Sunday, 22 May 2011

You're Terribly Unlucky...

For the past month my life has been ordinary.  No headline news stories to shout from the roof tops. 

Life has just trundled on as normal.  And it’s been the same for my 71-year old mother.  We’ve been comparing notes on what’s doing well in the garden, and well, not much more than that.  Humdrum.  Mundane, even.

Except she’s been waiting for her cataracts to be sorted out. 

There are plenty of charities which carry out cataract procedures across the developing world and a glance at any of their websites shows it’s something which costs less than £20 to carry out if I’d like to make a donation.

We’re not talking about titanium hip replacements with hours of intricate surgery to treat a cataract.  It’s a couple of hours’ visit to a day surgery in a hospital, 24 hours wearing a patch, a month of eye drops, avoid wind and dust for a couple of weeks, avoid bending down, and don’t drive for a week.  Bob’s your uncle, you’ve got clear, colourful sight once more.

When I told friends that Mum had to have them sorted out, it seemed like a rite of passage for anyone over 70, and was healthily dismissed as a chore akin to putting the washing on the line.

The appointment for Eye Number One (ENO) was impending.  Given that she lives on her own, I arranged to take leave and go home for a few days.  She had the ‘pre-flight check’ phone call from the hospital.  The next day, another phone call.  ENO postponed.  Someone with greater need.  These things happen, and if I had a detached retina I’d want to be bumped up the list, too.  New appointment given – ENO was now being done on the day of Eye Number Two (ENT), and ENT pushed back. 

New arrangements were made for lifts to and from hospital.  This time I couldn't  take leave as work load just wouldn't allow. 

The day comes.  Arrangements for texts to be made to me when it’s all over and she’s back home.  The start of her day is thus: 8am: safe arrival at hospital.  Drops are put in.  Forehead is marked with an ‘X’ to ensure correct eye is treated.  She sits down, reads her book, and makes polite conversation with other cataractees in the queue.   An hour later, a text.  ‘It’s cancelled.  The machine’s broken.’  She's sent home without any mention of when it’ll be done again.

So I phone admissions, and am told by Mary the Admissions’ Coordinator she’ll be seen ‘as soon as possible’.  I ask what ‘as soon as possible’ means.  ‘Within 28 days’, says Mary.  I point out ENT is due to be done within that time.  Mary puts her hand over phone, there's a rustle of papers, and muffled voices.  ‘Well, seeing as you’re the first to call, she can come in next Monday, subject to the machine being mended’. 

The next day Mum phones the hospital to double-check on arrangements.  Yes, next Monday is fine.  Half an hour later, the hospital rings again.  Mary tells Mum it’ll have to be next Wednesday, as there’s another more pressing case for Monday. 

‘You’ve had terribly bad luck’, says Mary. 

Really, Mary?  Maybe your employers haven’t shared the annual strategic plan for your own hospital with you.  Search for it online.  I did.  And came across these two relevant bits:

"Increase operating capacity for cataract surgery to bring service into line with referrals demand and continue to provide assurance that we will meet our 18 week referral to treatment targets."

And this:
"It has become clear, however, that there are a number of opportunities to further improve our services – in particular by focussing on the way in which we manage patients through our systems. There are too many repeat visits for investigation, too many delays in surgery, too many cancellations of outpatient appointments and operations."

It’s the end of May.  Almost halfway through the ‘strategic’ plan year.  You’d have thought they might have made a bit of headway addressing these objectives.  On the plan there’s no mention of when they’ll have achieved all this, how they’re going to do it and how they’ll measure success.  Those boxes on the document are left blank.

Oh, how we try to laugh and shrug our shoulders.  We think that if we had £3,000 for ENO to be sorted in a private hospital by the same consultant, it could all be done by teatime tomorrow.  Oh, and £193 for another initial consultation as her notes can’t be transferred from the NHS.  Notes which were good enough to brief the same consultant on the NHS. 

So, £3,193 for the procedure for ENO in a private hospital.  But, remember, if you want to donate to a charity to do work on cataracts overseas, then it’s £20.

By chance, I come across this article  So I now know that there are others encountering the same frustrations, and the Daily Mail's Tom Utley feels the same way as we do when you have 'terribly bad luck' with The System. 

I don’t think Mum has had ‘terribly bad luck’, Mary.  I think this is what we’ve got to look forward to for the next 20 or 30 years.  A couple of decades of low level, unsatisfying encounters with The System which don’t merit a headline but which are happening to hundreds, if not thousands of people all over England every week. 

The sum total of my mum’s medical encounters in the past decade has been to have a knee washed out, have her cholesterol watched and her cataracts sorted.  She’s healthy, she has an active life, she uses the internet, she thinks the Eurovision Song Contest has had its day, and she balks at paying ‘ten shillings for a first class stamp’.

Her encounter with the hospital clearly isn’t unusual.  Each case on its own is hardly headline news.  It’s not even worth making a call to a local radio phone-in.  But taken as a whole, every day across England there are probably far too many people like Mary telling people like my mum that they’ve had ‘terribly bad luck’. 

And isn’t this what we’ve got to wake up to?  An ageing population, still working, still able, still mobile, still sociable, but without a decent environment and systems able to cope with it all?

Currently everyone in Mum’s village is on stand by for  Wednesday.  She’s got to go and get a week’s food ready (legislating for a week off the roads), she’s got to find people available to take her to hospital and pick her up.  I’ve got to see if I could get to her house if there was a hiccup, and still juggle work.  All low-level stuff, but annoying and multiplied across the country it’s a huge waste of time, effort and resources. 

I have no manifesto for putting it right. I’m just sitting up and starting to smell the coffee.  This is our life for the next couple of decades, at least.


  1. Hi
    I'm sorry for all the inconvenience she has had. According to the McKinsey report cataract surgery on 'mild' cases is one of the procedures targeted for money-saving. They suggest reducing the number of operations across England by somewhere between 5 and 25%.
    Search the document for cataract to see the details.

  2. Hi Anne Marie
    Thanks for your info. I'll read the documents with interest. As far as Mum and I are aware, her cataracts had reached the 'tipping point' for treatment, with one in particular being quite thick (or whatever the correct term is). She's lived with them for longer than she should have done as she was coming to terms with the sudden death of my dad, and bereavement's a strange thing... your own needs can be pushed down the agenda.