Who's making toast if not the nurse?

The patients seemed the same as always - all reading `The Sun', all with tattoos

I CAME out of hospital yesterday, a minor op, no problems, no flowers please. All went well, thank you for asking, just a bit being chopped off my foot. What was interesting was the change in hospitals since the last time I was in, 20 years ago, for a cartilage op.

At that time, every doctor I saw was a Brit, floating through the ward in a high state, and a smart suit, ever so impressive, not to say pompous, while every nurse who looked after me was foreign - West Indian, Australian or Irish. This time, every doctor I saw was foreign. They appeared to be Egyptian or Arab, judging by their names and their accents. While all the nurses were local Brits, born and living in the immediate area.

Not a true comparison, of course, because they were different hospitals. This time I have been in the West Cumberland hospital in Whitehaven. Last time, 20 years ago, I was in a leading teaching hospital in London, the Royal Free.

Lots of other things have changed in 20 years. The waiting list for a start. I hardly seemed to wait for my cartilage op, but this time I seem to have been waiting for ever. Well, a year to be precise. Labour, when they came to power, promised to get the waiting time down, but have so far failed. Which is just as well. I was dreading the call coming during the World Cup. Then what would I have done?

I was in for only one night and two days, but straight away, I was aware of the shortages. There appeared to be only one staff nurse in the part of the ward I was in, looking after 12 beds. She was never still, always doing several things at once, but she did manage to come with me down the corridor, and up in the lift to the operating theatre for my cheilectomy operation.

The patients seemed much the same as last time - all reading The Sun, all with tattoos - but then I was in the male half of an orthopaedics ward again, along with lots of blokes suffering from football injuries. One nurse, seeing me read The Independent in the morning, asked why I hadn't gone private. I said I was against private schools and private health, believing that all education and health should be free. Also, I'm bloody mean.

"Oh well, everyone to their opinion," she said. "But you would have had it done much earlier."

Too true. Last September, I was told I could have my op in three weeks, perhaps even three days, if I went private. Otherwise, it would be a year. Not a hard choice, really, as I wasn't in agony, just discomfort, unable to wear shoes, though the pain was getting worse.

The present shortages are, of course, affecting the Royal Free as well as West Cumberland, resulting in more and more foreign staff coming in, if they can find them. Over three quarters of the nation's hospitals have at present got vacancies they can't fill, according to the BBC yesterday, which has got some leads from a forthcoming NHS Confederation report.

Up till now, the West Cumberland Hospital has not had too much of a problem recruiting nursing staff. Nigel Woodcock, Chief Executive, confirmed what I had observed - that the nursing staff are almost all local. They tend not to want to move away, because of family ties, and there aren't so many local jobs for women anyway.

Their big problem is among doctors and consultants, hence all the foreign doctors. He said the proportion was particularly high in orthopaedics. Overall, some 25 per cent of their consultants were from overseas. But finding doctors, from anywhere, is a continual headache.

"The problem generally is that there are not enough British medical graduates, and of the ones who do qualify, there is a large fall-out. Medicine seems to have lost a lot of its appeal. We have extra problems here because we are geographically remote. We often find that our main attraction in recruiting is the Lake District. People take jobs with us so they can go out walking.

"We have just appointed a consultant anaesthetist and consultant psychiatrist - and in each case the interviewing process was very easy - we had only one applicant for each job."

As a patient, though, I have no complaints. All went well. My op was fine, though I was a bit alarmed just as I was about to be wheeled into the operating theatre to see a clergyman arrive in the ward, dressed all in black, carrying a large Bible. I tried to hide under the bed clothes, but he came across to my bed and spoke to me - in an American accent. I though my ears were playing tricks. You just don't get Americans in west Cumberland. He used to be a New York cop, he said. Now he's vicar of Beckermet. Seems that the Church, as well as our hospitals, is having some problems recruiting people...