
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My ambulance crew is forced to put a plaster over society"s failure
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