East Kent NHS: You Can’t Just Turn Up and Have a Bloody Heart Attack

In a remarkable breakthrough, NHS bosses have discovered why hospitals are overcrowded. People keep turning up unexpectedly, often without the slightest consideration for the annual budget.

FICTION | SATIRE

The East Kent Health Improvement Board has announced a revolutionary new scheme to reduce pressure on local hospitals.

From Monday, all medical emergencies must be booked at least 28 days in advance.

The decision follows an extensive review of hospital waiting times, which found that most people requiring emergency treatment hadn’t bothered making an appointment.

“Frankly, it’s astonishing,” said the board’s director, Mr Malcolm Pritchard. “We spend millions planning healthcare, and people simply turn up with heart attacks, broken legs and burst appendixes whenever they bloody well feel like it.”

The new system has been designed to eliminate this irresponsible behaviour.

Unfortunately, the first person to test it was Mr Arthur Mills, 72, from Folkestone, who fell down his stairs at 8.37am.

By 9.30am, Arthur had arrived at the East Kent General Hospital with a badly injured leg.

“Morning,” said the receptionist. “Have you got an appointment?”

“No. I’ve had an accident.”

“Oh dear. When did you book it?”

“I didn’t.”

“Well, you can’t just have an accident without telling us.”

“I didn’t know I was going to have one.”

“That’s hardly our fault, is it?”

Arthur stared at her.

“I fell down the stairs.”

“How many?”

“Twelve.”

“And you didn’t anticipate any difficulty?”

“No.”

“Well, I think we’ve established where the responsibility lies.”

The receptionist handed him a leaflet entitled Planning Your Accident: A Patient’s Guide to Responsible Injury.

It explained that patients were expected to give reasonable notice before developing urgent medical conditions.

Heart attacks required four weeks’ notice. Strokes could be accommodated with three weeks’ notice, provided they occurred between 9am and 5pm.

Sudden collapses were discouraged altogether.

“I can’t walk,” said Arthur.

“Have you tried not falling down the stairs?”

“Yes. For the previous 72 years.”

“Well, there you are. You know you can do it.”

A nurse passing through reception noticed Arthur’s leg and immediately arranged for him to be assessed.

Unfortunately, Mr Pritchard was conducting an inspection and had spotted the nurse helping him.

“Excuse me,” he said. “What’s happening here?”

“This gentleman’s injured his leg.”

“Was it scheduled?”

“No.”

“Then why are we treating it?”

“Because he’s hurt.”

Pritchard sighed.

“This is precisely the sort of old-fashioned thinking we’re trying to eliminate.”

The nurse looked at him.

“He’s got a potentially serious injury.”

“And I’ve got a potentially serious overspend. We’re all suffering, aren’t we?”

The nurse told him what he could do with his overspend and continued helping Arthur.

Pritchard made a note.

Staff displaying excessive enthusiasm for traditional healthcare delivery.

At eleven o’clock, a government minister arrived to inspect the hospital’s new approach to emergency care.

The minister was delighted.

“I understand you’ve made remarkable progress.”

“Absolutely,” said Pritchard. “We’ve reduced unscheduled emergency admissions by 100 per cent.”

“How?”

“We’ve stopped allowing them.”

“Good heavens! Why didn’t anybody think of that before?”

“Resistance to change, Minister.”

The minister examined the hospital’s performance figures.

“What’s this red line?”

“People requiring treatment.”

“And the green line?”

“People receiving treatment.”

“Why are they so far apart?”

“Social distancing.”

“But that’s an enormous gap.”

“Precisely. We’ve exceeded our distancing target.”

The minister beamed.

“Marvellous. Can we roll this out nationally?”

“Certainly. Although we’d need a bigger gap.”

At that moment, Arthur appeared, being supported by the nurse.

“Excuse me,” he said. “I’ve been waiting to have my leg looked at.”

The minister turned towards him.

“Ah! A patient! Splendid. How’s your experience been?”

“Bloody awful.”

“Wonderful. So you’re engaging with the process.”

“No, I’m complaining.”

“Even better. Patient participation.”

Arthur pointed to his swollen leg.

“Look at this!”

The minister examined it briefly.

“Good Lord. That’s nasty.”

“Exactly!”

“Have you considered keeping it somewhere less dangerous?”

“What?”

“Your leg. It seems to be causing you considerable trouble.”

Pritchard intervened.

“Minister, perhaps I could explain. This gentleman arrived without an appointment.”

The minister looked shocked.

“Really?”

“Yes.”

“With that leg?”

“Yes.”

“Extraordinary. Some people have absolutely no sense of responsibility.”

Arthur opened his mouth.

Then closed it again.

He’d reached the point where arguing seemed more likely to cause a stroke than improve his chances of getting treatment.

Fortunately, the nurse had already arranged for a doctor to examine him.

Unfortunately, the minister had now announced an unscheduled inspection of the emergency department, causing an immediate administrative crisis.

“We can’t have an unscheduled inspection!” cried Pritchard.

“Why not?” asked the minister.

“Because we’ve abolished unscheduled activities!”

“But I’m the minister!”

“That doesn’t make you an emergency.”

“It bloody well will if you don’t let me in!”

An emergency meeting was hastily convened to decide whether the minister’s unscheduled visit should be permitted under the new rules.

The meeting lasted 47 minutes.

Arthur, meanwhile, received his medical assessment.

The nurse returned to find Pritchard congratulating himself.

“You see?” he told the minister. “Everything’s working beautifully.”

“But that man was treated without an appointment.”

Pritchard froze.

“Was he?”

“Yes.”

He looked genuinely horrified.

“Well, that’s a serious breach of procedure.”

The nurse folded her arms.

“He’s a patient. He needed treatment. We treated him.”

“But that’s not how the new system works.”

“Then the new system’s bloody stupid.”

The minister coughed.

“Steady on. We mustn’t let common sense interfere with a major government initiative.”

Pritchard hurriedly consulted his policy manual.

After several minutes, he found a solution.

“We can classify the treatment as a training exercise.”

“A training exercise?” asked Arthur.

“Yes. You weren’t really a patient. You were participating in a simulated medical emergency.”

“But I really fell down the stairs!”

“That’s excellent acting.”

“My leg’s really injured!”

“Wonderful commitment to the role.”

“And the doctor really treated me!”

“Quite. A highly successful simulation.”

The minister clapped his hands.

“By Jove! This is marvellous! We’ve treated somebody without recording a single emergency admission!”

Pritchard nodded.

“And because the gentleman wasn’t officially a patient, he couldn’t have been waiting.”

“So we’ve reduced waiting times too!”

“Precisely.”

The minister turned to Arthur.

“How would you like to take part in our national healthcare improvement campaign?”

“I’d rather go home.”

“Splendid. Discharged already! Another successful outcome!”

Arthur was taken home by his daughter, who asked what the hospital had said about his injury.

“They said it didn’t happen.”

“What didn’t happen?”

“The accident.”

“But you fell down the stairs!”

“Apparently that was a rehearsal.”

“For what?”

“I’ve no bloody idea.”

The following morning, the East Kent Health Improvement Board held an emergency meeting to celebrate the success of its scheme.

Unfortunately, the meeting had to be cancelled because nobody had booked the emergency.

A routine meeting was held instead.

The board agreed that the hospital had achieved outstanding results.

Waiting times had been reduced. Unscheduled admissions had been eliminated. Patient satisfaction was described as encouraging, although nobody had actually asked any patients.

The minister sent a congratulatory letter.

Pritchard was nominated for an award.

The nurse was invited to attend a mandatory workshop on respecting administrative boundaries.

And Arthur received a text message.

Dear Mr Mills, thank you for taking part in yesterday’s successful simulated emergency. We hope you enjoyed your experience.

Would you be willing to participate in another simulation?

Arthur replied:

“Yes. I’d like to simulate strangling the bloke who invented this bloody scheme.”

Within minutes, he received another message.

Thank you for your interest in our Mental Health Services.

Your appointment is on 17 March 2029.

Editor’s note: This is fictional satire. The characters, conversations, policies, meetings and events described are invented. The pressures facing East Kent’s NHS are real, however, and are examined in Shepway Vox’s 9 November investigation

The Shepway Vox Team

Dissent Is Not a Crime