I WAS going to dissect government/ruler responses to covid this week, and remind you again how freely our taxes have been used without a sound and scientific basis. The round figure you will recall was £400 billion, equivalent to the NHS annual budget times three!

About once or twice a week citizens seek my advice. I am honoured that they do so, and I enjoy still being a doctor, although it is years since I was registered by the General Medical Council. It is good in fact not to be in chains and only to consider, in giving advice, ‘what would your Mum want’ of me. That little test was often applied in the wards.

This is the diversion from dissection. Before we were being picked up for a family gathering around our dear daughter in a rented house in Cornwall, I had a desperate call on the evening before, from a lady of about 87 years whom I have known for at least 45 years. 

She recalled sometimes that I had repaired a son’s femur, suffered in a motor cycle accident, with a Kuntscher nail. (A German invention, and I recall dealing with an ex-POW who had had this type of fixation shortly after he had ‘landed’. Gerhard Küntscher first used this in 1939 I read. ) 

She had turned in her chair about two weeks before and suffered sudden pain in the middle of her spine at about the eighth thoracic level. 

This pain was increasing and sleep was very broken.

She had no appetite and had lost half a stone in that time. There was an additional symptom – red blood per rectum about a month before. 

A colonoscopy had revealed no cancer. I could not examine her generally of course but did find sharp tenderness over this one vertebra. 

She was moving about the house but had spasms of increased pain as she did so.

She had suffered several compression fractures of her vertebrae in previous years, but as is typical she soon got better from each. 

These are common in women who are more prone to osteoporosis – diminished bone mass. It is countered partly by people continuing to work lifting things – like fuel for the fire, the heavy laundry basket etc. Her history was of increasing pain, not gradual improvement.

I thought a type of cancer in the bone marrow was likely, and could not tie the important bowel symptom into the picture.  Bone secondaries from cancer of the colon are uncommon.

She had seen a GP at the start, and had three telephone ‘consultations’ since, with recommendations about pain killing. She felt that the nettle of her pain was not being grasped. I said she needed to be seen face to face urgently for her story to be taken, for a full examination, and then with blood tests and plain Xrays taken. 

So I decided to speak with the practice, because this woman looked ill and was in severe pain. There was a minute or two of ‘covid’ advice – ring 118 if you require a booster etc, and then at least four minutes of ‘music’. 

A young receptionist answered but I felt the seriousness of this lady’s state was not being felt. So on return home I wrote an e-mail to one of the doctors speaking of her pain and her need for skilled and urgent attention.

I learn tonight, by phoning her, that her pain continues, there is no appetite and she is down to 7 stone.

This is my main point. If there was still a cottage hospital at Bovey Tracey, or the existing one at Ashburton with its eight beds removed, she could have been admitted for a few days. 

‘Sarah. We need to admit you – first to help control your pain, and to do our best to diagnose the cause’. 

The alternatives – there are none.  Except dialling 999 and joining the ambulance queue outside Torbay Hospital, whilst junior medical staff try endlessly to produce an empty bed by finding an inpatient who could be discharged homewards, given that a bed in the remaining community hospitals are hens’ teeth.

Why have OUR community hospitals in Devon, and elsewhere in our sceptred isle been closed? Essentially because OUR NHS has been dismantled bit by bit, and quietly, so a complacent public was not fully aware of how the National Health Service was not going to be able to cope with acute illness especially. 

As I wrote previously, a committee of GPs called the Clinical Commissioning Group, set about closing these little but vital hospitals one by one, and with vigour. 

There were public meetings when the apparatchiks spoke their spiel, in a false ‘consultation exercise’.

These committees had been set up, along with other ‘reforms’ under the Health and Social Care Bill April 1st 2012. And as I told you, the statutory duty of universal care was removed – so our rulers can in effect say ‘too bad’ - ‘pressure you know’.

It was denied that cost of care in these community hospitals was a factor.  I recall a set of false figures from ‘admin’ at Torbay seeking to show that Ashburton was more expensive bed for bed than Torbay. 

The benefits of the patient being close to home, and often with the local doctors and nurses knowing the patient, did not come into it. Neither did the skills and love of ‘end of life care‘, nor other benefits. The Torbay board were fully behind these closures.

https://dhalpin.infoaction.org.uk/  search NDDI, and you will see clearly in a box the five unique benefits of care in Community Hospitals. 

With others, I spent many thousands of hours fighting for them, and many miles in driving to North Devon. 

I believe I recall correctly that letters to Admiral Sir Richard Ibbotson KBE, CB, DSC, DL chairman at Torbay, and to the GP who was ‘CEO’ at the North Devon District Hospital went unanswered.  

The latter was signed by ten doctors – GPs and specialists, with over 300 years of combined service in the NHS!

Know that the BMA, the doctors’ union, opposed the setting up of the NHS in June 1948. We need to assert ourselves and undergo a revolution of the mind.

The last stanza of Percy Shelley’s Anarchy -

‘Rise like Lions after slumber

In unvanquishable number,

Shake your chains to earth like dew

Which in sleep had fallen on you –

Ye are many – they are few.’  

A date should be set in April when thousands gather round the closed Community Hospitals nation wide.