A doctor with a grim bedside manner safe in a swish hospital sums up all that is wrong with the NHS THE CHRIS DEERIN COLUMN

THERE is a cut-and-paste section in every conference speech given by every British political leader. Or at least by the ones who know what’s good for them. It runs like this: ‘There is no service closer to our hearts than the National Health Service. I am proud of the NHS.

‘The staff who work in our hospitals do an amazing job. Today, on behalf of us all, I thank them from the bottom of my heart for all that they do.’

This was Nicola Sturgeon’s version, delivered to the packed hall at the SNP’s gathering in Glasgow on Saturday. But the words could just as easily have come from the mouths of David Cameron, Nick Clegg or Ed Miliband. And it’s mostly true – we all have reason to be grateful to certain doctors and nurses who have been there at moments of difficulty for us and our loved ones.

But it’s also true that not all of the staff do an amazing job. In the NHS, as in every profession, there are weak links in the chain: the lazy, the burnt- out, the plain incompetent. And, of course, the callous – a characteristic that, when found in someone practising medicine, a profession that deals with human beings at their most vulnerable, is particularly distasteful.

I’ve had mixed experiences of the health service. I’ve had some terrific GPs but also some I wouldn’t trust to know which way round a stethoscope goes. There have been hospital consultants who have exuded authority, confidence and a warm bedside manner – the perfect mix. But there have also been those who suffer from the kind of God complex you find in recent ex-leaders of the SNP.

Contempt

The birth of our first daughter was fraught, in part due to a midwife who, for reasons known only to herself, was so focused on treating us with sullen contempt that she forgot to do her job properly. It was very, very scary and upsetting. In conversation with an eminent obstetrician a few months later, I mentioned her name. ‘Oh yeah, she’s like that,’ he replied, and moved on. I was gobsmacked.

My family is currently having another bad experience. I’m not scared or upset this time but I am angry. And so I’m going to write about it. That same daughter, now a Labradorish 13-year-old, has had a minor medical issue for the past few years that has required regularish meetings with specialist doctors. Last week she had the latest meeting with her current one, whom we’ll call Dr Ratched.

I had to take time off work and miss two meetings that, frankly, I could ill afford to, in order to drive my wife and daughter to our local hospital, which is in Larbert, near Falkirk. Forth Valley Royal Hospital is a temple to the glory of the NHS.

Opened in 2010, it cost £300million and is Scotland’s largest ever health service construction project. It has 860 beds, 16 operating theatres, sits in 70-acre grounds that include a loch, a walled garden and woodland, and serves 300,000 people, from Killin in the north to Bo’ness in the south. It has robots to dispense and label medicines, remove waste, deliver food to wards and clean the theatres. It has its own Starbucks and M&S. There could be no more grandiose symbol of the status our country grants to its free-at-the-point-of-use health system.

I waited in the Starbucks for half an hour, catching up on work while my wife and daughter went inside. When they emerged, they were both bristling and shaken. And this was entirely unsurprising. Yet again, it seemed, Ratched had played to type.

The very first Deerin-Ratched meeting, a few months before, had not gone well. We’d missed the initial date given to us and when we arrived at the rescheduled time she swivelled round in her chair and barked: ‘You have a responsibility to make sure your child is here for the appointment’. It was explained to her that the hospital had sent the appointment card to the wrong address, which barely placated her. Only after a heated exchange – her choice – did she back down a little.

Each meeting since has been tense and her tone throughout impatient and accusatory. Remember, we’re not talking about a liver transplant patient who has blithely carried on boozing – it’s just a 13-year-old girl needing a wee bit of help.

At last week’s meeting, Ratched had a pop at my daughter and groused at my wife. There was a lot of eye-rolling and sighing. They were then ushered from the room, the purpose of the visit dismissed as she had ‘no time to do any more’.

Now, it may be you’re thinking: ‘Perhaps this is only one side of the story. Perhaps your wife is a bit of a battleaxe herself.’ And it’s true that she once rammed some frozen muffins down my back after I grumbled my way through breakfast. It’s also true that, when I’ve been naughty, she has a death stare to rival Henry VIII’s.

But she is, at all other times and to all other people, kind and friendly and as adverse to confrontation as most. She’s certainly not the type who would willingly go toe to toe with a doctor responsible for her child’s health. Who is?

So what gives? It may be that Lady Macdeath is a ray of sunshine with everyone else but I doubt it. What drives this Cruella of Camelon, this Bellatrix of Bannockburn, to treat patients – even children – in such a way? Perhaps her personal life is troubled. Maybe she has never got over her unfulfilled dream to dance at the Bolshoi or learn to play the trombone. Perhaps she has health issues of her own. Maybe, like many, she is overworked, stressed, struggling. Or she could just be an unpleasant, arrogant individual.

Whatever the reason, she is lucky she works for the NHS. I can think of no other customer-facing job in which this behaviour would be acceptable – in the private sector, your business would quickly go bust as consumers took their business elsewhere. Or your boss would intervene and demand you change your behaviour, and if you didn’t, it wouldn’t be long before you were fired.

It doesn’t work that way in the public sector. The ‘company’ is never going to fall over. No one seems to gets sacked, short of a murder conviction. The taxpayer may fund your wages, which are on average higher than you’d receive in the private sector for doing the same job, and your pension, which is more lucrative than most of us could dream of, and envy your job security, which appears to be recessionproof, but he or she is at your mercy. You are the state. You are, for most, the only option. You have the whip hand over the folk that pay for you.

Rudeness

Consider this: a study found that between 2007 and 2012, 590 ‘stream one’ investigations – into serious accusations against doctors – had taken place in Scotland, as well as 562 ‘stream two’ inquiries – for those that are less serious but nevertheless concerning. Of these 1,152 cases, only 54 led to a ‘fitness to practise’ hearing by the Medical Practitioners Tribunal Service, after which 19 doctors were suspended and only nine were struck off the medical register. Seems awfully low, doesn’t it?

In 2013-14, 24 teachers were removed from the General Teaching Council Scotland’s register, out of the 70,000 that work in the profession and are subject to the GTCS’s rules on conduct and competence. Few parents have put their children through school without encountering a teacher who shouldn’t be anywhere near a classroom. Any teacher can instantly name a fair few in their own school who should have been kicked out long ago.

If we’re going to stick with this model – we shouldn’t, but I doubt there’s a politician brave enough to force the public sector to work to the same disciplines as the private – we need to feel we can call out poor performance, face up to rudeness, challenge those who fall below the basic standards we should expect from public servants, however smart, well qualified and well remunerated they are.

It’s OK for me – I’m a middle-class guy with a column in the Scottish Daily Mail and a strong sense of my rights. My family will be taking the matter further with NHS Forth Valley. But what about the timid pensioner, the jobless father with low selfconfidence, the child whose parents don’t want to make a fuss? Should they have to put up with poor service? And if not, how do we put the Dr Ratcheds of this world in their place?