The Staggering Inadequacy of NHS Scotland

22 September 2021

by Montgomery Scott

It happened quickly and out of the blue. We’ve three young children – a six year-old, three year-old and our six month-old ‘lockdown baby’. Any parent with children in an education or nursery setting will tell you that from September to June they spend 80% of that time with a cold, cough, sneeze or sniffle. On occasion, it can be much worse. Our eldest once had scarlet fever and had to be rushed to hospital while he was having a sleepover at his grandparents. He was fine but they’ve never quite recovered. After your first sprog, you tend to roll with the punches and are able to tell if something is seriously wrong and make plans accordingly.

We were not, however, prepared for the events of this week. Having inherited a lurgy from his siblings, the baby hacked his way through the past seven days. His temperature soared now and then but we brought it down with sleep, Calpol and Ibuprofen.

On Monday we realised it was getting worse. His breath came in short gasps; he was managing only every third inhalation to get oxygen into his tiny lungs. We live in Scotland so it was also the September holiday weekend, meaning the older children were around our feet until the babysitter arrived. By evening, we decided that if the baby could get a long sleep it might nail whatever he was struggling with internally. He didn’t. When he refused to eat, drink and had a dry nappy we knew the game was up.

I’m 40 now but when I was a child I had bad asthma – meaning regular visits to Ninewells Hospital in Dundee. I grew up in a town 15 miles from Ninewells and when anyone in our household became ill we could telephone our local GP who would – if required – visit our house. It didn’t matter whether it was day or night. This was the case for both adults and children; my father when he crumpled with appendicitis and we children when suffering a fever.

As a rule, I have a soft spot for things from the past. I like old cars with roaring petrol engines. I admire the quality craftsmanship of Edwardian and Victorian furniture. I love gothic fiction. Yet I am also a progressive in its true sense. I’m receptive to new ideas and fascinated by technology. I listen to others’ opinions even if inside I’m thinking “what total crap”.

My experience this week, however, has confirmed that the health service in Scotland is gasping its last breath. Rather like my son could have done had we not taken matters into our own hands.

I looked online to remind myself what options were available for out-of-hours GP advice. I checked our local practice first and their pages directed me to NHS 24, or ‘111’. On their website, there are so many options – probably to confuse the time wasters – that I thought perhaps there was no alternative to calling 111 other than by an online contact form. I gave up and just called 111.

The phone line proved infuriating. I’ve worked in some senior roles in my time and as I listened to the repeated messages about Covid symptoms I had an increasing sense that NHS Scotland is grinding to a halt – with management either disincentivising those without coronavirus symptoms from getting in touch at all, or trying to process what (I thought) must be thousands of people with Covid symptoms through the NHS.

I heard midnight chime in the village steeple. It took 10 minutes to speak to a call handler. Our baby’s breathing was at its worst. Barely there at all. He was gulping in air but seemed unable to get it down. We put the call on speaker. After going through patient details we read the symptoms out. The telephonist was polite and clear and asked straightforward queries. He brought in a second person – a nurse – to ask specific medical questions about our boy’s pallor and the movement of his chest and stomach. As soon as we answered she said: “Okay, I’m going to get an ambulance to you.”

Of all the things I’d waited for her to say, I didn’t expect that. My wife was upset. She felt it was her fault. A ridiculous notion but mothers are hardest on themselves.

We leapt to action and packed a hospital bag for baby and one for mummy. It took us 10 minutes.

I put the lights on downstairs and in the hall and opened the curtains so we would be a spotlight in the midst of the village – drawing the ambulance to us. If lucky, my wife would manage a cup of coffee before she went in the back with the baby.

We discussed the possibility that she and our son might get separated – either by the ambulance or at the hospital – but thought we were only applying our worst fears from the past 18 months, and if such a question were to arise she would dig her heels in and refuse any intervention which cited Covid rules.

My wife and I are what I’d describe as “informed sceptics”. We take precautions, don’t believe in lizard rulers, stick to the rules like wearing masks in heaving crowds, don’t wear them in the school playground (as we ought in Scotland) but do our research. We dithered over the vaccine, skipping our appointments only to then attend the drop-in clinic when vaccine passports were brought in in France. We also know that children and babies without life-threatening conditions statistically are safe from Covid harm.

To drive from our village to the new Edinburgh Sick Kid’s Hospital takes around 30 minutes on quiet roads. We also have smaller community hospitals on each point of the compass around us. I’d figured on the shortest time for an ambulance to get to us as 15 minutes, and the longest half an hour.

Our baby continued to gasp like a fish on a ship’s deck.

After 45 minutes of waiting the clock read 1am. My phone rang. A telephonist from the Scottish Ambulance Service on a Glasgow number cheerfully opened up the conversation. He was sorry to bother us. He’d been given limited information from NHS 24. Could we describe the symptoms. Has our baby suffered a seizure or convulsion yet. “No,” we said, thinking, “Why on earth would we wait for that to happen before doing anything?” I mean, for Christ’s sake, our son can barely breath.

The conversation came to an unusual impasse. We were informed that unless our six month-old suffered any of the above we wouldn’t be deemed a critical case and the ambulance would come in 12 hours time. “What?” I heard my wife say from the middle of the room. “12 hours?” Immediately my wife put on a jacket and grabbed the car keys. “We’ll drive him in ourselves.”

On arrival at Edinburgh Sick Kid’s Hospital matters dissolved into farce. Nurses took vitals in the waiting area and we waited. We were informed that no rooms were free. This is a £1 billion flagship Scottish hospital in our capital city that’s just opened. My wife waited for four and a half hours for a room. The mother next to her had a wheezing toddler, who had had convulsions and arrived by ambulance – only to wait two and a half hours to be taken to a room. In the course of the night, the waiting room filled up with coughing, gasping children.

Our family’s fears about Covid restrictions proved unfounded. Neither our baby nor my wife was tested for coronavirus and no sign of that happened with the other children present.

Instead, we received an outburst of frankness from an NHS nurse after the four-and-a-half-hour wait. She told us that cases of serious chest infections – such as acute bronchitis – which our six month-old had contracted, were exploding. The reason? Not enough exposure to minor ailments and infections to boost their developing immune systems due to the lockdowns.

NHS Scotland is the mids of a crisis. The Scottish Government has borne considerable public wrath in recent days over ambulance waiting times. Some people have had to wait 40 hours for an emergency vehicle only to die anyway. Based on our experience, this fury is earned.

My wife drove home with our son at 7am. Ninety per cent of the time spent waiting, half an hour to decide it would be best fixed by waiting it out – to try another day to see if he suffers a convulsion and therefore could be close to death.

Work often takes me to London. I could have taken the Edinburgh to London journey three times before an ambulance reached our house from a brand new hospital 30 minutes from our home.

We have come a very long way from the days of GP home visits. Centralisation of the health service, closure of local acute care facilities across Scotland with more on the way, and the main centres of healthcare simply unable to cope. Add to this a hesitancy from the Government to acknowledge that children and young people are now not only the sufferers in terms of their education but their actual health – weak immune systems coupled with paralysis from many terrified parents to expose them to ‘normal’ life – and you have the perfect storm.

I hope there are better days ahead. We as a family, however, will be taking the Scottish Health Secretary’s advice. We’ll neither call 999 or 111. We will ourselves operate an ambulance service and drive our children to A&E. Woe betide those poor people with no money and no transport.

It truly is a matter of life and death. Only the privileged ones who can drive to hospital themselves will be safe. Shame on you, NHS Scotland.

Montgomery Scott is a pseudonym.