Michael Matheson iPad: NHS reform feels impossible given leadership

There was an almighty commotion behind us in the hospital ward – a staff member breezed in and crashed into a chair set aside for visitors.

Luckily, she wasn’t hurt, but it could have been worse.

I noticed she was one of the occupational health therapists who was supervising my mother-in-law’s discharge after a spell in hospital.

Living alone at 91 with dementia and serious health issues – yet fiercely independent – her return home was a challenge. Which was why one of the therapists, with a trainee in tow and armed with a tape measure, had carried out an inch-by-inch inspection of her house a few days earlier. To make sure it was safe from unnecessary obstacles which might make her fall over.

We’d also completed some alterations to enable her to carry on living alone, you see, and they were running the rule over them, too.

They complimented us on installing a 90cm-high loo for mother-in-law, which was apparently a very good idea – from a comfortable-height point of view. We basked in this praise (even though it was our plumber’s idea), as we had been rather anxious about whether we would pass muster.

I didn’t wish the therapist who almost came a cropper any harm. Yet I couldn’t help but think it funny that one of the people on constant lookout for dangerous obstacles had just walked into a chair.

NHS staff are under more pressure than ever before. Image: Cryptographer/Shutterstock

It was just the irony of it all which brushed my funny bone; black humour helps in the NHS trenches. But so as not to upset anyone, I excused myself to the ward loo – right next to the therapists’ office – to compose myself.

It looked to me like an old storage or cloakroom, which had been converted into a toilet, as there was a row of hooks on a wall for coats. Every time my wife and I went in there, we tripped over a doorstop – positioned in the centre of the toilet for some strange reason.

One false move, and you might be propelled head-first down the toilet, or impaled on one of the coat hooks.

I wondered if I should report this to the therapists on the other side of the wall. But they looked worn out and might think I was some kind of clever dick.

The right hand doesn’t know what the left is doing

You can’t deny the level of dedication among most of the medical staff we observed at close quarters during 10 weeks of going in and out of various hospitals, depending on where mother-in-law was at the time. But confusion and contradictions abounded.

So, we experienced two extremes: moved to tears of joy or frustration. A sense of interdepartmental rivalries and turf wars; the right hand not knowing what the left hand was doing.

If I was called once, I was called six times by different therapists wanting to know her full back story. Surely there was one common record they could look at to save them the trouble?

So many toes to be trodden on, it’s a wonder A&E isn’t full of medical staff looking for treatment

Letters arriving at her home demanding why she hadn’t attended appointments – even though she was lying in a hospital bed a floor above the department where these messages were emanating from.

A ward sister whose body language made it obvious she took great exception to a social worker drawing the curtains around mother-in-law’s bed so she could carry out a highly personal interview – because there was nowhere else to go.

So many toes to be trodden on, it’s a wonder A&E isn’t full of medical staff looking for treatment.

How do you reform the NHS?

How do you reform the NHS? An institution so monolithic, it’s like reforming the government or military: impossible.

Maybe they should start small, by improving communication and relations between departments first. And – who knows? – it might save money and improve the service to patients.

We look in vain to our political leaders for solutions. First Minister Humza Yousaf and Health Secretary Michael Matheson, for example.

Unfortunately, Yousaf was famously dismissed as a failure at the NHS when Kate Forbes (possibly Scotland’s best unifying leader the SNP never had) devastatingly described his unholy trinity of disasters at health, transport and justice.