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"What would you like to see?" asks the scrub nurse as a surgeon beside her feeds a wire through a patient's urethra.
“你想看什么？”洗手護士問道，旁邊的外科醫生正在將一根導線穿過患者的尿道。
It is a Friday afternoon in Theatre 2 at Huddersfield Royal Infirmary in West Yorkshire, and the surgical team is showing your correspondent their equipment.
這是西約克郡哈德斯菲爾德皇家醫院2號手術室的一個星期五下午，手術團隊正在向記者展示他們的設備。
There are tweezers "to take out the specimen"; sponge rollers to soak up the blood. There is the resectoscope, an electrified half-moon wire to burn through bad bladder tissue.
有鑷子“取出標本”；海綿滾輪用于吸血。還有電切鏡，一種帶電的半月形導線，用于燒灼壞膀胱組織。
"But obviously you can't see it because it's in the patient," she says. That patient—call him Mr Jones—can count himself comparatively lucky to live where he does.
“但顯然你看不到它，因為它在病人體內，”她說。那位病人——叫他瓊斯先生——可以認為自己很幸運能住在那里。
Calderdale and Huddersfield Trust has climbed the ladder for hospital waiting lists in recent years:
近年來，卡爾德代爾和哈德斯菲爾德信托基金會在醫院候診名單上名次不斷攀升：
72% of patients are seen within the target time of 18 weeks compared with 59% in England overall.
72%的患者在18周的目標時間內就診，而英格蘭整體這一比例為59%。
Mr Jones's path through the system shows how the National Health Service (NHS) could use its resources better.
瓊斯先生在系統中的經歷表明，國民醫療服務體系(NHS)可以更好地利用其資源。
Wonks and politicians alike agree that productivity—the ratio of treatment the NHSprovides to its inputs, such as labour, equipment and drugs—is a pressing problem.
專家和政客都一致認為，生產力——NHS提供的治療與其投入（如勞動力、設備和藥物）的比率——是一個緊迫的問題。
Hospitals have more staff than ever, yet they are doing less than they were before the pandemic.
醫院的員工比以往任何時候都多，但他們做的卻比疫情前少。
Between 2019 and 2023, the amount of surgery carried out by each surgeon decreased by 12%;
2019年至2023年期間，每位外科醫生進行的手術量減少了12%；
the numbers are almost as bad for outpatient appointments and significantly worse for emergency care.
門診預約的數量幾乎一樣糟糕，急診的數量則明顯更糟。
A paper published for an NHS England board meeting in May identified some reasons for this.
5月份在NHS英格蘭董事會會議上發表的一篇論文指出了其中的一些原因。
Chief among them was industrial action, which since late 2022 has led to the cancellation of more than 1.4m appointments and operations.
其中最主要的是罷工，自2022年底以來，罷工已導致超過140萬次預約和手術被取消。
Other factors included an increased use of agency staff, longer hospital stays, maintenance backlogs and rising prices of new branded medicines and technology.
其他因素包括代理人員的使用增加、住院時間延長、維護積壓以及新藥和新技術價格上漲。
That still left a mysterious productivity gap whose likely cause, the authors concluded, was a lack of "discretionary effort" from staff.
這仍然留下了一個神秘的生產力差距，作者總結說，其可能原因是員工缺乏“自由裁量權”。
Some of this may be temporary: the new Labour government has settled pay disputes with some NHS workers, for example. But many problems pre-date the pandemic.
其中一些可能是暫時的：例如，新工黨政府已經與一些NHS工作人員解決了薪酬糾紛。但許多問題在疫情之前就存在了。
To understand more, rewind to before Mr Jones reaches the operating table.
要了解更多信息，請回顧瓊斯先生走上手術臺之前的情況。
His first interaction with a doctor would have been when he went to his general practitioner (GP), complaining of weight loss and bleeding from his rectum.
他第一次與醫生互動應該是在去看全科醫生(GP)時，說自己體重減輕和直腸出血。
It may well have taken Mr Jones a while to get an appointment: Britain has almost 16% fewer fully qualified GPs per person than other rich countries.
瓊斯先生可能需要一段時間才能預約：英國的人均合格全科醫生數量比其他富裕國家少近16%。
But those symptoms were enough for his GP to refer him to hospital.
但這些癥狀足以讓他的全科醫生將他轉診到醫院。
In the NHS in England only 57% of patients start urology treatment within the target time of 18 weeks (it is 69% for Huddersfield's trust).
在英格蘭的NHS中，只有57%的患者在18周的目標時間內開始泌尿科治療（哈德斯菲爾德信托基金的比例為69%）。
One problem is a lack of diagnostic capacity. Britain's number of CT scanners is among the lowest in the OECD, a club of mostly rich countries.
一個問題是缺乏診斷能力。英國的CT掃描儀數量在經合組織（OECD）中是最低的，而OECD是一個主要由發達國家組成的俱樂部。
The NHS also has a measly number of radiologists. And trusts need to be able to track and triage thousands of patients.
NHS的放射科醫生數量也少得可憐。信托機構需要能夠跟蹤和分類數千名患者。
This should be "100% automated", says Tim Ferris, who until recently oversaw digital transformation in the NHS.
這應該是“100%自動化的”，蒂姆·費里斯(Tim Ferris)說，他直到最近還負責監督NHS的數字化轉型。
But some trusts still rely on "lots of people filling out spreadsheets".
但一些信托機構仍然依賴“大量人員填寫電子表格”。
In the year to March an estimated 20,000 operations were cancelled on the day because of administrative errors. Mr Jones is, on both counts, relatively lucky.
截至3月的一年中，由于行政失誤，當天估計有20000例手術被取消。從這兩方面來看，瓊斯先生都相對幸運。
A timely CT scan showed a thickening of the lining of his bladder; a separate test, a colonoscopy, also found polyps in his rectum.
及時的CT掃描顯示他的膀胱內膜增厚；另一項結腸鏡檢查也發現他的直腸有息肉。
Huddersfield's analytics are some of the most advanced in Europe: clinicians use speech-to-text software to dictate their notes, freeing more time to spend with patients.
哈德斯菲爾德的分析技術是歐洲最先進的：臨床醫生使用語音轉文本軟件口述筆記，從而騰出更多時間與患者相處。
After consultation it was determined that both procedures could be done together—"front and back", as Jonathan Cowley, a colorectal surgeon, puts it.
經過會診，確定兩種手術可以一起進行——正如結直腸外科醫生喬納森·考利(Jonathan Cowley)所說的那樣，“前后同時進行”。
That means a quicker recovery, too. Around three to four weeks before the operation comes a pre-assessment with a nurse.
這也意味著恢復更快。手術前三至四周左右，護士會進行一次術前評估。
This appointment should help reduce the risk of complications, which happen in 10-15% of operations.
這次會面有助于降低并發癥的風險，10-15%的手術中會出現并發癥。
