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When the nearest hospital is 40 miles away

Friday 26 August 2005

Our countryside commentator John Sheard suffered a slight but painful accident last week - and suddenly discovered how vulnerable you feel when the nearest hospital is 40 miles away

IT WAS a stupid, silly sort of accident. Standing in a shallow pool in the middle of the River Ure in Wensleydale, I slipped on a rock whilst changing a trout fly - and skewered my thumb.

Now this is not an uncommon accident amongst fishermen and, mostly, you can pull out the hook and suffer only a pinprick of blood. But this time, the hook has sunk in past the barb and - as I know from painful experience - you cannot pull that out without tearing away a lot of tender flesh.

40 miles for country folk?

It happened to me some 20 years ago outside a small town in the Scottish borders and I was directed to the local GP, a man who had dealt with such injuries many times before, and his treatment was swift.

He gave me small painkilling injection, pushed the barb through the skin until it protruded, snipped it off with a pair of pliers, and slipped out the now smooth hook backwards. It took perhaps ten minutes, five of which were spent waiting for the pain killer to take effect.

With this is mind, and hopeful of continuing my day's fishing with only a short interruption, I snipped off the line and, hook still in thumb, drove a few miles to the excellently equipped health centre in Hawes. It was then that I came face to face with the reality of today's NHS for country folk.

No, said a very pleasant nurse after speaking to a doctor on the phone, they couldn't help. I would have to go to a hospital Accident and Emergency Unit. And that meant going 40 miles back the way I had come to Airedale, between Skipton and Keighley, much the same to Westmorland General in Kendal, or more than 30 to Northallerton.

As I was heading west that night anyway, I elected for Kendal - and there can be few rougher routes in Britain. I was not in danger, but I was in some pain and driving a long, bendy and hilly road with a hook stuck in your thumb is not the best way to spend a day in the country.

On that drive, I had time to ponder this: what would it be like if I were in extreme pain? What would have happened if, say, I had scalded myself? Or was bleeding from some more serious wound? Or had damaged an eye? Would I have to drive myself 40 miles then?

Then I began to think of the long gone days when almost every small country town had its own cottage hospital, where multi-skilled doctors could tackle virtually any emergency apart from specialist work like neuro-surgery?

They are long gone now, of course, swept away by so-called NHS efficiency drives and replaced by big, shiny health temples based, inevitably, near big towns or cities. What happens to the poor farmer who comes off his quad bike 1,000 feet up in the Howgills?

However, that thought was overtaken by one even more sinister. If a Scottish GP could have whipped out that fly in his ancient surgery 20 years ago in the time it makes to make a cuppa, why was there no-one to do the same in the new and lavishly equipped health centre at Hawes?

And then, of course, the penny dropped. I'll lay a hundred pounds to a penny that the lawyers, not the doctors, are to blame. The NHS is now so terrified of being sued by the ambulance chasers who advertise their ways so relentlessly on TV that doctors are having to pay large chunks of their salary in insurance premiums in case something goes wrong.

The major hospitals will, of course, be covered for such misfortune. Any GP could have performed the minor operation on my thumb - the nice nurse could no doubt have done it too - but what if something had gone wrong?

Pity our poor country doctors who have to go about their vital business with their necks corkscrewed by having to look permanently over their shoulders. There was a time when we called our lawyers Legal Eagles. Can anyone think of a word that rhymes with vultures..?

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