There is no question that violence against medical staff is totally unacceptable.
Yesterday’s report by the Royal College of Nursing paints a worrying picture of physical and verbal assault in hospitals and in particular A&E, with one worker attacked every two hours.
Nothing excuses such behaviour. But there is a telling line in the RCN’s report: ‘Middle-class patients and their families are among those driven to rage by long waits and dehumanising care in corridors.’
Britain’s middle classes are the backbone of this country. We are polite, hard-working, law-abiding and, for the most part, non-complaining. We get up early, do what we’re told and generally try to live useful and productive lives.
Our hard work and taxes pay for education, healthcare, infrastructure – and, of course, for all those who, for whatever reason, are unable (or unwilling) to fend for themselves.
We get no thanks for it, of course. In fact, we are often mocked for our values, belittled for our love of fairness and order, characterised as bourgeois and small-minded.
Our political classes take us for granted. We live in a world which increasingly seems to reward failure, and where those who do the right thing are punished by a system seemingly ever-more intent on bleeding us dry.
Inheritance tax on pensions, crippling taxes on small business, rapacious grabs on property… the list is endless. Sometimes you have to ask yourself: why do I even bother?
This injury wasn’t self-inflicted. It was a simple accident. And yet – along with pretty much everyone else that long night – I had been made to feel like something you find on the bottom of your shoe, writes Sarah Vine
Still, we plough on, because it’s who we are. But when even the docile and compliant middle classes are ‘driven to rage’, you know something is seriously wrong.
In the case of frontline health services, we all know budgets are tight. But that’s not our fault; that’s the fault of successive governments who have shied away from the tough decisions needed to reform the NHS while allowing wave after wave of uncontrolled migration to place ever more pressure on the system.
Meanwhile, we’ve kept our side of the bargain, funding this profligacy through our (rising) taxes. I think we’re perfectly entitled to feel a bit miffed when things don’t work.
Especially when, on the rare occasions when we do need to access some of the services we’ve paid for, we are treated at best with indifference, at worst contempt.
We all get that staff are stretched. And I understand that this report by the RCN is designed to flag a real problem. But they might also want to consider a few hard truths: kindness and compassion cost nothing. And the sad fact is there seems to be precious little of either in the health service these days. I’d go so far as to say that many medical staff seem to actively despise their patients.
That has been my experience, at least, in the past few years of dealing with the NHS. If you are polite and patient, you just end up being penalised, while those who make the loudest fuss are dealt with quickly.
And when, last week, I was foolish enough to break my ankle while visiting friends in north Norfolk, this grim reality was brought into sharp (and painful) focus.
The trouble with that part of the world is that it’s so damn pretty you take your eye off the road. In my case, distracted by a church on the horizon, I stumbled into a ditch. There was an audible pop, and an explosion of pain.
According to Vine, ‘if you treat people with hostility and incompetence, you can’t expect them just to take it lying down’
‘Oh dear,’ said my friend. ‘That sounds like a trip to the hospital.’
We headed to King’s Lynn A&E. But when we arrived, the queue was so long it was snaking out onto the road.
I decided to go back to her house, pop some paracetamol, pack it with ice and wait and see. It was probably just a sprain.
Fat chance. By the time we got back, I couldn’t put any weight on it at all. Any sort of movement was agony and it was turning an unpleasant shade of mushroom.
I had planned to stay the weekend but clearly that was pointless now. My friend knew someone who was driving to London that evening, so I decided to hitch a ride in the hope I could get it seen to closer to home.
Three hours and what felt like about a million potholes later, the dogs and I arrived back in West London. With the help of my daughter, I hauled myself up the stairs and into the house on my bum and then up another two floors to the bathroom. Whereupon I fell over and banged the affected ankle trying to go to the loo. Ouch.
The ambulance crew were very sweet. One of them said his mum read the Daily Mail (if you are reading this and your son was on duty in West London last Thursday, please send him my thanks). Despite my protestations, they insisted I go to hospital.
And that, dear reader, is where my troubles really began.
In fairness, I was ‘assessed’ relatively quickly and sent for an X-ray. But when I got there, I was instructed to lie my foot flat on the machine, which I just couldn’t do: it was too painful.
Impatiently, the nurse – rather more of the Ratched than Florence Nightingale school – just held it and forced it firmly into place.
Tears pricked my eyes, but I was too embarrassed – and actually a bit shocked – to say anything.
After she had finished, I hopped back to the wheelchair, shooting pains in my leg. ‘Where am I supposed to put you now?’ she asked, as she wheeled me back down the corridor.
How was I supposed to know?
After some deliberation she parked me back in the main waiting room. By now it was about 1.30am, more than eight hours since the fall which, as it turned out, had broken my ankle. I was tired, shivery and in a lot of discomfort. No one had offered me painkillers and, since Ratched had disappeared behind the double doors, there was no one to ask.
I’ve sat in public toilets more salubrious than that waiting room. The stench of booze, cigarettes and urine was impossible to escape. Several gentlemen of the road were in residence, in various stages of stupefaction.
A few seats away, one was asleep on a rucksack. Every now and again he would come to, shout a few unintelligible words then pass out again. Further away, towards the vending machine, a man in his 20s was talking to himself, eyeing the other patients with ill-concealed malice.
The seats were hard and edged with rigid metal armrests, obviously designed to prevent people from falling asleep in them. Unless blind drunk and insensible, of course.
For anyone not under the influence of alcohol or drugs, the Guantanamo Bay-style strip lighting and incessant pop music made any semblance of comfort or rest impossible. In fact, the entire set-up had clearly been designed to encourage people to give up and go home. Which several people did, including one elderly man who had come in with his wife, complaining of chest pains. I hope it was nothing serious.
The only point of contact with authority was a Cerberus-like creature behind a glass screen, which one had to address via a narrow slit, as though through a cell door. One by one as the hours ticked past, we supplicants made the pilgrimage.
‘Please sir, when will I be seen?’ the answer wasn’t quite a growl, but almost. Somewhere around 4am, by now needing a pee, I approached the altar myself, hopping on one foot.
One of the security guards watched me with faint amusement. I don’t imagine it occurred to him to help. I asked whether I could be given a pair of crutches so I could go to the loo.
I was told that I couldn’t have crutches until I had seen a doctor. When would that be, I wondered? When they were ready for me.
I hopped back to my perch, crossed my legs and waited.
It was approaching 6am when my name was finally called. Almost 12 hours since the accident.
A young female doctor told me what I already knew: I had fractured my ankle. I would need a boot and a course of blood thinners. Our interaction lasted approximately four minutes, maybe less.
The nurse arrived with the boot (doctors don’t do boots, apparently). Perhaps because she didn’t speak much English, perhaps because I was very tired and not making much sense, she failed to understand me when I said I couldn’t put my foot flat inside the boot.
She kept pushing my heel down, which – as I had not had any painkillers – was horrible.
Eventually she got me strapped in and handed me some crutches. I stood up, and it was agony. She could see I was in pain, yet she said nothing, just went away and came back with a cup of water and two white pills. ‘Co-codamol,’ she said, and I took them. I spent the next few minutes trying, and failing, to control my tears.
All I wanted now was to get out of there. She returned a few minutes later with my blood thinners, a box of daily injections, and an appointment card for the fracture clinic. I was done.
I made my way back to the waiting room, unaided, every step agony, messaged my daughter to come and get me and sat there, woozy with the drugs, wondering what I had done wrong to be treated with such contempt.
I wasn’t angry, I wasn’t abusive, I wasn’t drunk.
This injury wasn’t self-inflicted. It was a simple accident.
And yet – along with pretty much everyone else that long night – I had been made to feel like something you find on the bottom of your shoe.
So, I’m just putting it out there: maybe that’s why patients are getting upset. Maybe that’s why they are losing their tempers.
We all appreciate that the system is under pressure, and we all appreciate the hard work that doctors and nurses do.
As I said, violence is never acceptable. I condemn it completely. But if you treat people with hostility and incompetence, you can’t expect them just to take it lying down.
When you treat us like scum, can you really expect us to just keep smiling?
