Funny coincidence

 Yesterday, Viv and I were on our way out when the postman called out from the other side of the street.

'I've got a parcel for you', he announced. He fetched the parcel and I put it safely in our hall before we continued on our way, for it was a parcel I'd been waiting for.

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Around fifty-five years ago Viv, then at primary school, had to travel from her home in Welwyn Garden City to London, for appointments at Moorfields Eye Hospital. Her mother took her on the train, buying her a pack of Toffets at the station from a vending machine on the platform while they waited for the diesel hauled train. She used to enjoy these journeys, for the train was formed of British Railways Mark 1 suburban carriages, with comfortable, if dusty, six-a side sprung, comfortable seats in warm, unconnected compartments. Inside one of these, passengers would talk to each other, and there would be no gust of cold air at stations unless someone within that compartment was getting out, or someone boarding wanted to sit within it. 

Few people of our generation would have not been familiar with this type of railway carriage, for they ran throughout much of the south east, and around other cities, until they were replaced by modern, sliding-door trains in the 1970s or later.

Viv and I both had fond memories of such trains, and, when I started to build a model railway in our attic I decided I wanted to somehow recapture the memories I have of that time: the shabby, dusty exteriors, and almost as dusty interiors, of the rolling stock, the filthy, under- used station buildings, and the shabby atmosphere of dereliction about it all. To help in this endeavour I had bought three model Mark 1 suburban coaches, in authentic British Rail 1970s dirty blue, to run on my layout, and these were what was in the parcel the postman gave us.

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It was a strange coincidence, for we were on our way to the local station, to catch a train to London. It may have been in the middle of lockdown, but we had a 'good reason' to be travelling: Viv had an appointment at Moorfields, for treatment on her right eye, required as a result of a damaged seventh cranial nerve.

There was no vending machine offering Toffets on the platform where we waited. The train, when it arrived, was a long, modern, electrically-powered variety, well lit and very much less dusty inside (if not outside) than the 1970s version. But, whenever we stopped, doors somewhere in the train opened, and, because the internal layout was more of a long tube, a draught of cold air came in. As if this was not sufficient discomfort to which travellers had to be subjected, the seats resembled an ironing board both in appearance and amount of upholstery. All of the passengers on board (except us) seemed to be ignoring each other, even those that appeared to be travelling together.

Will today's seven-year-olds, travelling with their parents on an occasional trip to town, have fond memories of these monstrosities in fifty years time, and want a model of a Thameslink class 700 for their model railway? Or will they have lifelong memories of the discomfort of these trains, and decide to avoid the railways as much as possible, opting for the far greater comfort of a car, complete with adjustable heated seats, draught proofing, and climate control?

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There is a parallel with the NHS, which, like the railways, has been run by people (politicians) who don't necessarily know much about a business of which they find themselves in charge. Viv's appointment at Moorfields was, because of the pandemic pandemonium, a private one, for the treatment she needed was not available in the foreseeable future on the NHS, and it was a complete contrast to most of our NHS experiences.

The consultant did the operation - not a junior. The same consultant had seen Viv twice beforehand, and had spoken to us twice more on the phone; she had also personally sent through all the care instructions by email; after the appointment, she promised to personally phone at 6pm the next day to check on how things were going. She also took time to talk to us, on not-quite-relevant matters - such as how we were getting to and from the hospital - giving us the opportunity to ask questions.

That's how doctors used to be, around the time those blue suburban carriages were in use on the railways. Since then many doctors have become too busy to give the patients the time to tell them what their problems are.

This, we are told, is because of high demand on the NHS. But, if the NHS focussed on the patients, and 'right first time diagnosis' of their problems, rather than meeting the needs of clinicians, those clinicians might have time to do their job in a different way, that better meets the needs of the patient. 

Is the NHS there to serve the needs of the clinician, or the patient?