I FIRST need to declare two interests, first as a surgeon who served at the Princess Elizabeth Orthopaedic Hospital with its 120 beds – bulldozed in 1996, and at Torbay Hospital looking after victims of trauma from 1975 onwards. Secondly as a taxpayer and one of about 45 million adult citizens.

I attended the hospital for an Xray of my left wrist having sometimes almost disabling pain. I had ignored a violent flexion injury of it 12 years ago. As always I was struck by the vast space, compared say with the fracture clinic in the void below the surgical block of Torbay Hospital where I treated mostly the walking wounded.

One of the two receptionists met me with a smile and immediately remembered me from the fracture clinics. She was proud to say that she had served in OUR NHS for 43 years. We shared our warmth towards our work.

The Xray took place within a few minutes of the appointed time, and the young radiographer who had trained at the RD&E was professional and courteous. I did not have my specs but saw some evidence of degenerative disease and a possible old fracture of the proximal pole of the scaphoid bone. The radiologist’s report will be going to ‘my’ GP.

I passed again through the waiting area of the MIU, or whatever its current title is, at Newton Abbot Hospital. Every chair was occupied – perhaps 45 souls were waiting. There was silence and a glum feeling overlaid by great patience.

I learned the numbers attending had gone up, so the newly registered were directed to chairs in another area. Why is it busier? Firstly many cannot see their general practitioner face to face as is proper, and have great difficulty in even getting an appointment for a telephone conversation.

Secondly, more people are physically ill, or, being anxious and depressed, see physical ailments enlarged. What skills and experience are being afforded these patients? Are they seeing a medically qualified person or a registered nurse? How many are advised to go to the A&E at Torbay, or to see their own doctor?

There were no parking spaces so I parked round the back where Rydon employees had allocated spaces. Rydon is the company that services this very roomy hospital. A predecessor company built it for £21 million under the Private Finance Initiative. I recall that it is held for about 40 years and interest and service charges are paid by the NHS.

I also recall that there is uncertainty whether OUR NHS will eventually own it. The Rydon group are based in East Sussex. In the last financial year I see it had a turnover of £19 million +, and a profit of £3 million. No dividends were issued in 2020.

Out the back there was a CAT scan pantechnicon labelled ‘InHealth’, with the NHS logo added. There appeared to be no active scanning going on. I looked up this company. I quote - ‘InHealth is the UK’s largest specialist provider of diagnostic and healthcare solutions.

‘Our mission is to make healthcare better. We do this by working with hospitals and commissioners across the NHS and independent sector. 99 per cent patient satisfaction (how estimated) ‘About our locations - InHealth work in over 800 locations, including hospitals, community based medical centres, GP surgeries and health clinics, providing convenient access to a wide range of diagnostic and healthcare services for patients across the UK.’

I comment solely on the scanner. A very great deal depends on the radiologist reporting on the images, and often with a very sketchy clinical history. Where is he or she based? Is there easy collaboration and discussion with the referring clinician?

I believe I wrote in 1998 to the MDA opposing this building because it was being built under PFI. The many billions spewed out since have clearly been shown not to be ‘good value for money’ and OUR NHS in particular has very large debts round its neck, against Treasury funding. Though that now would have big questions about it.

I acknowledge fully that the wards there do a very good job, mostly taking recovering patients from Torbay. But that leads to this – the absolute need to get the many closed community hospitals going again throughout Devon.