My dear cyber-friend, Howard, reads my blog despite himself.
Back in 1985, his family suffered dreadfully at the hands of the NHS. He finds the frustration, incompetence and horror of some of my posts all too familiar and hates to be reminded.
With that in mind, and because I'm painfully aware that my blog should never become one long, aimless, complaint, here are the improvements I value most over the time I've been a patient.
1) The big change is in focus.The patient is now at the heart of most systems, procedures and innovations. Where it used to be the doctor that had all the power, that power has gradually been handed over to the patient and though there is still some way to go, it's made a world of difference.
2) Pain. Over the years, research has shown that if pain is controlled, everything else is improved. The patient is less stressed, the pain never gets so out of control that you need more analgesia just to get on top of it again. Pain is more often than not a top priority now and it has changed my hospital experience totally.
3) Food. By the late nineties, hospital food had become so unpalatable and of such poor quality that it was almost never eaten at all. Patients suffered malnutrition and it even hindered their recovery. These days the food is really quite good, there are nice desserts and there are even biscuits on the tea trolley. This might seem a small thing, but it's not. Patient's used to regularly miss meals because of tests or doctor visits and now, they are encouraged to ask for food whenever they are hungry and encouraged to eat as much as they can. Personally, I feel this might be the most important improvement of all.
4) Respect. The patient is now consulted on everything. All procedures are explained, permissions are sought and staff are courteous. We aren't always quite where we should be, but I think Howard would be delighted with the improvement.
5) Waits. Whenever I heard someone complaining about waiting lists, it was always a doctor or a politician. From a patient's point of view, they were marvellous. Gone were the days of 2 year waits for surgery, months on a waiting list to see a Consultant or endless investigation lists. A & E was transformed and doctors lost the ability to play favourites with the procedures they preferred, leaving the mundane stuff until they literally couldn't put it off any more.
6) Ditto targets. Finally, doctors had a reason to get on with stuff and a consequence if they didn't.
7) Finally, and of course most importantly, technology. In every field, enormous steps have been taken in research, treatment, investigations and understanding. As a result, we, the patients suffer less, live longer, have a better quality of life and suffer fewer symptoms.
It's an infuriatingly slow process. Often you feel you have taken one step forward only to be pushed two steps back, but gradually, over the years, things evolve, and on the whole, they've evolved for the better.