Downstairs at Downton Hospital

Downstairs at Downton hospital


I knocked on the door at the back of the grey, crumbling edifice.

“Tradesman’s entrance”

A short wait.

I looked around at the crumbling walls, rotting doorframe and broken floor tiles…

“Ah good morning. Please do come in. Welcome.

“It’s just along the corridor and turn left. No, we’re not in the upstairs suite.

Entering the small room I found a dozen more humble tradesmen, sitting quietly, obediently at tables, awaiting enlightenment.


The light was bright but their eyes were dull.

They were not expectant. They’d been there before.

We were the tradesmen and servants of the the wealthy holders of power upstairs, whose snapped fingers commanded obedience.

Or repairs.

The roomful of tradesmen and servants had been summoned to write down their own rules for their behaviour in the crumbling edifice.

Whom should they speak to?

How should they address their superiors?

What should they expect in return for their good behaviour?

How often could they expect to meet the upstairs dwellers?

What were the duties they should be carrying out for their invisible, unseen masters?

The deputy head butler welcomed the assembled humbles, and set out the terms for the morning’s work, for which they would be rewarded with light refreshments.

Sumptuous bread and dripping from the previous night’s ten ribs of beef upstairs.


The deputy head butler provided a schedule to be read by all, a (his) suggested list of rules for our consideration.

We started our discussions.

We are humble tradesmen and servants and our learning is but slight, and we found it hard to derive meaning from the classically phrased, flowing metaphorical flourishes.

Heads were scratched. Mumblings began. The fog was dense. We were but ordinary humbles.

Thus we began to scribe our own rules. Gradually, teasing out clarity from our confused thoughts, using the humble language of our upbringing.

I looked around the room. Our eyes were clearing, brightening. Here and there were raised voices, a chuckle, a guffaw, a slight cheer…

The deputy head butler looked down upon us. Was this proceeding as he had planned? The frown upon his forehead betrayed him.

The time came for we humble tradesmen and servants to stand and put forth our proposals.

“Could we perhaps sit at the same table as our powerful masters upstairs on occasions?

“Or might one of the powerful masters descend the depths to sit at our humble table?

“Might we have a role to play in determining methods for saving our powerful masters upstairs our time and their money? To perform our jobs a little more to our and their liking?

“Might we play a small part in bringing about the repairs to the crumbling edifice so that our families and their communities might continue to benefit from the gracious presence of the edifice and its powerful masters upstairs?

The deputy head butler knitted his brows. He coughed and perhaps spluttered a little. He turned a little red around his gills.

“I am grateful to you for your attempts to formulate your thoughts. You have, after all, only slight learning. I will take away your papers and find a suitable form of words for you to agree subsequently.

And now we were to enjoy our rich repast of beef dripping and steam bread.

We would not get such lavish refreshments again, he said.



The medication jigsaw

So I picked up my Christmas Present from the pharmacy.

A big bag of delights.


Brightly coloured, random shapes and sizes.

Packets, bottles…

Life saving, as long as I get them right each day.

30 a day. In halves. But not the same.

Life taking, if I get them wrong.

Next day I call the pharmacy.

Where is the Ro………….?

Ah, it’s in a bottle this month…

Another time I can’t find the yellow packet with the All………….

Damn it, they’ve forgotten it.

Search, search, scrabble, scrabble…

Check the cupboard…

Call the pharmacy…

Ah, it’s in a brown box this month.

“It’s the CCG. They keep changing what we can buy.”

Ok, I get the need to reduce costs.

I get the use of generic brands, and that’s fine if they do the same job.

But for God’s sake don’t keep changing the packaging.

How on earth are we expected to make sure we take the right pills day after day if they change colour, shape, size and come in different colour boxes, or now and then in bottles, each month?

Generic drugs should be in generic boxes. Or bottles. And always in those boxes. Or bottles.

Recent figures suggested that something like half of people taking medications are not compliant after three months. So the medicines are wasted, or the people end up in hospital with medication related illness.

That is just plain stupid.

It’s hard enough to get these things right when your brain is working well. Throw in a bit of dementia and you ain’t got a chance.

So in 2016 let’s campaign to get generic, consistent packaging for generic medicines.

Let’s remember who the drugs are for.

Not the drug companies.

The patients.