Most people can’t even differentiate because rights and privileges.  That is because there really is no such thing as privilege anymore.  Anything seen as a privilege is instantly shot down in this politically correct world. So, everything has become a “right”.

With that in mind, let’s just look at some of these “rights”.  We all have rights to health care.  Fair enough.  But, how much of it is a right?  Some would argue that all health care is a “right” and that no one should be turned down for anything just because of lack of funds.  That is a noble stand.  I agree that it is a shame to withhold medical treatment for purely financial reasons.  But, is there enough funding to continue with that stand?  Residents are entitled to free NHS care “because they pay their taxes” is an argument for free healthcare.  But, what about those who have never paid taxes?  Surely, they are not excluded?  Don’t they have a “right” to free healthcare?  And how far can we take treatment?  Is it a “right” for anyone and everyone to get life-extending treatment even when it is futile and costly?  These are ethical questions that then become legal battles.

On the flip side, what about responsibilities?  If you have a “right” to free health care, shouldn’t there be accompanying responsibilities to ensure that you maintain your health?  Such as following instructions by your doctor to take medications, follow treatment plans and follow-ups, and proper diet and exercise.  There is flagrant abuse of the system when people destroy themselves and then expect the healthcare system to fix everything. 

Case in point (an extreme case): recently, a young man was hospitalised for acute liver failure after a binge-drinking session.  While in hospital, he walks out and enters a pub across the street, attempting to order alcohol.  He was not served alcohol and authorities were alerted and he was taken back to hospital.  His father is understandably upset by the incident, and furthermore, as a good father, he is fighting to overturn a recommendation that liver transplant patients must abstain from alcohol for at least 6 months before getting a transplant.  This young man’s life is in acute danger.  Doctors have given him 2 weeks.  Therefore, he would be dead before he can get a transplant.  He is a binge-drinker, not a chronic drinker, and he may have been suffering some confusion related to the acute liver failure.  Or, he may have some psychiatric disturbance.  Either way, he has no idea why he left the hospital and attempted to get alcohol.  I feel for the father.  It is obvious he is concerned enough to fight for his son to get a liver transplant to save his life.  But, does he have a “right” to this transplant?  The number of liver donors is low; With alcoholism being a serious problem in the UK, that number becomes even lower.  Is it right to give a transplant to someone who may not be able to live up to his responsibilities to protect that transplant?

Of course, the answer to this case is not to make it available only to those who can afford it.  That would only lead to black market transplants.  But, the reason that recommendations are in place is to ensure that those who receive these scarce but life-saving measures are the best candidates. Too many people die waiting for transplants as it is.

Another case in point: An American woman has been granted a rich payout from a tobacco company, on behalf of her mother, who died from longterm tobacco use.  Or, in other words, tobacco abuse.  Of course, the argument was that the tobacco company was liable for the effects of tobacco and fraudulent in its advertising.  Though I would never defend the tobacco industry, is it right that they should pay out to survivors of those who smoked?  The health effects of smoking and tobacco have been highlighted for so long now, that those who really wanted to quit, could have sought help.  Smoking is addictive and it may be very difficult to quit.  Furthermore, lung damage from smoking takes years to reverse, if at all.  So, tobacco companies may be liable for some of the problems, but $13-million worth? 

Some people assert their right to smoke, or their right to decline medical treatment, or their right to make poor choices.  Where is the responsibility in that?  Then, when they run into trouble, they expect that medical treatment will put them right again?

Despite what one believes about fundamental rights to healthcare, it should be acknowledged that many specialists practice outside of the NHS and receive higher pay from private insurance and individuals.  This is an attractive option for many specialists who are at the top of their field, so is access to medical care really equal for all?  Should it be?

It seems the media is wrapped up with this Andy Coulson business and I can’t see the significance of it.  Meanwhile, the MPs second jobs list has been published somewhere.  I don’t know where to find it, but the BBC has printed a select few.  And, guess what?  It’s just as bad as the other non-stories.  Who cares if an MP filled out a survey and received a token payment?  Who cares if someone gave a paid speech, even if the pay was a jar of honey?  Has it gotten to the point that we have to look over the MPs’ shoulders to make sure they’re doing their jobs?  Politicians are always asked on their opinions or to give talks here and there.  What I would be interested in finding out is whether a doctor MP is working full-time as a doctor while still trying to serve his constituency.  Is there someone working as an executive in a company and still acting as MP?  Those are “second jobs”.  If you want to know whether someone gets extra pay for their work, then just say so.  Don’t categorise it as a “second job”.  And, for the record, unless it is a real “second job”, I don’t care what these MPs get for doing all these other extracurricular activities, unless the majority of their time is spent doing something other than their real “job”, if that’s what you want to call it.

But, while the media and the politicians are having their fun with trivialities, I’d like to point out some major issues that affect the common person.  I have had no contact with the NHS until very recently.  My mother-in-law fell while walking her dog.  He lurched after something and pulled her down.  She was very much alone in the commons and initially thought it was not a big deal.  However, when she tried to get up, her body wouldn’t respond.  She was lucky that someone nearby heard her crying for help.  It turned out, she fractured her wrist and her hip.

On visits to the hospital, we could not help making comparisons between the NHS and the private hospital and to US hospitals.  First of all, there seemed to be a sad lack of staffing.  She was moved from A&E to the wards and was literally ignored, except for occasional blood pressure readings.  She was made to starve in anticipation of surgery, but no consultant surgeon came to see her until evening (she had arrived early in the morning).  She was supposed to have had a urinary catheter, but it was not placed for 12 hours.  The poor woman could not get out of bed and had IVs dripping in her.  She’s an elderly lady, so bladder control does become an issue.  When we pointed it out to a nurse, he stood there joking with an aide, then finally turned to tell us it was supposed to have been done in A&E.  Don’t take this the wrong way, but the nurses did not speak English as a first language and it made communication difficult.  The consultant finally arrived and explained that she needed surgery (as if that wasn’t obvious).  He would not have said anything further and was happy to leave after five minutes had we not pressed him with questions. 

She had surgery the next day and was not seen by any members of the family due to the timing of the surgery and the fact that she was out from anaesthesia.  The day after, she looked groggy still and her appetite had not returned.  Her only visitor of the day had been the physiotherapist.  When we arrived, visiting hours on the ward had been shortened.  Though she is expected to remain in hospital for at least a week, no one has given her any ideas on what to expect in terms of recovery. 

To emphasise the point of lack of staffing, my father-in-law had called the hospital and the ward numerous times, but everytime that the call had gone through to the ward, no one answered.  We finally decided to just walk in and find out what was happening.  There was practically no one around.  Not only that, we arrived before visiting hours and fortunately, found her before we had to find a nurse.  We might have been kicked out if we had actually run into a staff member.  She reported she had been woken up several times in the night by another patient calling out for help.  Sure enough, said patient called out several times during our visit.  We had to resist the urge to go and find out what he needed in case anything should have happened and we would have been blamed.  But no one came.  He was practically ignored.

My mother-in-law was bored out of her mind in addition to the grogginess.  We had brought her a book, but she couldn’t read because of the effect of the anaesthesia on her eyes.  They provided her with a small computer screen attached to some phone device.  It was supposed to be for TV/radio, but we found that it did not work without a special card that had to be purchased; needless to say, no one knew how to get one (“That’s nothing to do with us, guv, it’s run by a private company” was the received, general issue excuse.)

All these things might seem trivial, but it points to a lot of apparent problems.  First of all, the staff.  It is a sad state of affairs that we have had to resort to hiring foreigners while our British nurses and doctors are working in private hospitals or with agencies.  It can create issues, especially with communication. I cannot comment on competency.  And, where were the staff when they were needed?  The ward was so quiet, you’d think you were in a mausoleum.  While US hospitals may be noisy, at least you had the feeling you were not alone.  I had had to be treated in a private hospital in England many years ago while I was visiting and it was the same feeling as the US hospitals.

Patient care seems lacking when staff are not hovering around patients.  But, it really doesn’t matter, as long as certain targets are met.  For example, infection control.  Everytime you entered or were near a ward, a motion-activated recording comes on reminding you to wash your hands.  How many people listen to it?  When you hear it everyday, I’m sure you start to ignore it.  I sure did not witness the consultant washing his hands either before or after examining my mother-in-law.  And the faucet outside the room had two separate taps – not very appropriate for recommended effective hand-washing techniques.  Of course, there was the alcohol hand sanitizer, though that is not the standard, even if it is convenient.

Patient comfort is definitely the least of their concerns.  Hospitals like to get patients in and out as quickly as possible.  There are many reasons for this, but I should think that they should only do so if everything is in order.  I would not like to think that my mother-in-law will be kicked out before a definite discharge plan is in place.  But, since they are so bent on quick turnarounds, it may explain why they want patients to be as uncomfortable as possible.  They wouldn’t want them to beg to stay in.  I could not believe the lack of a separate toilet.  In the US, each room, whether private or shared, had its own toilet.  Each bed had its own TV – and it was free unless you wanted something special – like the way they do in hotels.  For goodness’ sake, can the hospital not pay the TV license fee and allow their patients to watch TV?  The charge for TV use is ridiculously exorbitant. Perhaps if the patients were allowed easy access to the TV and/or radio, they might be distracted enough not to bother the nurses, or I should say, the other patients.

These are only my initial impressions of an NHS hospital.  I’m sure there will be more to follow as we progress.  I am starting to understand the frustrations people feel about the care they receive and the poor conditions at several hospitals named in the news.  Perhaps if politicians ever end up in an NHS hospital, they might understand.  But, pigs would fly before politicians are treated by the NHS.