In 2008, on the 60th anniversary of the NHS, with a colleague, a former Director of the Patient’s Association, I researched people’s experiences of health and social care. What emerged was a portent of concerns that emerged in the NHS in the last decade and exemplifies the importance of listening to ordinary people.
Many people had good experiences of hospitals but many were negative. As a former nurse, I was disturbed that nursing care, especially for frail older people was often reported as poor and lacking in compassion, and shortages of nurses was noted. Lack of cleanliness was observed: ‘ a piece of paper stayed under the bed…for over a week’. People were terrified of getting a ‘superbug’. There were dignity issues, with overcrowding in wards: ‘The ward was mixed, which I think is disgusting and insensitive’ ; and ‘It was impossible to get any privacy for the 5th person ( in a four bedded ward)… as there was no curtain to go around their bed’.
Dentistry on the NHS was described as ‘a joke’ and many people reported poor teeth: “ I do miss my dazzling smile…I look like the wickedy witch’. People felt that privatisation was coming in through the back door and there was an inferior lower tier system for poorer people.
GPs fared better and were generally applauded for their care but long waits for appointments were widespread with people commenting that’ it used to be easier to get an appointment’ and the ‘rigmaroles’ with answer machines and call backs. One man summed up the situation: ’I sincerely hope I never need to see a doctor urgently’. The out of hours service came in for the worst criticism. People wanted continuity of care especially those with a long term condition.
Ethical issues were also addressed thoughtfully. Most people supported organ transplantation and a number supported ‘presumed consent’ as ‘most of us are just too lazy to get a donor card’. On assisted dying, most felt that where there was no quality to life then it should not be prolonged but safeguards were needed and had made suggestions as to how this could be achieved. The right to fertility treatment divided peoples responses.
What almost everyone agreed on, in spite of shortcomings, was that the NHS and social care should be better supported and that the fundamental premise that heath care should be free when needed should remain, but many people had ideas on how funds could be supplemented and concerns were rife about social care and its funding.
Sadly, though there have been improvements, many of the issues and comments of 2008 resonate today. What is striking about this 2008 research is that ordinary people:
- were able to make perceptive and prescient observations on the NHS and could provide early warning for problems. This work was undertaken before the Francis review on poor hospital care. We also sent our report to Ministers, think tanks, academics, Royal colleges and the Ombudsman: but had just one acknowledgement.
- do understand the NHS and social care agenda. They have views and can give practical suggestions for improvements.
The research was based on 235 people in the UK who reported their experiences in depth to the Mass Observation Archive at Sussex University. The good news is that Warwick University is carrying out a similar piece of work at the 70th anniversary of the NHS. Let’s hope that people’s voices are used to improve services in the next decade. In the meantime, Healthwatch continues to press for the experiences and views of people who use services to be listened to and influence the planning, design and delivery of services.
Taken from 60 years of the NHS: Ordinary People tell the story’
Linda Lamont and Fran McCabe