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| Strong diagnosis of the ailing
NHS patient |
A family doctor has put her finger on the button
in this inspired and readable expose of the NHS, says Lord Rea
Doctor What’s Wrong? Making the NHS Human Again,
by Sophie Petit-Zeman. Routledge £12.99
This is a book which will help all of us – patients, doctors,
nurses, managers and the government – to understand the
NHS, its strengths and weaknesses; successes and failures.
It looks at problems from the viewpoint of both patients and doctors
– and administrators and ministers – in a readable, intelligent
form. It does this ingeniously.
The first half of the book is a ‘novella’ about life in
an NHS Trust Hospital as lived by three patients, seven doctors
(one of whom is also a cancer patient), the Chief Executive of the
Trust, the Chairman of its Patients Forum, and their spouses.
This fictional part of the book is entertaining and at times moving
as the doctor with cancer approaches the end of his life.
The characters are nicely drawn and very human, with a sense of
humour. My only criticism of this approach is that the doctors,
perhaps necessarily in a short book, spend an unreal amount of their
leisure time talking about the NHS. My experience is that doctors
when off duty would rather talk about anything other than the NHS.
The second half of the book is, in the author’s words, a kind
of glossary of current issues facing the NHS.
The subtle purpose of the introductory first half is to give a real
life flavour, in which people personally experience the problems
which are discussed in more detail in the second half.
Without this the issues would seem more remote, less relevant and
less easy to understand. The glossary (with subjects arranged neatly
to follow the letters of the alphabet) includes many of the problems
facing the NHS today and the structures that the Department of Health
has recently set up to deal with them, not merely instances where
the NHS seems less human than it used to. (But was it ever all that
human – are we not viewing the past through rose tinted spectacles?
My experience of the NHS 50 years ago is of a rigidly hierarchical
structure where patients were patronised to an extent that would
never be tolerated today).
The author’s approach is informal but informed, with many well
chosen quotations from ministers, medical journals, the media and
academics.
However I would have liked an index and a bibliography. Some readers
might have liked to follow up the sources that are cited in more
detail.
The approach is constructively critical but with plenty of side
swipes at jargon, acronyms, stupidity and pomposity, mainly directed
at bad managers. But doctors – and patients – are not
let off the hook. However, the reasons for their failings are explored
and different solutions discussed.
The reader is guided through current discussions on an impressive
number of fronts, ranging from ‘Choice’ through the MMR
controversy to Rationing and Targets.
All this is presented in a form accessible to the intelligent lay
person without being polemical or patronising and always focussing
on the need for better communication at all levels. This is a book
which is stimulating, informative and fun to read.
It is interesting to read the history of the book in the postscript.
Initially it was going to be an educational publication for professionals,
patients, and their families based on Sophie Petit Zeman’s
observations as a locum in-house writer at the Hospital for Sick
Children at Great Ormond Street. She was to be co- author with the
Associate Medical Director of the Hospital. However this was cancelled
by the chief executive at a late stage of writing for unstated reasons
(though most probably because it was too revealing; she was banned
from publishing it separately under her own name). The current book
derives from this idea but is entirely her own creation. All characters
are, of course, “entirely fictitious”!
• Lord Nick Rea of Eskdale was a GP at Kentish Town Health
Centre for a large part of his professional life.
• Sophie Petit-Zeman is a doctor, formerly of the Caversham
Road practice in Camden. |
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