Wealth Blog

Public hospitals - Britain versus Hong Kong

PUBLISHED : Thursday, 16 January, 2014, 10:33am
UPDATED : Thursday, 16 January, 2014, 10:34am

Having now experienced both Hong Kong's Health Authority and Britain's National Health Service hospitals, version 2014, it's interesting to make comparisons. Admittedly it's my father who is currently in the clutches of the NHS, but having now sat for a week beside him in first a high dependency and now a surgical ward, I've gained some good insights.

First off, the Musgrove Park NHS Hospital in Taunton, Somerset dates back to the Second World War when it was built by the US forces. The corridor from the front entrance to the men's surgical unit involves pushing my mother's wheelchair half a mile. I know this, because the porter told me the distance, but we usually make our own way because he takes 20 minutes to appear. The hospital was designed for US Army jeeps to zip up and down the endless internal corridors, bizarre though that might sound.

Hong Kong’s Queen Mary and Princess Margaret Hospitals are far more compact. My memory of the PM involves being unceremoniously tipped from the ambulance stretcher onto a trolley, by staff wearing pink Wellington boots. Wellies don’t feature in the NHS. The alarming tendency of PM nurses to shunt patients around on mobile beds four at a time, by banging them together like supermarket trolleys, is also mercifully absent from the NHS. Also, when you ask an NHS nurse for a drink or to go to the loo, she does not respond: "too busy - ask family member" - the stock PM response. Neither does the NHS allow mob-handed family visits, or banquet-scale picnics in the ward with relatives perched on the end of other patients' beds. That and terrifying unmasked coughing are my abiding memories of the Queen Mary respiratory ward.

But my experience of Hong Kong public hospitals is that they are efficient, effective and get the job done, even if bedside manner is a low priority. The NHS cannot claim all the rosettes. 

Zero communication

NHS doctors are revered and genuflected too. Everyone seems to forget they are not demi-gods, just mere mortals who studied hard.

The well-publicised NHS trait of withholding patient information is alive and well. Nurses seem to be so petrified of being held accountable that they will not even tell you if it's raining. Many even avoid eye contact, scuttling about like startled rabbits, heads down. Getting updates on Dad’s medical prognosis involves ambushing the consultant as he makes his early morning rounds. I feel slightly daft stalking a doctor in a hospital ward, but if you want to find anything out, it’s the only way. And it’s not easy. First it involves sweet talking a staff nurse to let you in, because it's outside the strict visiting hours. Then you must penetrate the cordon of fawning baby doctors and nurses who flank Mr Consultant, hanging on his every word. One junior houseman winked at me and said you wouldn't think we're short of doctors in the NHS, would you? He was one of six tailing my target vascular specialist.

Having wriggled through the gaggle, (I always knew those paparazzi door stepping skills would come in handy again some day) Dr God was friendly and told me all about Dad.

But if I hadn't skulked about from 7am waiting to nab him, I'd still be wondering what they planned to do with my father. I don’t know how other, let’s say less tenacious, people discover information about their relatives. It has to come from the horse’s mouth, because NHS nurses will tell you nothing. 

A hefty proposition

A time and motion study on NHS nurses would show that 75 per cent perform remarkably well, despite being spectacularly huge. Coming from Asia, at least half the British population appears unfeasibly fat, especially nurses. It’s amazing, considering most of them are very active. Close attention reveals that a key few do the bulk of the deep down dirty nursing chores. Others can be heard saying: "this needs doing", or "someone needs to do that." Two of them spend ten minutes discussing why it’s not their job to do tasks from unblocking drains to wiping blood off the floor. Meanwhile, more senior nurses, often older than their fastidious colleagues, see things that need doing and quietly get on with emptying the bed pans or whatever job it is. These are the ones who keep the NHS show on the road. Meanwhile senior Sisters and Matron lurk in offices and are a rare sight on the ward.

Gallows humour

Maybe Hong Kong nurses are an equally mixed bunch, but they seem more organised. Even if this means less gallows humour. The guy in the bed next to Dad was threatening to discharge himself a few days ago. “I’m just going to walk out of here,” he said defiantly. You hear this a lot. The nurse, a Filipina with a broad Somerset accent, stared at him incredulously. “No you’re not,” she said and laughed loudly. “You’re not going anywhere. You’ve just had your leg chopped off.” I looked at the shape under his sheet. She was right.