Labour's lost our vote

You get all sorts in an A&E department. I found myself treating an elderly relative of a New Labour politician: a delightful lady, bright as a button. She'd fallen and hit her head. As usual, there was a battle with the management. A suited young woman insisted that the patient be moved to a ward, so she would not breach the Government target - the one that promises that no patient will spend more than four hours in A&E. I said she should stay, as I had not finished assessing her. I wasn't happy for her to go until we knew whether she has a blood clot in her brain. I was told that it was not my decision, and that the bed manager would move the patient.

You get all sorts in an A&E department. I found myself treating an elderly relative of a New Labour politician: a delightful lady, bright as a button. She'd fallen and hit her head. As usual, there was a battle with the management. A suited young woman insisted that the patient be moved to a ward, so she would not breach the Government target - the one that promises that no patient will spend more than four hours in A&E. I said she should stay, as I had not finished assessing her. I wasn't happy for her to go until we knew whether she has a blood clot in her brain. I was told that it was not my decision, and that the bed manager would move the patient.

I explained the situation to the politician, sitting worriedly by her bed, who immediately agreed that she stay in A&E with me. Whatever the doctor thinks, he said. Suddenly, statistics were not quite so important.

Most doctors voted Labour in 1997. In 2001, Labour again led. But research by Hospital Doctor magazine in association with the online researchers Medix shows that the percentage intending to do so again has more than halved, and Labour now has the support of just 13 per cent of medics in the NHS. It has been reported that, of the 59 senior consultants and GPs who publicly backed Labour in 1997, more than two-thirds have turned their backs on the party.

But why? How can a government that doubled investment in the NHS have lost the support of so much of the medical profession?

Arriving at A&E for my shift in frosty darkness just before Christmas, I was confronted by a police cordon. I walked around the crime scene - a car, doors open, pool of blood on the road - and into the department. Surreally, a blood-drenched running shoe lay on the floor.

In the resuscitation room, doors guarded by armed police, were two men who'd been shot. I was assigned to the more stable one: he'd been shot in the face. I spent an hour suctioning blood from what remained of his mouth and fishing out pieces of tooth and flesh. I talked to him and kept his blanket around his shoulders while people bustled around us getting medicines and taking X-rays. He could only nod and shake his head.

This is why I became a doctor: to treat people who desperately need it; to enable them to live when they might have died; to improve the quality of the life they have left. And I became a doctor in the NHS because I believe that survival should not be means-tested. Judging by the circumstances, my patient would not be included in the politicians' target-voter group of "hard-working families" for whom policy is being tailored.

By 5.30am, I had seen a further 12 people, none of whom were unwell enough to be admitted, and I felt like death. I was talking to Alice, the night receptionist. They're still booking in, she said wearily. "Nothing bloody wrong with them. You can tell because they are complaining so loudly."

That night, she was having to ask patients to fill in a glossy questionnaire about why they had chosen to attend this A&E department. Was it our good reputation? The new foundation status? The nice buildings? The range of tick-box answers didn't include: "Because I was in pain," or: "Because it is near my house," and certainly not: "Because I was shot in the face."

Doctors despair because this government is interested in how things appear, rather than how they actually are. Patients don't matter in this election, which will be fought on clinically meaningless statistics.

So 95 per cent of people in A&E were seen within four hours? Good: but we know it means that people who ought to have been sent home with painkillers are filling the wards, while waiting-list operations are cancelled again and again because there are no beds. It means that patients who are critically unwell in hospital are neglected because the junior doctors are kept seeing patients in casualty by all-powerful managers.

Doctors I know are concerned about the accelerated privatisation of the NHS by sub-contracting out vital support and laboratory services, because this compromises care. They are enraged by the proliferation of managers, because managers usually have no understanding of clinical priorities, and their protocols waste precious doctors' time.

Last year, when I was working in one of the Government's new flagship Private Finance Initiative hospitals, John, a construction-worker under my care, sat up in bed and vomited two pints of blood, soaking his sheets. He was terrified. I ran to get two large drips, pulled a tourniquet round his arm and tapped his veins. Having started the fluid running into his veins (to keep his blood pressure up while we cross-matched emergency blood for transfusion), I sent my blood samples to the lab in the metal chute.

Fifteen minutes later, the lab had not received the samples: "It must be lost, send us another one." I took blood again: he was tachycardic, and his blood pressure was only 90/38.

I sent the blood to the lab again. Still no results. "Can't you look for them?" I asked, nearing the end of my tether. "It's not our responsibility if the samples don't arrive: the chute system is owned by a different company," the technician said, sounding bored and matter-of-fact on the other end of the phone.

John had hepatitis, a serious, easily transmissable blood-borne disease. When I punctured his vein for the third time and was rushing to put the blood into bottles, I stabbed myself with the needle. Then I ran with the samples myself to the lab, nearly a quarter-mile away, and stood while they analysed them and cross-matched the blood he needed to live until the morning.

It has never been truer than in the increasingly fragmented health service, where everything is someone else's problem, that if you need something done, you have to do it yourself.

So it's not surprising that, despite pay rises and the (theoretical) introduction of the working time directive for juniors, 80 per cent of respondents in the Hospital Doctor survey felt there had been no overall improvement for doctors working in the NHS. We had hoped that the election of Labour in 1997 would stop the rot. We were wrong.

While the Government pours money into the health service, and trumpets the fact, we know that the money is being diverted away from care and into the pockets of construction firms. While we wait for the building of new over-budget, overdue PFI hospitals, there is such disgraceful underfunding in public hospitals that doctors spend hours finding X-rays and notes, and portering patients around because there are fewer and fewer support staff.

People who want to hide the truth from you codify their language and resort to euphemism. This is true in medicine, as in politics. The euphemistic: "You've got a shadow on your chest X-ray and we'll need to do a few tests," doesn't quite convey the message.

When Tony Blair and the Health Secretary John Reid talk of choice, they mean privatisation. They mean a health service run for profit by global corporations. The threat is real. A vote for New Labour will mean the end of universal healthcare in this country, and specifically, of free healthcare for the poor. If you don't understand what your doctor is saying, you may not take the medicines he prescribes. If you don't understand what your politicians are saying to you, soon you may not get your hands on any medicines at all. Have a nice day.

The author is a junior doctor in an inner-city NHS hospital. Catherine Blake is a pseudonym