How a bad fall taught me the stark difference between healthcare in Scotland and France
A serious accident gave Martin Roche some instructive experiences of a French and then a Scottish hospital
I was careless enough last month not to switch on the light as I descended into the cellar of my friend’s house in the Minervois region of southern France. In the gloom, I missed my footing and tumbled through the air, desperately flailing my arms in search of some hand-hold that might break my fall.
None was found. I crashed onto an ancient and very hard French stone floor. The upshot was a shattered upper left humerus and the quad tendon on my left knee torn from its anchor.
Now, daft people do daft things all time, so why bother the good readers of The Scotsman with an everyday story of an accident to an ageing Scotsman? The clue is in the word. On saying I was “Ecossais”, almost every person I encountered during my two-week French health service journey smiled.
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A distraction from the pain
It started with the boss of the three-man ambulance crew. Having with great skill and tenderness extracted me from the cellar, the team loaded me onto the ambulance. During the 30-minute drive to Carcassonne’s general hospital, the chief told me about his holiday in Scotland last year. He’d been to Edinburgh, travelled up through Fife, Perthshire and Angus to Aberdeen.
My new 50-something friend, tough as old boots and trained in all the arts of rescue, transported himself nostalgically from the gentle vinyards of Minervois to the land of mountains and rain – all the time checking my vital signs.
Clever man, he had engaged my interest and flattered me by praising my native land, as effective a distraction from the pain and anxiousness about my upcoming diagnosis and treatment as could be imagined.
It is a Friday night and a holiday weekend. A&E is busy. It seems a short wait before I’m being wheeled to X-ray. I wave farewell to my ambulance champions, adding thumbs ups and crying “merci beaucoup”.
After X-rays, it’s off to a single room, with an en suite. The room is spacious. I have a typically French view of tall cypress trees on a distant hill. Many people appear to see me settled in. There’s a sense of calm, discipline and order.
I’m given painkillers and something to help me sleep. I estimate it’s been about three or four hours since my injuries. In the night, I’m vaguely aware of nurses checking my blood pressure and other vital signs.
‘Beautiful country. Wonderful people’
The morning sees a visit from my surgeon, Dr Claude Serra, and a senior nurse. “Anglais?” asks Serra, who is rather stern faced. “Écosse,” I reply. He breaks into a smile. Turning to his colleague, he says: “Beautiful country. Wonderful people.” Like the ambulance leader, he too had recently holidayed in Scotland.
Serra takes time to explain the surgical procedure and thoughtfully answer my questions. He will operate on arm and knee at the same time.
The operations are a success. Serra says I can stay in the hospital and be moved to a recovery unit for physiotherapy. “It will be weeks,” he says. I decline, saying I’m in touch with the travel insurers about being taken back to Scotland.
Temporally bed bound, I’m given daily bed baths. One morning, two fresh faces arrive to wash me and change the bedding. “Scottish?” asks one of the women. I nod. She presses a button on her mobile phone. The room fills with a choir singing Flower of Scotland, followed by Robert Burns’ great hymn to ‘liberté, égalité and fraternité’, A Man’s a Man for A’ That.
The final song delivers perhaps one of the most surreal experiences of my life. Here I am injured in a French hospital, far from hearth and home, being washed by two young women, while from the phone comes Matt McGinn singing The Jeely Piece Song. I sing along. “O ye cannae fling pieces oot a 20-storey flat...”
It’s great being Scottish.
Return to Scotland
After two weeks, I’m flown home and taken to Queen Elizabeth University Hospital in Glasgow. The staff are professional and caring but seem to be running hard just to stand still.
There is no sign of the measured and steady calm of my Carcassonne hospital. I rarely see the same person twice. The consultant in charge of my case seems impatient to be away when I ask questions about my ongoing care. I get some basic guidance on self-care from physiotherapists and occupational health folk.
On my third evening at QEUH, a nurse tells me I’m going home. I ask when. “Now,” she says and asks me to call a taxi. I refuse, reminding her that I live alone in a block of flats, up two flights of stairs. I am permitted another night. There has been no consultation with the patient.
Our NHS – in Scotland or across the rest of the UK – doesn’t lack skilled, dedicated, compassionate people. More money would help (that £350 million a week promised by the Leave lot 10 years ago ahead of the Brexit referendum was a blatant lie). The core issue appears to be endless firefighting. It’s a vicious circle. Somewhere, somehow, strong managers need to get a grip.
The NHS is one of the most beneficial political policies ever introduced. Its essential premise is that health is not a commodity. Taking back the NHS from its quagmire of quasi-privatisation would reinforce the idea that society working for the common good is far better than the insularity and selfishness inherent in medicine for profit. What we need is leadership. Where is it?
Martin Roche had a 35-year career in international public relations and is a writer
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