POLITICS MICHAEL WHITE

Did I ever tell you about my kidney stone, Tony Blair and the Great Wall of China? I thought not. But don't try to leave the room, I've already locked the door. I thought of it the other day when reading HSJ's interview with Frank Dobson, the bit where the health secretary describes the Holy Grail of co- operation between managers and clinicians 'to deliver top-quality services'.

Not that this is a whinge - far from it. Like Dobbo, I find that people react better to encouragement. But it is fascinating to observe the bits of the NHS which seem to work - and those which, er, could improve. What had started as a pain, dull but pervasive in late 1996, got me an ultrasound in February 1997. It would be almost two years to the day before I got the all-cleaar.

First time round nothing was found at my local London teaching hospital, which I won't name here because its A&E department has done my family some pretty solid service down the years. Let's call it the Royal St Charing trust. I desist. The pain does not. Second time lucky. A large-ish stone is found in the right kidney.

By now it is September. A month later I get an out-patient appointment. A nice doctor in urology does more tests and explains something called lithotripsy, the non-invasive option whereby high-frequency sound will blast my stone. Quite soon, too. Knowing that 20 years ago a kidney stone would have meant 10 days in hospital, I am almost as grateful as the great Samuel Pepys, who celebrated his survival of an operation for 'the stone' for the rest of his long life.

Now comes the tricky bit. I have told the medics that the one event certain to trigger two or three days of sweaty pain is my favourite food: cheese. A reckless addition, cheese. I strongly urge Tessa Jowell to start campaigning against it. At the hospital, however, it means I get side-tracked into the department of gastroenterology where they check the gall bladder angle.

Nice people, including a charming consultant of the old school. They are all puzzled by the cheese link, but politely so. No gall bladder angle. In March 1998 I have another ultrasound, like the one I first had a year earlier. Then nothing. In April I write to ask what next? I get sent back to urology, who write in mid-May to invite me in for what amounts to a chat in mid-June. Everyone always answers all my questions, I note. But you have to ask.

It helps to be a middle aged, middle class white man, my chum on the inside at the hospital explains. All the same, I'm puzzled. Why not just write a letter explaining lithotripsy (again), I ask my busy doctor? 'The system doesn't always run smoothly. We have to see you and talk it through.' I finally get my first session on the slab in late August: 2,500 shocks and, yes, I will accept the offer of pethedine, thanks. The 'ping' noise sounds innocuous, but it feels like a hard smack with a plastic ruler. Zap, zap.

'I hope you're not flying because the stone sometimes moves,' my nurse remarks casually. A bit late to tell me that. Of course I have flown - I am a journalist, I explain. I hope to fly again on 6 October, visiting Beijing, Shanghai and (with luck) the Wall with T. Blair. Will my stone be gone by then? To my surprise and delight a system which has hitherto been sluggish is now responsive.

I get an early second and third zapping appointment and am promised any suitable cancellation vacancies. Time flies: 2,500 zaps, 3,500, five appointments, the last on the morning of my trip, and I pee away my last fragment just in time. Though my temperature zooms nastily during the flight and next evening, I perk up in time to visit the Great Wall, an engineering achievement even more recklessly ambitious than New Labour's pledge on hospital waiting lists.

I had a formal all-clear letter the other day and I'm grateful after what was my first serious brush with the NHS since I mangled my finger in 1950. The administrative process seemed to slow my progress right down. 'My' hospital is not a well-managed one, some people tell me. But this was not a life-threatening situation and the team was brilliant with the zapper in the closing weeks. Even the delays in out-patients were not bad, though it helps to get the 8.30am appointment.