Palliative care doctor who inspired the ITV show starring Joanne Froggatt about the realities of working in emergency departments – and talking to dying patients on trolleys without so much as a curtain for privacy

A leading palliative care doctor has revealed how she has to speak to dying patients on trolleys without even a curtain for privacy, while lamenting the “broken” NHS.

Dr Rachel Clarke admitted that it was “unlikely to overstate how bleak and dire the conditions were” and described conditions in emergency departments in Britain as “Dickensian”.

Speaking to Andy Coulson on his Crisis What Crisis? podcast, the Didcot doctor added that “crisis conditions are now the norm and it’s horrific”.

Dr Clarke is known for writing the book Breathtaking which revealed the realities of working on a Covid ward and was made into an ITV show starring Joanne Froggatt.

She also spoke about the challenges of palliative care, misinformation particularly around Covid and the online abuse that she and many other key workers face.

Discussing the current state of palliative care in the NHS, Dr Clarke said: “It is hard to overstate how bleak and crisis-laden conditions are.

“You know, we all see the headlines. I go to the emergency room in the morning and I see a team that looks completely broken from working the night shift.

“There are ten ambulances lining up outside the hospital, each with a patient. Some of these patients are dying, they can’t even get into the hospital. There are patients in the corridors on trolleys.”

“I might have to have an end-of-life conversation with a patient on a trolley in a corridor who doesn’t even have a curtain around him. It’s horrific, it’s a bit Dickensian. That’s how broken the NHS is at the moment.”

She said such “crisis conditions” are the “norm now and it’s horrible”, adding: “So you roll up your sleeves and you go into this chaotic situation, and it often feels like firefighting.

“As a doctor, you really have to do your best because you have patients who are scared, who are in great pain, families who are in distress, and you have to go into this crisis situation and try to make a difference, do the best you can.”

Dr Clarke said: “The living conditions are indescribable.”

She added: “I think if the British people – if the public knew that there are people suffering in this way at the end of their lives, that it is completely preventable, that we could fix it by changing the way we run and fund the NHS – they would want to do it immediately. You wouldn’t wish that on your worst enemy, let alone someone you love.”

Dr Clarke also explained how she tries to control her emotions when faced with difficult situations, adding: “I allow myself to cry.

“At work, I will be very tough, because my emotions don’t matter, it’s my patient’s and my family’s that matter. So I’m not going to give in to my emotions in a way that would prevent me from doing a difficult job. I have to do it the best I can.”

She said that if she were “talking to a six-year-old about his mother’s death,” she would not let her emotions take over the conversation “as best she could.”

But Dr Clarke continued: “Then I’ll go and cry with my team members. We all do it sometimes, we know we have to look after each other.

“And I don’t mind sitting in the staff parking lot and crying a little bit before I go home, because that’s human. It’s a natural response to the inevitable suffering that’s part of the human condition.”

She then spoke about the new Health Secretary, Wes Streeting, and his statement that “the NHS is broken” and needs to be “saved”, issued shortly after Labour won the general election.

Dr Clarke said: “I was really pleased he said that because it’s just empty pretense. It doesn’t help anyone. The NHS is in crisis.”

She continued: “This has been the case for a very long time. And you know, there is a very simple principle here: a country should get the health service for which it is prepared to pay.”

“And if you want world-class health care, you have to pay for it somehow. I’m in favour of general taxation, some people are in favour of insurance, but you have to pay for it. And there’s no real shortcut.”

“I think we’re very good at pretending these days that thunderbolts will never happen to us. You know, ‘I know cancer exists, but I’ll never get it. I know horrible car accidents exist, but I’ll never get into a horrible car accident,’ and suddenly I’ll find myself paying hundreds of thousands of pounds for NHS care.

“The very fact that we are good at denying this truth is one of the reasons the NHS is failing.”

She also said that “shaming people for smoking, eating poorly or not exercising” will not promote healthier lifestyles.

Dr Clarke said: “In fact, it’s likely to make things worse for that person because they’re not going to want to seek medical attention or come forward if they’re just going to leave feeling ashamed.

“If you are wealthy enough to afford five different fruits and vegetables a day or thirty different fruits and vegetables a week, then you are more likely to have a healthy diet.

“It’s much, much cheaper to buy a McDonald’s and stuff yourself and your kids with delicious, tasty, nutritionally worthless McDonald’s than it is to buy guava seeds, chia seeds, quinoa, whatever, your nice middle-class Waitrose supermarket basket, and spend two hours preparing what those ingredients would make.

“And if you’re short on time, if you’re short on money, if you’re working three jobs to make ends meet, how do you have time to go for a run, to buy good healthy food?”

She said that to improve the health of the nation, we must start by addressing the root causes of the problems. “So we have to address the beverage industry and the food industry.”

Dr Clarke also spoke about how the country has weathered the pandemic.

She said: “I think it’s really important to try to do with the pandemic what a good doctor tries to do with a patient and their family. That is to look at the situation, not back down and try to be honest about the causes.”

“So there is no point in politicizing decision-making. Some decisions were wrong to begin with, of course they were wrong. It was a global pandemic, nobody knew what they were doing.”

“We didn’t understand the disease. We thought it was a disease of the lungs, but a disease of the whole body. I wouldn’t have wanted to be Boris Johnson, I wouldn’t have wanted to be Prime Minister in a crisis like this. It’s terrifying to have to find a solution.”

“The only positive thing we can do is learn from our mistakes. Let’s not use our mistakes to intimidate the other side, let’s learn from our mistakes.”

She added that her commitment “to vaccines and to recognizing that Covid is a real disease” has subjected her for years to “the most unspeakable abuse on social media, including death threats, rape threats, threats against my family and a kind of constant flow of bile.”

Dr Clarke said it was a “staggering abuse” and he did not understand why “NHS staff were being abused for saying this was a real disease” during the pandemic.

She continued: “I can’t understand how people really believe that Covid doesn’t exist and that more people have died from Covid vaccines than from the disease itself.

“It says a lot about modern society, about the flow of information and what information is believed in modern society.”

Finally, Dr. Clarke also spoke about her life mantra and how it is influenced by the patients she works with.

She said: “We only have one life. It’s a spark in this huge darkness and then it’s gone. So I just want to enjoy every moment and make the most of it. And I don’t care about most things; I don’t care about wealth and status and a big fancy house. I care about the things that I see my patients worry about on their deathbed.”

“And in the end, it all comes down to one thing. It’s just love. It’s just the people that they love and wanting to have them around. That’s the only thing that matters. That’s the only legacy that matters. And that’s how I try to live my life.”

Dr Clarke’s latest book, The Story of a Heart, which is a true story about two families linked by a single heart, is released in the UK today and in the US on 10 September.