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I love the NHS. I pretty much live and breathe it. I work full time for the NHS and at weekends I work as a contractor for NHS Trusts on front line ambulances.  When I have a day off I am often to be found at the doctors or the dentists with one of the kids.  The NHS is awesome, always there when you need it.  Anyone who has been ill abroad will tell you that the NHS is something to be proud of.  If I am ill , I don’t have to think about whether I can afford to go to the hospital or the GP,  I can just go.  I might have to wait, the hospital or GP surgery may be a bit tired looking, but I know that I will be looked after. 
However good the NHS is though, 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.  Much as those who work in it would like to work miracles and cure each and every person who walks through the door. 

The NHS is stretched to breaking point everyday. There are a lot of reasons for this but some of them are easy to see. I’ve lost count of the number of times that 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 they do not really need an ambulance,  it’s just that there is no one else that they can call on a Sunday afternoon when they are at the end of their tether. When the loneliness hits hard and the prospect of not seeing a friendly face for another week is more than they can bear.  Or when caring for their loved one just becomes too heavy a burden to carry for another day, another night.  When they are desperate for a little bit of respite from the ceaseless pressure of responsibility for an old or dying loved one.

In the past this would have been dealt with, perhaps, 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 so with cuts to Local Authority budgets meaning that social care has been decimated,  there is no one to call. There is no relief, no respite in sight for a lot of these people; and so, in desperation, they call an ambulance.  And, 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 feel better, more able to continue in the thankless task of caring. We put a sticking plaster over society’s failure. 

And so there goes a hospital bed. A nurse,  a doctor, all of who’s time is taken up, instead of looking after the sick. And there goes that ‘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. The one that we hold so dear. And all the while the NHS covers up this deficit elsewhere, the worse it will get.

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 to be warm; to be safe. Again there is no reason for them to be taken to hospital, but where else is there for them to go?  It takes a cold hearted person to leave a person on a park bench when you know they have nowhere else to go and it is minus 3 centigrade outside. And so yet again we, the ambulance crew, paid for by the NHS spend our time and your money phoning around charities, forgotten contacts in our patients phone, in the hope that we can find them a warm bed for the night. And if not, due to cuts in social housing, there being by no easy access hostels, we take them to the warm waiting room of the hospital.  And 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 nearly 100 years old and barely lucid.  Struggling to even open his eyes; despite that, there was nothing significantly wrong with him; if I had to hazard a guess (and as I am helping to treat we have to do an educated one), I’d probably say it was just his time to go.  His body was just worn out.  He was nearly 100! But his daughter insisted he had been fine until he got pneumonia previously and was taken in hospital for a month.  Obviously the hospital had made him ill; before that he had been fine. Before that he had lived alone; was fine. 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 that she was blaming by for the state of her father, probably was to blame, only not in the way that she thought; because 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. Peacefully in his bed. Instead we dragged him off to A & E,  for more interventions. To prolong his life further such that it is.  And when he isn’t restored back to full health, no doubt his daughter will claim that the hospital killed him.  Because blame, it would seem is easier than the truth; that sometimes we just need to allow people to die.  Not play God and attempt miracles. We all have to die sometime. We all, as individuals and the NHS just need to learn to let them. 

The NHS cannot put a sticking plaster on the whole of society. As an ambulance crew friend once told me: if you just need a plaster, you don’t need us. 

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