THERE is massive pressure on the NHS at the moment, exacerbated by the winter flu, particularly obvious for A&E departments. It is damaging morale among staff, and very misleading for the public, that the BBC and newspapers are reporting repeatedly that “just 78 per cent of patients across Scotland were seen within the target time of four hours”. Most are actually “seen” within a few minutes.

That figure of 78 per cent in fact refers to the 78 per cent who, within four hours from arrival, have been seen, triaged, examined, investigated (with blood tests, X-rays, CT scans etc), treatments started and then transferred to a ward or discharged home.

What actually happens in large busy Accident and Emergency departments is this:

1. All true emergencies and accidents are seen and treated immediately, without any delay.

2. All other people arriving at A&E are seen for “triage” by a nurse, usually within 10-15 minutes, to decide how ill the person is, and who needs to see them (eg surgeons, physicians, nurses).

3. For patients arriving by ambulance, the ambulance staff remain with the patient until they are seen.

4. Those who need to see a doctor are all seen within 30-40 minutes.

5. The doctor takes a history from the patient and carers, examines, assesses previous drug treatments etc, and as appropriate to each case, sends blood tests, orders X-rays and CT scans etc to make a diagnosis.

6. Blood samples have to be transported, processed in laboratories and reported.

7. X-rays and scans have to be done and then reported by specialist staff.

8. Treatment is started to relieve symptoms and to tackle the underlying diagnosis.

9. Arrangements are made for transfer to an appropriate ward, or to return home.

As medicine has become more sophisticated, the extent of investigations has increased, and it is really extraordinary that so much is done within four hours. It should not be a serious criticism of the NHS if these steps exceed four hours in some cases, and an argument could be made to raise that target.

We call on the media not to refer to “patients not being seen for over four hours”, or “not treated for over four hours”. This negative language has creates unwarranted anxiety amongst patients and carers, and is hurtful to dedicated hard-working NHS staff.

Mike Lean
Professor of Human Nutrition, University of Glasgow and Consultant Physician, Glasgow Royal Infirmary

I HAVE watched this week as Reporting Scotland did their usual Pravda hit job on Scottish healthcare professional integrity whilst Theresa May’s “cancel 50,000 operations” plan proved the Red Cross description of the English NHS as a humanitarian crisis was not the hyperbole that Jeremy Hunt claimed it was.

Two nights ago I got a message from Northern Ireland, where my 77-year-old mother, a career psychiatric nurse in the NHS, moved to live out her twilight years. She had developed serious breathing difficulties at around 2pm, and as I got the message around 4pm I assumed she would already be in hospital so I gave her a quick bell on her mobile to see that she was OK.

She answered and said that the ambulance still had not arrived and she sounded really bad.

My sister who lives locally could not go near her as she is suffering from the flu and didn’t want to risk making things worse, but she told me that it would be impossible to take her by car even had she been fit due to the state my mother was in. This went on for another five hours.

Eventually at 9pm I was trying to get the local fire brigade to go round, as they have a qualified first-response medic along with supplies of adrenaline and suchlike. I got a message that the ambulance had turned up.

This was a 999 call made seven hours previously, for a 77-year-old with serious breathing problems. By the time they got her to hospital her oxygen levels were so low that she has been on an oxygen respirator since. The oxygen levels led to a blood toxicity level that was 60 times the normal average.

My mother started off as a ward nurse in the early 1960s, where Matron ran the wards and Doctor ran the hospital. The wards were cleaned by the nurses under the watchful eye of Matron and woe betide if a spillage was there a minute after it was made.

My mother won’t hear a bad word spoken about the people who work for the NHS. She won’t make a fuss.

Insidious privatisation has crept into the NHS since Thatcher decided to remove the working class – half by encouraging them to become middle-class by buying their council houses and shares in utilities, the other half by just cutting off everything they need to live. Jobs and community were thrown under the bus of the drive to turn manufacturing Scotland into North Britain Services Ltd.

So when you see these horror stories that Jackie Bird et al come out with daily slagging of the NHS in Scotland, ask yourself this: do you know anyone who has waited for seven hours for a 999 ambulance? No? Well I do and I hope you never have to.

There is one government standing between you and that kind of experience, and it’s in Holyrood. If you don’t believe me, ask the first nurse or doctor you meet.

Dave Llewellyn