Knowing what I know about the National Health Service, its patchy quality levels, its poor outcomes compared to other similar systems along with the extreme inefficiency and waste, I’m really not surprised to see yet another NHS scandal come to light. This time the scandal concerns what should be ‘never’ events in surgery which is the leaving of surgical instruments inside the patients body.

According to figures discovered by the Press Association and relayed by Sky News, there were in 2021/22, 291 incidents of surgical tools ranging from gauze and swabs right through to cutters and broken drill bits being left inside patients. This is a significant numerical increase over the numbers from the turn of the century when there were 156 episodes of foreign bodies of a surgical nature left inside patients following surgery.

There are I need to mention several caveats to the figures which the Sky article mentioned. Firstly it is not clear in what sector, NHS or private, where the initial surgery that required correction was done and that each individual number in the 291 figure might not represent in some cases an individual patient rather one patient being counted at several different hospitals. However, Royal College of Surgeons figures from 2013/2014 show that in that year there were 4.7 million surgical admissions to hospitals and its likely that the vast majority were to NHS facilities because the vast majority of Britons rely exclusively on the NHS. As of 2021, according to the Guardian newspaper, 13% of Britons have private health insurance, which means that it’s likely that the bulk of these ‘never’ events are coming from the NHS. The issue of the double counting of patients does make it difficult to pin down actual numbers of patients but it would be reasonable to guess that out of the 291 cases at least 250 of them may be from the NHS. If we assume, probably correctly, that the NHS is profoundly incompetent at handling data, something I’ve experienced, and be generous and halve that 250 number to take into account double counting of patients then that still leaves us with 125 ‘never’ events that more than likely took place within a healthcare system that we have been propagandised to believe is ‘the envy of the world’.

Whilst agreeing that there may be issues with the figures given out by the Press Association due to data accuracy problems, this number looks bad. Even if we give the NHS the benefit of the doubt and take into account the greater number of surgeries that the NHS performs, there should not be at least 125 incidents of stuff that should never happen.

If we run with the assumption that only 125 of the 291 cases where surgical instruments have been left inside patients were due to mistakes by NHS employees, then this figure is still appalling. After all the NHS is supposed to have systems and procedures that they say should ensure that left behind surgical instruments and materials are never a thing. These systems appear to have broken down and I suspect that they’ve broken down in part due to bad management and the incompetence that we’ve come to expect from the NHS. I can quite understand that surgeons and operating theatre staff who are supposed to monitor the stuff used and the stuff left over at the end of the operation might make the occasional mistake while busy or stressed or overworked, but to make so many mistakes of this nature for me take it beyond understandable human error and into the area of rank incompetence.

It’s pretty plain to those of us who take an interest in such things that the NHS has a lot of problems with how it is managed and how it manages its staff. It also has screwed up priorities which leads it to hire non-job wastrels such as a ‘lived experience officer’ on extraordinarily high salaries but can’t employ the sort of lower level but necessary staff to count the scalpels when they went in and count them back out again. This is the sort of incompetence and poor management that many of us have come to expect from the NHS. A large amount of incidents that even the NHS say ‘should never happen’ is an appalling thing for the NHS. The problem in getting people to understand that the basic problem with the NHS is how it is run is that the incompetence is not equally spread around, there are enough good people with good experiences of the NHS for them to assume that the whole NHS is like that, which it is not. Some bits of it are truly awful but those who have had good experiences of the NHS never see these bits or dismiss them as one offs, which they often are not. In short the satisfaction levels are just high enough to make people think that the NHS is not that bad, which is a sentiment that is exploited by NHS interests when they say that all the problems in the NHS could be solved by more public money. Unfortunately the NHS could consume the entire GDP of the United Kingdom and would still be badly run because the management who run the NHS badly will still be in post.

The NHS needs radical reform. It should be possible to craft a healthcare system that was either free or extremely cheap at the point of use, without the service becoming a dangerous, incompetent mess dominated by empty platitudes, piss poor outcomes and management bloat. To bring this much needed reform of public healthcare in Britain is going to be a mammoth task. It will an even bigger task than creating the NHS because that was built on facilities and staff who were mostly forcibly nationalised but which already existed. To reform the NHS would be far more difficult. It will be like dismembering a live monster. The NHS and those who benefit from the current mess would kick and scream, bite and kick and do all manner of things to stop the creation of a service that benefited the people rather than the management and staff. But this monster must be dismembered and what parts of the monster which are still useful used to create something better, before we end up as a piss poor healthcare system with a nation attached.