Hospital review – shining a light on an NHS at breaking point

This six-part series does for the health service what The Thick of It did for government or W1A did for the BBC – but sadly it’s no satire

Morning at St Mary’s hospital, London; who’s for a game of musical beds? There is no flu epidemic, no norovirus, it’s not midwinter, just an average Monday last October. But the hospital is on red alert, meaning parts of it are full to capacity. Such as intensive care, where there is only one bed left.

Prof George Hanna will need it after an operation to remove a cancerous tumour from the oesophagus of his patient, Simon, 67. Simon has already had one operation cancelled because of a red-bed situation, and the operating window after his chemo isn’t going to stay open for long. The trouble is that 78-year-old Janice, being blue-lighted down from Norwich for an emergency op on a ruptured aneurysm in her aorta, will also need the bed if she survives the touch-and-go journey, and if vascular surgeon Richard Gibbs operates successfully. If Simon’s wife looks as if she’s not entirely wishing Janice a safe arrival, then it’s understandable. Is via Buckingham Palace really the quickest route from Norfolk to Paddington, though? Maybe the satnav says it is. Unless Janice isn’t really in that ambulance and it’s just library footage.

Oh, and then another trauma comes in, an attempted hanging. He may need the bed as well. It could be a three-into-one-doesn’t-go problem for Simon Ashworth, the consultant in charge of the ICU and whose difficult decision it is. “It does feel to me like the elastic is a bit nearer to breaking now than perhaps it ever was,” he says, gloomily.

Former nurse, now site manager Lesley Powls has the job of trying to ensure the entire hospital doesn’t grind to a halt. She tries to keep her teams motivated, uses appropriate management speak such as “going forward” and could be played by Joanna Scanlan if she wasn’t playing herself.

Hospital (BBC2) does often feel like satire, doing for a part of the NHS what The Thick of It did for government or what W1A did for the BBC, as wobbly cameras chase bad-tempered doctors, moaning about not being able to do their jobs properly, along busy hospital corridors. The bicycle Richard arrives on is racier than Beeb head of values Ian Fletcher’s folding one; that’s why he also takes it up to his office. “We’re aware of the problems,” director of medicine Tim Orchard tells an assembled group of senior managers, with a nervous little laugh. “Anybody got a solution?”

In fact, this six-part documentary series is a timely slice of the reality behind the headlines. A reality in which exasperated surgeons are spending as much time trying to unblock blockages in the arteries of the system as they are unblocking actual arteries in their patients. A reality which itself is on the point of massive – and terminal – cardiac arrest. It makes a change from the usual stories of heroism you get in shows such as 24 Hours in A&E. I suspect a lot of people who work in hospitals will find this more familiar.

Janice’s operation is fun, though. Richard has opened her up. “Don’t touch the haematoma whatever you do,” he says to his team. “What I mean is, it might blow at any minute, I mean it really might do, literally … Don’t press it too hard, this is going to go, so we need to get a wiggle on.”

There’s no music in the theatre, unfortunately, otherwise it’s straight out of Green Wing. They approach the crux of the procedure. “The difficult bit’s just about to start,” says Richard, impressively. “Everybody do it slowly, diaphragm away from us … so just go gentle … the last bit and then we’re there … relax, let go, let me just do this … fuck, fuck fuck fuck fuck fuck.”

“Pressure’s just gone,” someone says. “What! Has it completely gone?” asks Richard, sounding properly alarmed.

The pressure comes back, and amazingly – brilliantly – Janice is all right. The operation is a success, she’s stitched up, and goes into the ICU to recover. Yes, Janice got the bed, because without it she would have died.

Simon is sent home, again. But he’s in the next day for his operation, which is successful, and he responds well. “It really is as if we’ve been in a thick fog, and now we can see the sunshine,” says his wife. Happy outcomes all round, in spite of the red alerts and the pressure problems (not enough inside Janice, too much everywhere else).

But then a sad postscript. A few weeks later, at home, Simon developed a rare syndrome and died. A reminder that it’s not all about budgets and beds and targets, it’s also about human life.


Sam Wollaston

The GuardianTramp

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