Wednesday, 2 July 2008

Bevan's Baby At 60

This week the NHS is 60 years old. I know it is a popular pastime to moan about the ever beleaguered institution and to prophesise its imminent demise but it truly is a wonderful thing. Just think about it, free health care from the cradle to the grave. Yes, I know we pay for it with our taxes but it is free at source when you most need it, whether that be after evening of binge drinking, drilling through your hand whilst doing DIY, or contracting a life threatening disease. Or, like me, have a congenital condition of the kind that makes insurance companies reach for the 'Sorry Closed' sign and avoid eye-contact with you. But how good is it? This good.

Yesterday morning, on the hottest day of the year so far, Polly and I got into our non air-conditioned van and drove in to London for me to attend the Lind clinic at the Royal Brompton Hospital as I do about once every six months. The Brompton is a hospital with a world-wide reputation as a centre of excellence for treating heart and lung disease and is a place I have been attending for the last eight years when I was first hurtled there in an ambulance with lights flashing and siren blaring after failing to recover from double pneumonia and escape from my local hospital's intensive care unit after 3 months. The lung wing of the hospital is based in a Victorian building and Lind ward is on the top floor. The waiting area is a long corridor packed with wheelchairs and people attached to portable ventilators and oxygen tanks. It's one of the few times I look at a group of people and think 'Cor, look all those cripples. I'm really fit.'

After a while someone cuts my earlobe with a razor blade and takes blood with which to analyse my gasses from. They check my BiPap machine settings and then it's back to the increasingly hot and crowded corridor where I slalom my way back through the wheelchairs, walking frames and oxygen tanks. We wait a little longer and then are invited in to a consultation room where I am seen by a doctor. We've met before and he is familiar with my condition. My blood gasses are just about okay but the time has come for me to use the ventilator for an hour or so during the afternoon to rid myself of excess CO2. Deep joy.

I hate using the BiPap during the day. I'm not that keen on it at night but when it broke down a few months ago I discovered what it was like to go without it. I'd spent the following day in a miserable fog of Carbon Dioxide infused headaches. So, love it or hate it, I'm stuck with it. Life with out it would be. . . well, short. The trouble with using it during the day is that it ties you down. You are connected to the machine via a mask and hose and the machine is connected to the mains via. a cable and plug socket. So you are stuck in one place for at least an hour. And they want me to do this every day. Now this is where it gets good.

They asked me what I needed.

I told them I needed a face mask that was suitable for use during the day. The mask I have been using is a small nasal mask which I fancy makes me look like a WWII fighter pilot, but in reality makes me look like a demented scuba diver. It is fine for sleeping with but if you move around it leaks and cold air under pressure is blown in to your eye. It also has a tendency to whistle tunelessly in time with my breathing. I also wanted a way to move around and if possible get outside, more than a few feet from a power socket, so did my BiPap have an internal battery? No. Go and see Steve said the doctor.

Steve is the ventilator man. Steve knows more about BiPaps, Cpaps and all things ventilatory than any one in the south of England. So, while Polly went to book my next appointment I took the lift downstairs to the sleep labs, where Steve hangs out. He greeted me in his usual friendly manner and after listening for a minute vanished in to a store room to reappear with a couple of items. The first was a new type of face mask that plugs directly into my nostrils and is so sophisticated it comes with its own CD-Rom and carrying case. The second item was a battery the size of a small paperback book. Steve apologised that it didn't come with a case but the company that supplied the battery changed extra for them. He reckoned that if you paid £500 (that's $997 or €631) for a battery you should get a protective cover thrown in.. He showed me how to connect it to the Bipap and then stuck a 'Property of The Royal Brompton Hospital' sticker on it and that was that. I wheeled away with both the things I needed to make using the ventilator during the day practical and comfortable. There were no quibbles, no money handed over, I didn't even sign anything. They just gave me the equipment for as long I need it. How good is the NHS? That's how good.

Happy Birthday!