Presented by Ray Thomas, Open University, Milton Keynes at our conference May 2008

I felt flattered to be asked to give a talk because I have little experience of the NHS and have never studied it. And I am getting a bit old (77) to give talks a about a subject matter that is new to me. So I am going to avoid any attempt at generalise. Instead focus on a bit of personal experience that poses questions that seem relevant.

MEMORY

For most of my life I have enjoyed excellent health and have rarely been a user of the NHS. But things  change with old age. The main thing that has worried me is short term memory loss. Sometimes I do not remember what I am doing. That slows me down. I have to stop what I am doing to try to recover my memory before I can go on to the next stage. And maybe I don’t recover all and what I wanted to do is not achieved.

The other area of loss is for memory of names. Loss of peoples’ name is a social embarrassment. Loss of memory of all kinds of other names also slows you down.

So I went to my GP. He arranged an appointment with a psychiatrist at my local hospital. So on the morning of 10th April this year I went to my local hospital where a psychiatrist asked me a lot questions and then gave me a memory test. I don’t remember the questions but I do remember that most of the test that seemed easy. I was asked questions such as what date it was and what day of the week it was. I had been waiting for this appointment for some time so the answers to such question were in the forefront of my mind. The psychiatrist pronounced that my memory was normal for my age.

FALLLING INTO SLEEP/UNCONSCIOUSNESS

Later that day I went to London for a meeting of the Royal Statistical Society addressed by the Chair of the newly created Statistics Board that oversees the production of official statistics. The meeting was an outcome of the 2007 Statistics Act. The talk by the Chairman and the reception to the talk seemed to me to demonstrate that the new legislation did nothing but encourage the creation of bodies that would hold meetings and talk about the government of statistics without making any significant impact on official statistics. It was a case of jobs for the boys and especially jobs for a kind of London elite. Jobs like that of the Chair of the Statistics Board whose only qualification seemed to be experience as a government committee man. I was very irritated by the meeting.

Perhaps to make up for a very uninteresting meeting there was a reception afterwards at which the wine flowed very freely. I drank a lot. I caught the train back to Milton Keynes but I woke up in Northampton hospital. Northampton is where the train terminated – twenty miles beyond Milton Keynes.

Northampton hospital examined me and told me that I had suffered a stroke. They looked for evidence of any damage resulting from the stroke. But I felt fine and could not identify any kind of loss of any faculty – except loss of memory between catching the train in Euston and waking up in the hospital in Northampton.

One part of the examination I remember well. A young doctor ran her hands up and down my up stretched arms. Perhaps slightly under the influence of the wine I said ‘Very pleasurable’. She caught my mood and giggled.

They also gave me a memory test. Exactly the same as I had experienced in Milton Keynes in the morning. I passed with flying colours. It must be rather unusual to be given the same memory test in two hospitals on the same day.

PRESCRIPTION

The outcome as far as the NHS is concerned was a prescription that I should take to my GP. One item on the prescription was for an aspirin tablet a day to reduce the chance of a blood clot that may have contributed to the alleged stroke. The other item was for a drug that would reduce the likelihood of me getting a stroke. There was no prescription for memory loss.

EVALUATION

I suspect that my experience in this episode indicates some of the major strengths and weakness of the NHS. The major strength is to deal with what appears to be a life threatening situation. It is difficult to imagine that a hospital could do more for an unconscious body delivered to their doorstep than Northampton hospital did on this occasion.

But the major weakness seems to be that it does not listen to the patient or involve to the patient in other ways.

This was not the first time I had fallen into what I think of as a deep sleep when people have found it difficult or impossible to wake me. It has happened on half a dozen occasions over the past ten years. It happened twice on aeroplanes. Not related to alcohol. But no-one at Northampton asked me about this experience as part of the examination. Nor did they ask about my wife who was actually getting rather worried about me at this time. She could have told them something of this history.

Can you generalise from this experience?

1)If the NHS does not listen to the patients does not this carry the danger that patients do not regard their feelings as relevant to their medical condition?

2)If this happens does it not carry the danger that patients regard their medical condition as belonging to the NHS?

3)If this happens does this not carry the danger that patients are encouraged to think that they do not have responsibility for their own health?

What do you think?

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