A top palliative care doctor has revealed how she has to speak to dying patients on trollies without even a curtain for privacy as she lamented the ‘broken’ NHS.
Dr Rachel Clarke admitted she ‘can’t really exaggerate how grim and crisis-laden conditions are’ and described conditions in A&E wards in Britain as ‘Dickensian’.
Speaking to Andy Coulson on his Crisis What Crisis? podcast, the doctor from Didcot added that ‘crisis conditions are the norm now and it’s horrendous.’
The book Breathtaking, written by renowned physician Dr Clarke, exposed the reality of working on a Covid ward and was adapted into an ITV series starring Joanne Froggatt.
She also discussed the difficulties in providing palliative care, the misinformation about COVID-19 in particular, and the harassment that she and many other critical professionals encounter online.
Discussing the current state of palliative care in the NHS, Dr Clarke said: ‘You can’t really exaggerate how grim and crisis-laden conditions are.
‘You know, we all see the news headlines. I walk into the A&E handover in the morning and I see a team who look absolutely broken from the night shift.
‘There are ten ambulances queueing outside each with a patient, some of those patients are dying, they literally can’t even get into the hospital. There are patients in corridors on trollies.
‘I might have to have an end-of-life conversation with a patient on a trolley in a corridor who doesn’t even have a curtain around them. It’s horrific; it’s sort of Dickensian. This is how broken the NHS is at the moment.’
She said that such ‘crisis conditions’ are the ‘norm now and it’s horrendous’, adding: ‘So you roll up your sleeves and you go into this chaotic situation, and it feels like fire-fighting, often.
‘You really have to be on your best possible game as a doctor, because you have patients who are frightened, who are in extreme suffering, families who are distressed, and you have to go into that crisis situation and try and make a difference; do the best job you can.’
Dr Clarke said it was ‘unspeakable how bad conditions are’.
She continued: ‘I think if people in Britain—if the public knew that there were people suffering at the end of their life in this way—that was wholly avoidable, that we could fix if we changed the way we are managing the NHS and funding the NHS—they would want to do that immediately. You wouldn’t wish that on your worst enemy, let alone someone you loved.’
Dr Clarke also explained how she tries to control her emotions while dealing with tough situations, adding, ‘I allow myself to cry.
‘So at work, I will be hard as nails in the sense that my emotions don’t matter; the emotions of my patient and my family are what matters. So I will not indulge my emotions in a way that stops me doing a difficult job. I’ve got to do it as well as possible.’
She said that if she was ‘talking to a six-year-old about Mummy dying’, she would not allow her emotions to get in the way of the conversation ‘as well as I possibly can’.
But Dr Clarke continued, ‘Then I’ll go and have a cry with my members of my team. We all do that sometimes; we know that we need to look after each other.
‘And I don’t mind if I’ll sit in the staff car park and cry for a bit before driving home, because that’s human. That’s a natural reaction to the unavoidable suffering that’s a part of being a human being.’
She then spoke about new Health Secretary Wes Streeting and his statement that the ‘NHS is broken’ and needed ‘saving’, which was issued shortly after Labour won the General Election.
Dr Clarke said, ‘I was really delighted that he said that because it’s just empty pretence pretending otherwise. That doesn’t help anybody. The NHS is in crisis.’
She continued, ‘It has been for a very long time. And you know, there’s a very simple bottom line here, which is a country gets the health service it is willing to pay for.
‘And if you want a world-class health service, you pay for it one way or another. I favour general taxation; some people favour insurance, but you have to pay for it. And there isn’t really a shortcut.
‘I think at the moment the very fact that we as individuals are good at pretending the bolts from the blue are never going to happen to us. You know, “I know cancer is out there, but I’m never going to get cancer. I know that horrible car crashes are out there, but I’m never going to have a horrible car crash,” and suddenly need hundreds of thousands of pounds worth of NHS care.
‘The very fact that we are good at denying that truth is one of the things that is causing the NHS to fail.’
She also claimed that ‘shaming people because they smoke, they have a bad diet or they don’t exercise’ is not going to bring about healthier lifestyles.
Dr Clarke said, ‘In fact, it’s probably likely to make that individual worse because they won’t want to see a doctor or present if they’re only going to come away feeling shamed.
‘If you are wealthy enough to afford your five a day or your thirty different fruit and different vegetables a week, then you are more likely to have a healthy diet.
‘It is much, much cheaper to buy a McDonald’s and fill up yourself and your kids on tasty, delicious, and sort of nutrition-free McDonald’s than it is to buy expensive kind of guava and chia seeds, quinoa, whatever it is, your nice middle-class Waitrose supermarket basket, and spend two hours rustling up whatever those ingredients would make.
‘And if you’re time-poor, if you’re money-poor, if you’re working three jobs to make ends meet, how do you have time to go running and buy nice, healthy food?’
She said that improving the health of the nation needs to begin with tackling the root causes of problems, so ‘we need to go for the drinks industry, the food industry’.
Dr Clarke also discussed how the country has been moving on from the pandemic.
The NHS’s inefficient and dishonest administration is the issue. Millions and millions of pounds are being pumped into the NHS’s sticky fingers.
Since patients cannot leave the hospital without a care package and there are not enough carers to cover them, funding for social care is badly needed. Carers ought to be paid more since they work long hours and get little in return. Most people couldn’t handle the difficulty of the work, and I have so much respect for those who can.
The NHS seems to be in dire straits, yet money keeps getting pumped into it apparently, but it seems to make little difference. Hospital managers are getting far too much money, and the NHS needs a massive overhaul from the top because something needs to be done. After all, it can’t go on like this, but the more we complain, the more it gives our government a reason to say, “Well, that’s okay; if you don’t like it, we will make it private.”
We should ban tourists from coming here and getting free treatment because there are too many freeloaders in the UK who have never paid a day’s taxes in their lives but receive everything handed to them on a silver platter. If you decide to travel, be sure to purchase health insurance.
The number of individuals using services who shouldn’t even be here is causing problems for the NHS. The NHS wouldn’t be broken if they stopped giving immigrants and the rest of the world free treatment. British people in the UK don’t get free treatment in other countries, so why should they get it here? Soon our government will make it private health care, so what will non-British citizens do then? Will they go back home because it would cost them a fortune compared to other countries, especially when tax is added to treatment?
Reducing demand or raising supply is the answer. In the previous 30 years, the population of the UK has expanded by 10 million, yet despite this, hospitals and general practitioners have not been able to keep up, nor could they, and NHS funding has increased.
Instead of attempting to control and cure the entire globe, the NHS and the UK should concentrate on taking care of their own.
If a public body like the NHS is struggling, look at it this way: if your bath is overflowing, your first act would be to buy a bigger, more expensive bath. No, that is not the answer; turn off the tap, pull the plug, and let it empty. It’s a shame we can’t do that while they’re crossing the sea!
THE MONTHLY MOSQUITO 