A scalpel and cuts

Betsy Evans knew that she wanted to work in medicine from just 12 years old.

“My father was very unwell,” she said. “He had issues with his heart. That’s not why I became a cardiac surgeon but he was in hospital for many months and I saw how significantly transformed he was by good medical care and attention.”

The daughter of a doctor (her mother was an anaesthetist), Evans (pictured) would go on to blaze a trail in her field. Now a consultant cardiac surgeon at Leeds Teaching Hospitals Trust, when she first took up the post she was just the seventh woman in the UK and Ireland with the title.

“It’s changing but it’s very slow, because you need to get a critical mass of role models before people can accept that they genuinely will be able to do the job,” she said.

Evans recalled that when she was first starting out, there would often be no other female trainees in the changing room before heading into the operating theatre.

“It was that sort of aspect of the job that you felt maybe you were missing out a bit, because the male changing room would have been dominated with male surgeons and trainees,” she said. “It’s the fear of the unknown, I suppose – whether they got opportunities that didn’t arise for me. I don’t know if that was the case.

“The other thing was understanding that I wanted to have a family. I’ve got three children and that was something that for male trainees was just accepted – they were going to be fathers and carry on with their training because they had people at home to facilitate that. So that aspect took a bit of negotiation.”

However, despite the challenges that inevitably come along with being one of the first, Evans’s evident skill, passion and determination led her to her current role. And now, thanks to BBC 2’s Saving Lives in Leeds, a bigger audience than ever is being introduced to the surgeon, her colleagues and the people whose lives they are able to radically transform.

The issue, as we see time and time again i, is bed space – without an intensive care bed, operations cannot go ahead

One of those people is Barry.

A retired care home manager, Barry appears in episode seven of the series. Aged 76, he was taken into hospital after experiencing a burning sensation and difficulty breathing. When we meet him on ward L16, he’s been waiting two weeks for a double bypass operation.

The issue, as we see time and time again in the series, is bed space – without an intensive care bed for post-surgery care, operations simply cannot go ahead.

“I came out of medical school in ‘96 and Tony Blair’s government got in in ‘97 and the NHS was inundated with cash and you could do whatever you want,” Evans said.

“I did my junior doctor roles, the first three years of which there wasn’t any question about beds, waiting times, innovation. Everything was on tap. Since then it’s been constrained, constrained and constrained.

“We’ve got to a point where pre-Covid it was ridiculous – the work that had to go in just to ensure that we could operate because we’ve got such tight bed numbers.

“But it’s not just the number of beds – it’s the staff to go alongside that. We’ve been so underprovided for financially from the nursing perspective that you can’t run the service. And then you throw Covid into the mix and people are leaving in their droves. Why should they stay? They’re not respected and are expected to work way beyond what the expectation was when they first started.”

Fortunately for Barry, a bed does eventually become available and his surgery is a success. More than a year later, he’s doing well.

“I’m doing great,” he said. “I wish I could do a bit better but then I guess at 77 you’ve got to be thankful for what you’ve got. The way I am now is thanks to the team at Leeds General Infirmary – Betsy and the team.”

The team, he tells me, moved as a “cohesive unit” – and if there was stress behind the scenes, “they didn’t show it”.

“Betsy was fantastic,” he says. “She’s got one hell of a responsibility. I wouldn’t want that.”

A man who clearly doesn’t like to sit still, Barry said that he “resigned himself” to the limbo position that he found himself in – opting to “go with the flow” rather than getting frustrated at the circumstances.

“I got told off once or twice for helping to tidy up wards – empty bins and collect the cups and saucers,” he said. “But I just cannot sit around even though I was told I was very poorly. I just thought while I can do it, I’ll do it because I was doing my bit to help the staff.”

The series is full of patients just like Barry – at the mercy of waiting lists and cancellations but, ultimately, thankful for the care that they do eventually receive.

Evans said there is no sign of the two new hospitals that were originally due to be built at LGI by 2025. When asked, the trust said that it is continuing to work closely with the government’s New Hospital Programme team to confirm an agreed programme to push forward on the work.

It added that it is targeting a completion date of 2029 that is “subject to being able to proceed” and that it is anticipating a government announcement about the national programme “soon”. This plus a constant battle with staffing means ensuring that patients receive the transformative treatment that they need is an uphill battle for Evans and her NHS colleagues.

“There’s a lack of infrastructure,” Evans said. “Then there’s a lack of internal provision for kit, meaning your wards, your theatres and your ICUs and your outpatient facilities. Medical students are getting trained, finishing their training, doing their registration year and then going to Australia or New Zealand.

“The intention is not necessarily that they are there forever but they see that they get a much better work-life balance, they get remunerated much better – so why come back? That’s a loss, there’s a drainage of skill.

“It doesn’t all come down to money but that is a big significant impact and whether the NHS can truly function as it was intended to in this era – I don’t know.”

Saving Lives in Leeds is available on BBC iPlayer.