If you are going to fall from a horse and break your back, try to do it in France, not Britain:

The lower, lumbar region took the full impact and the pain was instant and appalling. When the ambulance came, I was strapped to a body board and taken to a local hospital. An X-ray confirmed I had broken my back and was in grave danger of permanent paralysis, so I was transferred to Pellegrin, a large teaching hospital outside Bordeaux.

The hospital was immaculate and the staff attentive and professional. I was bedbathed daily – virtually unheard of in British hospitals – my sheets were changed every day and the two-bed room was cleaned and dusted on a rolling basis. I later discovered that France is tackling MRSA by making nurses personally responsible for the cleanliness of their wards – it showed.

In the UK, by comparison, contract cleaners are employed. That shows, too.

...

My medications were always on time and there was an air of pride about the place that instilled confidence in me, despite the language barrier. After the most traumatic week of my life, when I lay terrified and immobilised on a morphine drip, I underwent surgery.

My L2 lumbar vertebra was crushed, so titanium screws were drilled into the L1 above and L3 below, to hold that section of spine in place as it healed. The pins were designed to stay in permanently.

The operation was deemed a success and, post-surgery, the nurses – a kind but forceful bunch – had me sitting up in a chair within three days, which involved a lot of screaming and moaning and was a far greater feat than it sounds.

By day six I was walking with a frame, which they took away after 20 minutes – so I could climb the stairs. It was a steep relearning curve, but I felt supported and looked after. I didn't have any travel insurance, but the bulk of my medical expenses were paid for under the European Health Insurance Card scheme (formerly covered by the E111), although I had to pay about £2,500 for ambulances and drugs.

I returned to Britain, weepy and sore, a week after the operation, to a very different scenario. My husband hired a private ambulance to take me home from the airport, because the NHS doesn't do airport pickups and I made it home breathing gas and air to help numb the pain.

It was all downhill from there. My GP had arranged for a community nurse to visit me that day, but she never came. It was left to my husband to change my dressing, and I had to inject myself in the stomach with the blood thinners prescribed to prevent deep vein thrombosis because I was so inactive.

The next day it was a similar story, so we rang and asked the nurse not to bother coming. But she turned up, with such a sullen, surly manner I decided I'd rather inject myself. She took 20 minutes apply a dressing that fell off before she'd reached the garden gate. Again, we phoned and said we didn't want a nurse – but still someone appeared on our doorstep for the next three days.

At my local hospital, Homerton Teaching Hospital, in east London, I saw a back specialist, who examined my X-rays and gave me a back brace to wear 16 hours a day, telling me that if all went to plan it would come off after eight weeks. When I returned for my next appointment, he was no longer at the hospital.

While orthopaedic doctors are trained to treat broken bones, backs are such complex structures that it is absolutely crucial to see a skilled specialist, as I did in Pellegrin.

But I was told by a general orthopaedic consultant – who, rather worryingly didn't seem to know how read my X-rays – that this wouldn't be happening. Instead, I would be seen in a fortnight by someone who "knows a little bit about backs".

"I mean, it's not as if he's never seen a back before, heh, heh," he laughed. "It's just that – and I'll be honest with you – he's not an expert. Is that all right with you?"

"Um, not really, no," I said, weakly. "That's not all right with me. Do I have a choice?"

He shrugged, smiled and said I didn't.

This is from an article by Judith Woods in today's Telegraph.

Of course it is only an anecdote and does not prove anything. But it is part of a great deal of evidence.

Actually the article leaves a number of questions unanswered including the nature of the ownership and management the French hospital she went to. But the nature of the unreliable NHS service is well described. Sometimes you feel you are at the mercy of an organisation which gives and takes as it sees fit and/or insofar its serious limitations allow. The patient has little power or ability to choose and sometimes has to plead or try to use contacts to get the treatment needed.

Posted by James Bartholomew • Indexed in NHS

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