I hope when my local trust gets its traffic light it is red. Only then might my faith in the concept of the 'modern'NHS be restored. Clinical governance? Evidence-based practice? Direct booking? I doubt the trust (one of England's larger acute trusts) has come across any of them.
My recent experience of elective surgery there has convinced me that NHS standards have deteriorated, that an awful lot of people working in the service haven't even heard of the NHS plan, and that taking out private health insurance is not such a bad idea.
I waited a year before I had my gall bladder removed. I was offered a date after 11 months but with less than a week's notice. I explained that with three children and a full-time job, I needed a bit more time to get organised.
Having arranged cover at work and changes to childminding, I attended the pre-admission clinic the week before surgery. I answered the same questions I had previously answered in writing and had some blood taken, but what struck me most about the visit was having to wait in what seemed to be a small storeroom that stank of urine.
Two days before my admission a letter arrived saying the operation had been postponed for two weeks.When I complained, I was told the alternative was to come in a day early and have a different surgeon: the admissions officer was taken aback that this was my preferred option.
The next day, I arrived on the ward to be told that my bed was in the men's section. 'do not worry - they're very nice men, ' the sister said. I spent the rest of the day in a chair studying a crack the length of the wall. There was one shower for the 20-bed ward and the two female toilets were filthy. The food was shocking. I had a sandwich for dinner (and for every meal while I was a patient), turning down 'some kind of mince - maybe pork, maybe lamb' accompanied by packet mashed potato and frozen veg. I watched the staff throw out as much food as they had put on the plates.
I was moved to the female end of the ward in time for lights-out at midnight - the cue for one elderly man to start abusing two female student nurses.
Security guards, the night sister, a doctor, a paramedic and male nurses from other wards all tried to calm the man, who paraded naked up and down the ward carrying his catheter bag. The older women, who were bedbound, were terrified. Each of the three nights I was on the ward he and his neighbours shouted virtually non-stop, largely ignored by staff.
Because no 'nil-by-mouth' sign had been placed by my bed, I was twice offered breakfast.
The operation itself was fine. But I was in a lot of pain.The healthcare assistants who carried out halfhourly observations clearly had no idea of their significance. That evening, while I was still dopey from morphine, one nurse introduced herself - the only time this happened during my stay. Like 50 per cent of the staff, she was an agency nurse.
After another sleepless night, I tried to get up but pulled my bare foot back quickly before I stood on the unsheathed needle.When I pointed it out, one of the staff picked it up as if it were a piece of paper.
It was then time for the rounds. The senior registrar bellowed questions about opening bowels at everyone. The Vietnamese woman who spoke no English in the next bed was yelled at most loudly.
Later that day, I asked for the two needles to be removed from my arm as the drip had been taken down - the staff nurse said she would have to check with the senior sister (who never once appeared on the ward). I kept the venflons for a few more hours.
I can't complain about the clinical treatment, but my experience made me feel every NHS document produced since 1997 has been a waste of time - the supertanker is not turning around; it has run aground.
Ihave a chronic skin condition, hidradenitis supporativa, for which there is no known cause or cure. It is characterised by outbreaks of painful abscesses which refuse to heal, and create channels under the skin linking infected areas together. If long-term antibiotic courses fail, surgery to remove the infected area is the only option.
My dermatologist put me on the plastic surgery waiting-list three years ago.After 15 months, I was sent a date for the operation which I had to defer by six months. That was the last I heard. The hospital confirms surgical appointments by letter. Since the Post Office allegedly loses a million letters a week, is one letter the most effective way to communicate?
Once my dermatologist realised what had happened, I was put back on the waiting list - at the bottom.After another 15 months, I had two letters: one giving me the admission date; the other inviting me to a preadmission check. The check would present an 'opportunity to ask the doctors any questions'. I had prepared a list of questions, and my husband - anxious to know what post-operative support he needed to provide - did the same.We saw the doctor five minutes before the scheduled time. But as we removed our coats, his pager went off.He was due to attend an afternoon clinic 40 miles away and his colleagues were waiting for him in reception.
The doctor was unable to tell me anything about the operation. He had little experience of hidradenitis and didn't want to comment. Someone with more experience would see me once I was admitted.My husband did not get the chance to open his mouth.
Anxiety, exasperation, frustration and confusion were to become familiar emotions. During my hospital stay I was presented with a folder of patient information about breast surgery, although my operation was on my arm. It took some time for a nurse to track down a doctor who was able to explain that the healing processes would be similar.
Before the operation, I was seen by doctors who cheerfully contradicted one another. One wanted to operate on a fledgling site on my right arm, the other favoured conservative treatment, leaving that site to see if it would heal on its own.
Waking from the anaesthetic, the anaesthetist stood over me, saying I 'had given everyone quite a shock'. I had suffered an allergic reaction to a muscle relaxant, which had caused me to swell up and have difficulty breathing.My throat had constricted and it had taken them an hour to intubate me.My throat and mouth were badly lacerated and I shouldn't try to talk. She joked (I think) that as they had already made the cut they had done a tonsillectomy to save me trouble in future.
I was kept in the recovery room under observation for four hours. Staff said things like: 'It is a good job You have got a strong heart', and 'on a scale of 1 to 10, if death on the operating table is a 10, you were an 8.5 back there'.
On discharge, I was given a date to have the staples removed, a course of antibiotics, some melolin dressings and told to ring the hospital for a followup with the plastic surgeon. But despite my questions, there was little other help.
Days after returning home, the wound split with a heavy, thick green discharge.My GP was unable to advise me, but was surprised my husband and I had been struggling with the dressing when I should have seen the practice nurse. So I spent another couple of frightened hours in A&E, convinced I had gangrene.
I later found out that green discharge is normal in wounds of this nature. It is also normal for stitches from the inside of the wound to be expelled by the body before they have time to dissolve. I have yet to find out if it is normal to be sent an appointment letter a week after the appointment has taken place.
Faulty communication systems are undermining the quality work in most of our hospitals.
Improving communications need not be expensive, but will need an investment of time.
Until then, the patient's experience will not improve and the government cannot claim to be truly modernising the NHS.
Maura Thompson is news editor and Lesley Hallett is deputy editor, HSJ.