Last night I had dinner with some fellow novelists in the upstairs room of a North London pub. It is said that when novelists gather together they discuss their advances. Far from it. Our meeting was devoted to sex at one end of the table and Jane Austen the other. The novelist Kathy Lette kept casting longing glances down to the sex end of the table as words like "oral" caught her attention. My first appointment of the today is across Regent's Park to a Wimpole Street oral (as in teeth) surgeon, and to my amazement I stumble into a light, galleried waiting room. I fear I am in the wrong place. The private doctors and dentists who line the streets of Harley Street and Wimpole Street have all, up until now, had identical waiting rooms with high ceilings and cornices and high-backed chairs set wide apart as if trying to prevent other patients' illnesses from being observed. Then I hear a warm, maternal voice calling my name from the gallery above. Usually receptionists sit menacingly at desks in hallways with chequer-board floors, like the Russian women who used to preside over every hotel floor in Moscow, keeping tabs on visitors for the KGB. Then Jenny appears, welcoming me, and within minutes the surgeon comes out to greet me, too. Unusually for a British doctor, he seems perfectly normal and does not behave as if he thinks he is Zeus.
I persuade myself that this combination of unintimidating waiting room and normal doctor represents a moment of social change (do these moments have a name?), a bit like the first time I entered a British pub and found goat's cheese and Mediterranean vegetables on the menu rather than just egg and chips. From then on, however, it became impossible to get egg and chips; and now pubs, even in the grimmest areas of Britain, only serve light nouvelle cuisine. Perhaps, however, in England we will start having doctors who treat their patients as if they are sentient human beings. It would be about time too, as my mother would say. The God complex of the British doctor is dangerous because it means too many doctors don't question their own judgment. If they come to a conclusion, it must be right. They can be as rigid as their waiting-rooms in the grim dirt-tarnished town houses of Wimpole Street and Harley Street.
The British system, by which to reach a consultant you have to be referred by a GP after waiting ages for an appointment, means it is difficult to see another consultant if you are uneasy with the one you're given. No sane individual would take the first baggy-trousered plumber who turned up at the door, but we entrust our entire health to the first person we're told to see, however senile or pompous or stupid he may be. Doctors can't advertise, of course, and there are no reliable reports on them, so really it is all just luck. The power of the doctors means some extraordinary abuses are allowed to happen. If a wealthy Arab, for instance, has an operation in a private hospital and something goes seriously wrong, he is simply shipped off to a National Health hospital, jumping queues, to go into intensive care at the British taxpayer's expense. The intensive care units are blocked with these interlopers, so other operations have to be cancelled. Essentially, the National Health provides the back-up to allow British doctors to charge huge private fees. While they can charge such fees, it is clearly far more tempting for them to be doing just that rather than slogging away seeing lots of ill, old, and probably poor people on the NHS. No-one complains when they don't turn up because, they are, after all, doctors.
My mother is in hospital in London now with a heart problem, and to my amazement the whole place closes down at 5 o'clock every evening and all through the weekend—the whole building, including all the operating theatres with their expensive equipment. No tests are carried out, nothing is done (apart from feeding the patients in their beds) unless there is an emergency. The odd thing is that doctors find themselves able to work for private patients happily outside these hours. Many private operations are scheduled for Friday nights. The waiting lists could be quickly cleared up, and huge amounts of money saved, if the hospitals became properly functioning seven-days-a-week institutions. After all, people aren't any less ill at weekends. I spend the afternoon at the hospital, the Brompton, with my mother, where there is a spirit of camaraderie among the elderly women on her ward, and my mother appears to be rather enjoying herself. All are courteous Chelsea ladies who read The Times. They spent last Saturday gathered round the window together, watching a wedding at St Luke's Church, which the ward overlooks.