A Winter’s Tale

This blog has long documented my family’s experience of the shortcomings of the NHS, on the part of both the institution and individual staff members. I have not mentioned this incident before, but it is perhaps, worth recounting in the current situation.

It was in the depths of winter in hill country some years ago. Drifting snow had filled the narrow local lanes to the tops of the banks and hedges, cutting off a number of houses, among them the isolated home of an elderly relative of mine in the advanced stages of terminal cancer. For the best part of a week, the only vehicle to pass the house was a high-clearance tractor driven by the local farmer.

This is not an unusual state of affairs in a hard winter, so there was plenty of food in the house (and gas cylinders to cope with the inevitable power cuts), but, with over a mile to the nearest clear road, getting to the surgery or pharmacy for routine medical care and drugs was clearly not an option.

On the Sunday - her day off - the local pharmacist arrived on the doorstep, bringing repeat prescriptions and offering to do some basic health checks. She had loaded the morphine and essential drugs into a backpack and, leaving her car at the main road, walked several miles through the snow to deliver them to the homes of three patients who would otherwise have run out.

What makes this worthy of comment - apart from the altruism of the conscientious pharmacist - was that one of the GPs from the local surgery lived nearby and was also cut off by the snow. Several times during that week, she and her husband were seen (and heard) out on their cross-country skis, following the tractor ruts in an extensive circuit of the blocked country lanes with much vocal hilarity.

While the doctor was in no way obliged to knock on the door en route and enquire about the patients, it seems less than neighbourly, under the circumstances, to ski cheerfully past the doors of sick people trapped with no access to medical supplies or care - in a relatively small community, there was no question of her being unaware of their predicament. 

Whether it was a lack of imagination, a fear of breaking rules or callous indifference, we’ll never know, but it’s an interesting illustration of how some GPs see their role within the community. As my relative pointed out, it highlights the unpalatable truth that, leaving aside community spirit and common humanity, the pharmacist had a far greater incentive than the GP to keep her regular customers alive and kicking.

Tradition has it that the ancient Chinese paid their doctors only when they were well. We aren’t going to turn careless indifference into altruistic concern but perhaps, among the much-needed changes to the NHS, we could incorporate some kind of motivation to preserve the health of patients in situations like this rather than picking up the pieces when things are allowed to go wrong.