National Health Service: It’s time to move on to the 21st century

By TD Fuego

Like me, Mona Babajee’s piece in the previous week’s MT (01-Nov-20 12) must have left many readers feeling mad, sad and absolutely disgusted. What a dreadful way to treat a sick old lady! Contrast this with her account of the treatment she received recently as an inpatient in the UK. Those personnel at Jeetoo are an utter disgrace to the caring profession, and should be made to hang their heads in shame.

Unfortunately for us, alas, poor treatment is not all that rare in the National Health Service (NHS). Just because we do not contribute directly for treatment in the NHS seems to confer some doctors and nurses with all manner of licences to use, and abuse the patients who are put under their care. Some of the ancillary staff members are not much better.

My dad passed away in 2007 at the ripe old age of 81. Fortunately for him, he never suffered from any major ailments. But when he reached 70, for some unknown reason, his BP and blood sugar went haywire. So, I suggested we take him to a Hospital (meaning a paying one, known as a Clinic in these parts), but he was adamant, “Lopital, to fou, zotte pou touye moi laba!”  Eventually, he was admitted to City Clinic in Port Louis and, after a fortnight under the care of Dr Audrey, made an excellent recovery.

Angio and PTCA

In 2001, I was struck down with an inferior Myocardial Infarction and had to be admitted to Candos Cardiac Centre (CCU) as an Emergency case. After the initial stay of a week, due to the absence of the appropriate apparatus at the time, there was little more they could do.

So, Dr Dhuny referred me as an URGENT case to the Cardiac Centre in Pamplemousses (DDY) for an Angiogram (Angio), and further treatment — which meant either an Angioplasty (PTCA) or a Coronary bypass, depending on what they would find. Incredible as this may sound today, I had to wait for 2 long years and, eventually some strong lobbying from a friend of a friend, to get the Angio and the PTCA performed in 2003.

However, when I was discharged back to CCU, the Consultant was very disappointed that I did not feel much better. My health went from bad to worse and I ended up house-bound for the first half of 2005. So in August 2005, having got the apparatus by then, CCU decided to perform an Angio to see what the problem was. To his utter horror, the doctor found that the major blockage in the right coronary artery (RCA) had not been dealt with!

Yet, in his discharge letter, the Cardiologist up North had mentioned occlusions of 99 percent in the RCA and 65 percent in the left artery (LCX); and that PTCA had been performed. The obvious impression given was that this procedure had been carried out on both arteries. It is a miracle that I did not get another heart attack and kick the proverbial bucket — it is then that I understood fully my old man’s abhorrence of the NHS.

Anyway, the tandem of Drs Ramjuttun/Patel performed the much needed PTCA on the RCA and, 7 years later, I am here to tell the tale.

Alle Candos

But, that is not the end of the story. In between toing and froing on a monthly basis between Plaines Wilhems and Pamplemousses (2001-2004) waiting for the Angio, PTCA and post-operative outpatient attendance, I had a terrible chest pain one morning whilst staying with family in the North. So, with my appointment card in hand, my brother and my wife took me straight to DDY. We stupidly assumed that, since I had been on their books for two years and they had all the record of my condition and treatment, they would take care of me straightaway.

But, how wrong can one be? Instead of an Emergency admission, I got sent packing as a routine case to the Casualty Department of SSRN. In spite of the insistence of the doctor there, and for reasons best known to them, DDY refused to take me back. Thus, followed an hour of investigations — whilst I felt like I was dying — before I was finally admitted to SSRN cardiac ward. They put a Nitrate infusion in my left arm, and waited for the Consultant.

In the state I was in, I really cannot remember whether he came the same day or next but, when he did arrive, the first thing he asked me was why I had come to SSRN instead of going to CCU which was closer to home. When I explained, he looked me straight in the eyes and said, “prochaine foi ou gane ene problem, ou bizin retourne Candos!” I was flabbergasted.

Imagine a cardiac patient, possibly having another heart attack in a town 15 minutes from the nearest hospital, being told to drive to his local one which is one hour away — longer if it is the rush hour. Although I kept mum as you tend to do when your lamain en ba roche, I wondered where this guy had studied his Medicine and whether he had an iota of common sense or humanity left in him.

The money

Since my adventures with the NHS, I have written at least twice to the MT* with suggestions that would help modernise the NHS, with funding through a National Insurance scheme and family doctors at the heart of system. Whilst I would not be so presumptuous as to assume that my ideas would be used as a template, I had hopes that they would spark off a long overdue national debate. Because, it is high time for civil society to get involved; health matters are simply too important to be left to politicians only!

The government spends (a measly) 2.35 percent of GDP on the NHS, which equates to R6k+ for every man, woman and child. With just a little extra, the average family could buy into a private health insurance scheme that would provide it with medical care on demand. So, why do the authorities not encourage more of us to go private by means of tax breaks?

Otherwise, the people need to be reassured that there is no implicit hidden agenda. As consumers, we already spend an additional 1.55 percent of GDP on private health care. And even a shipload of feathered Brazilian Samba dancers are unlikely to succeed in bringing mass medical tourism to our shores. We have neither the medical infrastructure, expertise nor reputation to attract the international customer needing serious medical treatment.

So, who will be filling all those empty beds in the existing and the planned Clinics? If we are relying on the local population, then who will foot the ever-increasing bills?

Time to move on

The founding fathers did a good job of the NHS with the means available 45 years ago. It is up to us now to move it into the 21st century. In my conversations with all stakeholders, I have found that the majority would be agreeable to go for a monetary contribution, provided that it is used to provide better working conditions for carers and efficient treatment for patients.

Someday, the powers-that-be will perhaps pay attention to the serious concerns of the little people and the shrill cry of distress emanating from them! Unfortunately, we Mauritians are very good at complaining among each other, and equally bad at doing so with those who have the power to do something about it.

So, even if they may be aware of our dissatisfaction, the authorities are happy to assume that we are satisfied with the second rate, third world service on offer — Mo Ibrahim and all those meaningless prizes notwithstanding. I am sorry but self-congratulatory back-patting at winning against rock bottom competition is the luxury of the fool!

Loto

Finally, do you remember that ad back in 2009 — leading up to the launch of Loto — which used to proclaim that the 58 percent of Gross Income (surreptitiously changed to Net Income later) would be spent on health care? I am sure we all remember the beautiful colour picture of that very happy looking, grey-haired granny being taken round in her wheelchair by a man in a white coat.

Can anyone at GM House please tell us how much of the billions reaped (or should I say ripped off) so far has been spent on the care of the elderly? On any category of patient for that matter!

* 25-Jul-2008  – National Health Service: a case for urgent treatment

* 11-Jun-2010 – A healthy message for our Lavenir


* Published in print edition on 16 November 2012

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