One More Look At The National Health Service

This week I spent another three days as a guest of the National Health Service (NHS). I won’t bore you with details of what and how, except to say Swimming New Zealand (SNZ), in the view of health professionals, is responsible for the what and the how. More of that in the coming months.

What I do want to discuss is something way more positive. New Zealand is a most fortunate country. Why? Because of the standard of its health service. The reason for my visit was to have a problem with an artery and vein in my arm addressed. The procedure involved going into Auckland Hospital on Monday, having the operation on Tuesday and being discharged on Wednesday. The operation is not huge; certainly no heart/lung transplant. But it is more serious than having a mole removed. Until very recently it always involved a general anaesthetic. Today that is still usually the case, but not always. Evidently advances in ultrasound scanning have meant that for selected patients the nerves of just the arm can be selectively blocked and the operation conducted as a local anaesthetic procedure.

Two types of the procedure are available AVF and AVG. The more recent AVF is made by connecting a vein, most often in a patient’s arm, to a nearby artery. In contrast, the AVG uses an artificial device, a plastic tube, to make the artery-vein connection. In the USA 25% of operations still involve the older and less efficient AVG procedure. In New Zealand, what I had done this week and what is always done in New Zealand is the new AVF operation. Additionally, in the USA, the average annual cost for creating and maintaining an AVF is, an incredible, $US60,000. That’s 93,000 downtown Auckland dollars.

Just consider that fact for a moment. I walked into Auckland Hospital on Monday. I had the most modern procedure under local anaesthetic on Tuesday and walked out on Wednesday at no direct cost. In Florida I’d be searching for $NZ93,000 before I was allowed in any hospital door. And even then there is a 25% chance I’d have to accept the old plastic tube treatment. We are indeed a lucky, caring and generous nation.

But it does not stop there. Everyone always says this, but it does not make it any less true. The staff in New Zealand hospitals are bloody incredible. From the cleaners, to the porters, to the nurse who checks your blood pressure at two in the morning, to the theatre nurses and the surgeons; without exception they are kind, they are caring and they are courteous. I don’t know how they do it day after day – but they do.

But more than that they innovate. I was pleased enough that my operation only involved a local anesthetic. As I was being prepared in the operating theatre the anesthetist asked if I’d like to watch the operation on TV. “Of course,” I said. Seconds later a wide screen TV was found and for an hour I lay and watched two incredibly skilled people cut me open, fix me up and sew me back together. Bloody amazing. The detail is stunning. Tiny little blood vessels and nerves are manipulated and repaired. The skill is beyond belief. There is a surprising lack of blood. The commentary explaining what’s happening to a medical novice is first class. It’s an hour of riveting TV with no ad-breaks.

Even when a major fire broke out within view of the theatre windows I’m delighted to report that the two surgeons appeared to be far more interested in my arm than the drama outside. And so thank-you National Health Service. Thank-you for looking after me again. As Mohammed Ali once said, “You done splendid.”

I have found that most trips to a hospital have their lighter moments. Not every patient is as lucky as me. For some their procedure involves a general anaesthetic. The chap in the bed next to mine was recovering from a “general”. He was still very confused.

He asked his nurse, “Where am I?”

“In Ward 71,” she replied.

“Where is that?” he asked.

“In Auckland Hospital,” she patiently explained.

 “Where is that?” he said again.

Calm and without any sarcasm whatsoever the nurse gently replied, “In Auckland.”

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