St Sometime

By Andy Berry

This is a story of sometime in the future, when skies are blue and society has found a way to overcome the funding crisis in health services.

It describes a hospital, yet to be built, where the patients (or rather, some of them) receive the best of care.

Let's just say that I hope that St Sometime is really called St Never for I fear the consequences if such a place ever exists.

A brand new hospital has just opened near us.

It's got all the latest gizmos and is absolutely bristling with the shiniest technology that money can buy.

The hospital is built on a slope. At the back is the Accident and Emergency department. Ambulances can get right up to the doors for maximum efficiency.

The front of the hospital is grand. In the middle is a staircase, rather in the mould of 1930's musicals, which sweeps down to a beautifully manicured lawn and gardens. Originally, there was going to be a running track right at the bottom of the staircase, until someone pointed out that doctors aren't very fit and nobody seemed quite sure how to make them a special case.

Off the main corridor, there's another exit, labelled "To The Rest Wards". We won't talk about that just yet...

The doctors are extremely well trained and the nurses are very caring - but not necessarily the other way round.

There's always activity - people arriving, being dealt with and leaving. Most patients are treated immediately and the maximum length of stay in St Sometime is three days. The General Manager, Ms Quickly, proudly says "if we can't cure them, no-one can".

The entire operation of St Sometime is devoted to the speedy treatment of patients. Ms Quickly explains: "The doctors tell me they can assess whether a patient will recover within ten minutes and I always believe them". After all, she says, they have statistics that prove it. And who, in this technological age, dares to argue with statistics?

Recently, an awkward person with a disability (poor soul, the problem wasn't detected in any pre-natal genetic tests and her parents then won a court case that bypassed the normal procedure) asked "What does 'recovery' mean?" The answer, unsurprisingly, was: "To recover means to regain entirely normal functioning". Further discussion on the nature of normality was curtailed by the arrival of the Counselling Team and the removal of the questioner to a 'R' ward, to the great relief of Ms Quickly who likes a quiet life undisturbed from the certainties of life at St Sometime.

Let's follow a patient. Ah, here's one now...

The ambulance pulls up and in goes a newly qualified nurse (doctors are too valuable for such routine work, after all). Five minutes later, he shakes his head as he leaves. Oh dear, it's a 'R' ward for this one.

'R' (or Rest) wards are never full for long, that's a good thing. A quick approval procedure by the resident General Advocate is essential, Ms Quickly says, to prevent staff turnover exceeding 300% a year. After all, even 'R' ward staff still have some human feelings.

Most patients on the 'R' wards are so heavily sedated that the most you hear are rumbling tummies (well, after two weeks without food, whose tummy wouldn't rumble?) and the odd moan. For patients whose Advance Directives stipulated "please treat me" there's the customary token therapy - you know, five minutes every week - the High Court can't be persuaded to see the futility of this yet.

Unfortunately, patients will be patients... Frequently, a patient can't walk down the staircase to leave, despite the best efforts of the doctors and nurses over the full three days. There's nothing else to do with them - it's off to the 'R' wards. When asked whether anyone had ever tried to cheat and get down the stairs with assistance, Ms Quickly says simply "Our job is to cure patients and the security guards have strict instructions".

Funny thing is, nobody every leaves a 'R' ward...

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