Merry Christmas

And may all the patients in NHS hospitals be given their pain relief much more promptly after requesting it in NHS wards

May the Healthcare commission be banned from giving good and better ratings to any hospital repeatedly slated by the local coroners

Unlike Dr Crippen I've been spending the days of the Christmas season on NHS premises, and in homage to the great Dr Crippen if anyone comes up to me and says "you're not Dr Rant" I'll give them a sweetie

What would I do instead of the NHS?

In a quick (no time) nutshell
1) Everyone pays whatever they currently pay in tax for the NHS into a new "state backed medical insurance fund"
2) That fund has minimal headcount, circa 20 or 30 people max, less if they outsource more of the donkey work
3) All NHS providers of care are sold or given away to whoever wants them, else they get shut down, all hospitals etc are then forced to compete for patients directly with patients (and by implication with their GPs, but patient keeps the ultimate choice)
4) For most secondary care on diagnosis patient gets give a cheque by "state backed medical insurance fund" to take anywhere they dam well want, including abroad, including to BUPA etc with a top up of their own if they so choose
5) State stops funding cheap/infrequent stuff for the vast majority, so GP appointments are charged at full commercial rates, free market allows some innovation, and patients and doctors come to better compromises about what suits both sides
6) Central NHS IT is shut down, all senior bods involved sacked from where ever they are in government/public sector and never allowed to work again, lock them up, throw rotten fruit at them
7) To compensate for 5 above, SBMIF covers expensive stuff much better, much better funds for cancer treatments, heart treatments etc
8) Special dispensations to 5 for folk with long term life threatening conditions, diabetics etc, SBMIF picks up tab
9) Some subsidies for rare places, remote parts of Scotland etc, dished out directly to patients for them to spend locally as they see fit
10) Any patient is allowed to go to any doctor or consultant, no artificial barriers to access
11) All doctors are forced to work one year in four in an inner city
12) Task force sent round "best of rest of world" such as Europe, New Zealand, States, and brings back best practise from those areas and refines regulations with this in mind
13) Medical business becomes a state regulated not a state run business
14) NHS dentistry is abandoned, poorest patients given cheques to take to any dentist they choose
Needs a good transition plan, wouldn't want to do it overnight, but over the course of say 4 years this could be implemented easily

Docs issuing prescriptions with no signature

And pharmacy's handing out the drugs when the prescription has no signature

And some prescription signatures are nothing more than a one or two centimetre straight line

Are the GP receptionists so clever that they don't actually need the docs to keep the patients prescriptions flowing?

Or does this make a mockery of the whole prescription system?

Does anyone audit the prescriptions returned to the nhs for payment from the pharmacies to verify the signatures even exist?

Are docs too busy to be bothered with which patients get which drugs when?

Is self-prescribing and self-referral really so much worse than this?

Are the untrained receptionists way out of their depth?

Man dies after inhaling anthrax

I wonder, was he told to piss off you don't get antibiotics in the nhs for a chest infection until you've visited the doctor at least half a dozen times? Fuck off and die cos that's gonna solve the c diff problem much better than actually cleaning the wards of the hospitals?

Fucking useless cunts in the NHS

So we have the comments

"The death rate from inhalation anthrax is very high regardless of clinical intervention. As far as I am aware there is nothing to suggest that this mans care was sub-standard.

How this example relates to everyone in the NHS being cunts is beyond me."

Which is bollocks, anthrax is routinely wiped out by antibiotics if caught early enough

The NHS are cunts because those old fashioned medical fashions like examinations and taking history from the patient have been replaced by "looks similar to the cold flu to me, we don't give antibiotics out for that, go away and come back if it doesn't clear up" if you can get to see a doc in the first place

Another related tale, nothing to do with Anthrax but brings similar issues out:

Large family on holiday somewhere in Asia, towards the end of the holiday they all develop minor cold like symptoms

At the end of the holiday half the family fly to Australia, the other half to the UK

The symptoms for the entire family get worse, sore throat, fever, etc and all of them go to different docs in Australia and the UK.

EVERY SINGLE ONE OF THEM IN AUSTRALIA WAS GIVEN ANTIBIOTICS and was symptom free within a few days

Every single one of them in the UK was given the old fuck off its a cold we don't give antibiotics for that clap trap, and went on to have a fever and bad symptoms for 2 weeks or more

NOW IM NOT A MEDIC but this demonstrates for me how fucked up and useless the NHS is, stories like this are too common place, my own experience of the difference between prescriptions from private docs in the UK and the non prescription from NHS fucktards is all there for the public to see day in day out

The lies and crap from the NHS are so obvious for all to see

THAT'S WHY THE NHS IS FULL OF CUNTS

Late opening of GP surgeries

So now even the most battle hardened 9-5 GP surgeries (or so they claimed, 10.30 till 3.30 more like in practise) are now caving in and doing the bare minimum to tick the "late opening" box to keep their political masters happy, and no doubt trigger some incentive payment or other
Lets look at it from the patient perspective

So your GP's have 3 physical sites, spread quite far apart, THEY ONLY NEED TO DO LATE SURGERIES AT ONE OF THESE 3 SITES to satisfy the politicians

Lets look at the type of appointments, "no emergencies", "no appointments made the same day", "no appointments for routine procedures such as blood pressure check", "no dressing change by nurse"

and while we cannot register with any other GP (we tried when we moved here but the closed shop dictates all other GPs will refuse to register anyone at this address and claim we are "too far away", yet these are the 2nd and 3rd (and so on) closest surgeries, giving the patient in practise no choice of GP at all

So no consumer pressure able to force the GP's to open at more client friendly hours, cos the patients have no say in who their GP is, and only the top down government dictat which means that if you attend one of the 2 surgeries where this practise of 3 sites works you will not be able to access any out of hours appointments

Late appointments for GPs seems to be a bit of a laugh as well, as they close well before most commuters will have returned home

So all in all the government spin and mismanagement have led to hype and change but the piss poor access for the patients remains

'Stayin' Alive' has near-perfect rhythm for CPR

http://edition.cnn.com/2008/HEALTH/10/16/disco.song.health.ap/index.html

Scottish NHS in under investigation for breaking European competition laws

European Commission has written to the Government asking it to explain exactly how a contract for a new telephone network was awarded to BT

Patricia being employed by BT doesnt have anything to do with it

how rubbish is the nhs

anyone in any doubt at how rubbish the nhs is should read, and the feedback from the public

http://www.telegraph.co.uk/news/newstopics/politics/health/3204594/Two-thirds-of-patients-fail-to-get-GPs-appointment-within-48-hours.html

as ever the patients dont rate the crap they get from the rationed nhs, they know the service in other western countries is significantly better

and yet it continues

i see the healthcare commission have rated the trusts, im really struggling as some of the best rated trusts are in my personal experience crap, how can such much effort be going into monitoring the nhs and yet have so little clue how massively crap it is

the leaders of many of these trusts should be stuck in prison for the rest of their lifes, its that bad, how dare they take the public purse and provide such shit?

i really dont know

WHAT THE FUCK ARE PCTS FOR?

So while Hull PCT plan to buy a 72ft yacht for unemployed youngsters "to give unemployed 17 to 19-year-olds a healthier lifestyle"

NHS Coventry, no longer simply called Coventry PCT has launched a major programme of community engagement called ‘Healthcare in Coventry – Join the Conversation’ which aims to put public views at the heart of healthcare decision making, err THE PUBLIC THINK YOU ARE A FUCKING DISGRACE YOU CUNTS, stop wasting money on false engagement with the public where all the tough messages will be censored, you have been told lots of things repeatedly by the vast majority of the public, regarding simple stuff like how blood tests are organised and you've ignored the public every fucking time you cunts, how dare you waste more money on bollocks "community engagement"

The PCTs no longer help you find a GP rather they say "call NHS Direct on 0845 46 47" (its on their web sites check it out) not that they ever helped anyone find a GP anyways

Essex PCTs prevent diabetics being prescribed what their consultants and GPs recommend

It's fucking impossible to get to see a GP in Coventry, anyone in the PCT been sacked for this state of affairs?

Great NHS Service

So Lord Mandelson got first class treatment for his kideny stones, no long wait in dirt in A & E

Fantastic

Bet he didnt recover in a ward 2 feet either side from other patients screaming in agony

Shame the NHS can only do it for ministers

This is not a 'service', it is a sham

"For far too many patients it is no 'service' at all. It lacks compassion, is bureaucratic beyond belief and takes far too long. This is not a 'service', it is a sham."

http://news.bbc.co.uk/1/hi/health/7662073.stm

and so say all of us

the nhs has just given up treating people

John Scurr surgeon tells the truth

the nhs has just given up treating people

http://news.bbc.co.uk/1/hi/health/7650549.stm

now im waiting for the urologists to admit the same, and their friends in other areas of surgery?

come on surgeons lets hear some honesty?

leaving people in agony and to early deaths is this what you joined the job for?

or are you all evil scum?

everyone in the nhs to blame, institutional crapness

i think most people in the nhs have been dulled by constant exposure to bad service into thinking this is somehow normal

i think there has to come a point where individuals in a system like this have to stand up and be counted or just be considered part of the problem

the mass acceptance of everyone involved in the nhs that this is the way it is condems all of the nhs staff in my view

just like a nazi prison gaurd there is a process of dulling and peer acceptance that allows otherwise sensible people to accept the nhs ways

there is a root and branch failure in the nhs

in response to the knifeman

in response to the knifeman
http://theknifeman.blogspot.com/
thanks for the note

i do not think "it's all the doctor's fault" far from it
but there are some rubbish doctors and they are not systematically taken out of the system, and the patients have no ability in the nhs to vote with their feet to bring about their downfall

also the dr rant solution to the nhs problems of "give us more money and put the doctors in charge" will not work in my view!

its largely the system, the way the incentives work (or dont work), and the lack of real power in patients hands

as for the swear words this is largely in reference to the dr rant blog, of which i gently take the mickey, dr rant started using rather strong swear language, and my blog reflects that style played back to them

i have not named any medics, as well i could, my frustrations are largely with the system
i do feel coventry PCT should be shut down as a complete failure, i do feel the hospitals in sunderland should be flattened to the ground due their exceptional bad work and the patients given money to go anywhere else they want (if you give the patients real money they will be able to find better choices)

so throwing the word cunt around you should lay firmly at the door of the drs rant, and to be honest in a peter cook dudley moore kind of way it does add a little fun to a conversation, check out some pete and dudley swear ridden dialogs to see how effective it can be at breaking down barriers

and its a little to do with the anti working class prejudice riding through our society at the moment, so much politically correct nonsense if you mention a persons race and yet its common practise to talk down to folk with strong regional or working class accents, in the working class clubs of the land cunt can be a form of friendship ud be surprised

on balance i prefer free speach, which there isnt in the uk due to liable laws etc, id rather we could all just say what we want

i like ur blog, but never seen any medics blogs that reflect the dire state of the nhs from the patients point of view, and there are limited ways of fighting back given the mass of resources the nhs throws at its complaints teams, legal team, and PR folk

keep up the good blog
regards!

why so much scanning?

so youre now on the final stretch, you were diagnosed in 2001, the nhs failed to treat you at all between then and 2008, you are now on borrowed time and could die any time, on no treatment but hormone therapy too late and sub the dose the makers say you should have (im sure theres a medical excuse i mean reason), unable to exist without massive doses of morphine

and the fuckers of the nhs call you back every week or so for another set of scans

why? what are you fucking trying to prove? carnt you see its agnony to leave the house, you know death is certain and there is fuck all you can now do about it you lazy fuckers

whats the matter you didnt use all those nice scanners years ago and fucking operate or use radiation therapy

so yea dying in the nhs made all the more miserable by investigations with no possible positive outcome

sure its keeping some tick sheet checker busy

staggering

thanks to the NHS

we really appreciate the cushion to sit on

thanks for the pretty leaflets explaining end stage prostate cancer

that really is so sweet of you

it really makes up for no fucking treatment since an early diagnosis in 2001

you evil cunts

hope you die long painful deaths

Defend the Mao model of healthcare

The website over at

http://gillgeorge.wordpress.com/

Calling itself "defend the nhs"

Deleted a short critique of its position in their comments section

Really does show the lack of openness to debate, lack of belief in free speech, and lack of tolerance for folk who do not share their own views

These left wing nutters who believe in a communist model of healthcare centrally controlled and run for the benefit of the staff really have lost the plot

Playing on the publics desire for better healthcare they trade on slogans such as "defend the nhs"

We don't need to defend a failing institution, we need to defend the British peoples right to decent healthcare against all comers including Stalinist nutters who believe their own view is the only valid one

These people really are nutters, no where else in the developed world has copied the crap nhs, cos everywhere else can see it does not work, we have the UK at the bottom of all developed countries in terms of healthcare quality, and these nutters want us to have more of the same, I very humbly suggest we learn from the best of the rest of the world - and I can assure you if we do that Stalinist centralist state controlled nhs style care will not be the outcome, and the British people will be a whole lot better off

The current nhs based so closely on how Mao organised rice production in China will always lead to
i) False positive statistics from the managers telling us how great they are doing, how short the waits are, while at the same time folk needing treatment don't ever get on the lists, just as the managers always produced statistics telling Mao how high rice production was
ii) Shit non responsive low quality healthcare, just as the people starved from lack of rice when centralist top down control freakery was imposed on rice production in China

You see we have a failed communist model of running healthcare in this country which even the old communist superstates have long since rejected as a failed organisational structure and business model, we need a radical reform turning the NHS into a slim state guaranteed provider of medical insurance and all of the providers in a regulated free market, we do not need the state running production, we need patients given total control over their individual spend of the health insurance payouts forcing providers to compete and ramp up quality

Power to the patients!

world medical isotopes shortage

so there is a world wide shortage of medical isotopes, of course the NHS wont give a shit because it has given up on medicine

http://www.canada.com/vancouversun/news/story.html?id=7c408ae7-832e-40a6-b96f-be4785c46558

Car parking charges

Car parking charges are to be abolished at NHS hospitals across Scotland, the health secretary Nicola Sturgeon has announced.

Scotlands version of the NHS is getting ever further away from the English version.

Like pay phones and pay TVs, these charges are obviously out of control. When the patients have no real choice of where they go there are no market forces to keep them down.

I'd rather just keep my tax contribution to the NHS and pay myself down at the local BUPA or Nuffield hospitals with large free carparks.

nhs IT

Got views on how IT in the NHS should look in 5 years time? The British Computer Society has been asked by the Conservatives to come up with some suggestions, and individuals can make suggestions via

http://www.healthitpolicyreview.info/

full story at

http://www.theregister.co.uk/2008/08/22/bcs_nhs_it_review/

me personally id change the NHS into a state backed medical insurance company that does nothing other than printing cheques to patients when they need treatment, letting the patients take the cheque anywhere they dam well want including abroad or one of the current private providers, sell off all the NHS providers of care, leaving all the providers free market and left decentralised and choosing their own IT at a business unit level, and the crap providers can close as is essential in the free market to ramp up efficiency through competition, don't suppose that will come out of the review

neither will sacking Patricia Hewitt from the board of BT who are screwing up but making lots of money on the current mess in IT at the NHS

neither will avoiding hiring consultancies like PA to do the procurement like the Govt has for the national ID card IT fiasco, do I really have to do a critique to expose how bad this procurement exercise has been?

Oh and there is a fundamental problem with the BCS review, its being led by folk who are primarily medics, they have replaced the piss poor consultants like Richard Granger, they've realised there is a problem talking to the sales dominated leadership of the large IT consultancies, and they've gone straight to medics with a special fucking interest, I tell you what you need some people who have spent their entire working career designing and implementing successful IT on the review not just fucking medics with a few hair brained ideas, and you also need some people who know how its done in the rest of the world having it dominated by Brits is a big mistake

Also I think "we are aware of the benefits to be gained from patient centred records. We believe that such records, appropriately designed, properly implemented, and made available to those providing health and, where feasible, social care would enable the improvement and efficient management of patient and service user outcomes." shows bias, the best solution to medical records is probably the patient carrying around their own health records on a USB stick or similar, suitably encrypted, rather than the Government holding it all centrally or in Fujitsu data centres opps sorry BT or CSC datacentres thesedays, cannot keep track of the suppliers telling the centralist nutters of the NHS to stick it, patient held records also addresses the issues for folk who travel a lot these days including internationally

The BCS is a failing professional organisation where the vast majority of practioners even at the most senior level in their business do not bother to join it, leaving it dominated by academics and wannabe politicians, and medics with a special interest by the looks of it, not a good place to get a sensible review of nhs IT, I repeat you need some people who have spent their entire working career designing and implementing successful IT - some people with substance not the presentional sales element of the business or the political crowd

The Conservatives can make a donation for this free consultancy to a prostate cancer charity of their choice, its better value then they will get out of the BCS

Zoladex

Zoladex

Lots of morphine

Not seen by consultant but rather a junior doc in outpatients

Given the bad news already deduced by the family and confirmed by the GP

No fucking excuse for having let it get this bad since 2001 with no fucking treatment

Murdering cunts how dare you call yourself a caring profession

Absolute evil organisation that puts out happy positive press releases while delivering such shit care

This is not medicine, this is just boy scout pain relief and token hormone therapy when its already far far too late

Cunts

Great hospital admin isnt it avoiding any surgery on many of your prostate cancer patients, and avoiding any radiotherapy, and even avoiding any interaction by a consultant for the poor sods dying from lack of care, probably helps the consultants concience that he isnt exposed to the death and mysery on his watch

What happened to care by a named consultant? nhs doesnt believe in that does it

Cunts

Been reading some books

One by a Canadian, in it he mentions his parents in their 90s having had multiple hip replacements at each hip, yet all ops being successful and them living happy active lives, travelling all over the place and generally living like a young couple booking into motels and such just for the fun of it - I was struck by how different this is to how life is for old folk in the UK, how unusual it would be here to have multiple successful hip replacements, especially in the nhs

Also been reading the Richard Hammond book about his time after the rocket car crash in an nhs hospital in Leeds, and later BUPA in Bristol and more, his wife goes into great detail about the facilities laid out for them in nhs Leeds, including a private room, she was allowed to sleep in the same bed as him, the consultants ringing round their mates and organising next phase of care etc, all stuff which just doesn't happen for ordinary folk in the nhs, the nhs really has become the worst communist nightmare of some being very much more equal than others, no criticism of Richard or his wife, but I think the obvious double standards from nhs Leeds and elsewhere lead a lot to be desired, you obviously need lots of journalists outside to get good care from the nhs

So the hospital sent him home

So the hospital sent him home

Not actually seen by urology consultant rather handled by the consultants in geriatric medicine aka "let the fuckers die" NHS style, sad that you don't merit actual time with the urology consultant at 70 years old having had prostate cancer for years and no treatment

Sent home with an exotic set of painkillers including morphine

With a diagnosis TO THE PATIENT of osteoporosis of the spine and the medics have gone to great length to tell the patient and family that its all due to wear and tear of the spine and there's nothing that could have been done

Err except he is on cyproterone acetate now, those of us with an education are not as clueless as the medics seem to think

Sent home on the Friday with no notice, no warning to the GPs, and openly "because we need the beds" with only a weekends pain relief

Pleading with the "sorry you need three days to get an appointment to see the GP" receptionists on the Monday for morphine script

And some of the family go to see the GP, explain gently that actually we may have working class accents but we are not total fuckwits, and we know dam well what cyproterone acetate is, and what the diagnosis and lack of treatment has been all along, and can they please find out from the hospital what the fuck is going on AND HAVE THE DECENCY TO TELL THE PATIENT HE IS DYING

The GPs seem as genuinely pissed off with the hospital as I am, and after a lots of bollocks about patient confidentiality, and the patient making clear the close family have his full permission to know what's going on, the whole sorry mess is confirmed by the GP

That patient as ever thinks the medics are gods

The NHS is failing in the most spectacular fashion

No doubt the Healthcare commission will make more gentle remarks about low numbers of urology surgeons, and the trust will put more nurses in place to talk to the patients, and ever more people will die

Die while the waiting lists for treatment look remarkably short and impressive

Die in beds where if you reach out you can touch your fellow patients in the next beds, making cross infection inevitable

Die a good 10 or 20 years before you would have done in another equivalent Western nation, cos they would have actually treated you

Meanwhile the country continues to pour massive sums into the cancer charities when the NHS doesn't even bother with routine proven treatments already discovered and in widespread use in the rest of the world and sporadically within the NHS

This is the saddest outrageous shambles and I really don't know if I can carry on with this blog, it's all too sad

Random observations on death in the NHS

So how the fuck does someone with prostate cancer get from 2001 to 2008 and with no fucking treatment? Only recently had a CT scan, never been on the waiting list for an operation (must make their waiting list figures look good), never been in for radiotherapy on the spine (like the prostate cancer charity say should happen as an emergency in the early days of cases like this, again must make their radiotherapy waits look impressive), never been on the wait for cryo or radioactive pellet treatments, never any attempt at any active treatment at all THE CUNTS OF THE NHS JUST LEAVING HIM TO DIE

Admitted to hospital now, not looking good

So we have 3 wards, three toilets for patients, one toilet out of action cos the taps don't work, another out of action cos the WC don't work, 3 wards of patients using one toilet, for a week so far, makes the hygiene posters look rather stupid

We have a nice big hospital garden, complete with nice park benches, the architects did a great job designing that feature of the hospital, LOCKED SO THE PATIENTS CANNOT GET INTO IT FOR AT LEAST THE LAST FIVE YEARS, obviously no government stats on garden access to meet

We have the mobile tobacco addicted patients huddled round the main entrance, surely the fuck the NHS must have a better way of handling cigarette addicted patients than make them stand outside in all weathers when they at their most ill? Fortunately not the patient I am focussed on but feel sorry for them anyways

Moved from ward to ward constantly, kicked out of urology early into the no-hope aging and let them die wards

Biopsy result from labs taken more than a week so far, would be same day in rest of world (I know I've been speaking to medics)

The visitor gents toilets downstairs has about 10 cubicles, 10 washbasins, and ONLY ONE hand dryer no paper towels, some fucking way to get people to wash their hands that is, what the fuck is the point of sprays and washbasins when there aint enough hand dryers to go around and obviously when that one dryer breaks... stupid fuckers

So the food in hospital is so obviously inadequate, for fucks sake could you really live on that? I'm sure as fuck I couldn't. It's fucking like a concentration camp if you don't have relatives to bring extra stuff in (yea top-ups like the NHS claims to hate is absolutely essential in the food dept)

And you end up squashed into a room smaller than my bedroom, less than 2 foot on each side away from other patients beds, surrounded by 8 people screaming 24/7 in dementia and various other conditions dying in the most horrible way right there in front of you, great for the morale that, leading to sleep depravation to add to whatever other problems you have

And what's the patient told, "oh its just ostiperosis of the spine" who the fuck is kidding who? Do you stupid medics think we are that stupid? The patient may have no medical general knowledge but that is not reason to abuse them, and as for treating the family/friends as stupid they are really taking the piss

Lots of morphine, a different nursing shift have different attitudes to how much to give and how timely, makes a big difference when you're in some much agony

Fucking locking the ward doors? What? Since when was it a fucking prison?

So depending on the biopsy will dictate a timeline, whether the ability to walk will go before death

And we have a nice hospice in town, apparently you need to be "in the know" to be able to pull strings to get into that in the NHS, oh yea some are more equal than others even in bog standard townland

And the docs claim to be working on pain control and quality of life, I tell you what the quality of life even if you were fit and healthy in what is jokingly called an NHS hospital is off the bottom of the scale

And the provision for assisting the family to nurse at home? We shall see, they may be keen on that one as it'll free up one of their beds for another no hope case they have not treated for years

Speaking to friends in Canada and Australia this is routinely survivable, and folk go on to live another 20 or 30 years, and often even have 3 or 4 (yes I said 3 or 4, meaning multiple after the 1st one wears out) hip replacements afterwards, how many people in the NHS get hip replacements versus the rest of the Western World?

AND THE WORST BIT IS THE MEDICS NEVER TOLD THE POOR GUY HE IS BEING SHAFTED AND LEFT TO DIE SLOWLY AND HE TRUSTED THEM

So we have death by dehydration to look forward to, that legalised form of killing folk the NHS use, not allowed to use Shipman tactics simply sedate them and withdraw fluids, let them die from dehydration WHAT THE FUCK IS MORALLY DIFFERENT ABOUT THIS THAN JUST FUCKING PUTTING THEM DOWN LIKE A VET WOULD A PET?

The standard of care from different nursing shifts is obviously massively different, why are the crapper shifts allowed to get away with it?

Oh yea the majority of patients are happy with the NHS are they? Only cos they don't realise they have been let down big time and they are too fucking nice

CUNTS

Lots of new "nurse pathways" to help the lack of Consultants and Urology surgeons, "help lines" by run by nurses for GPs to ring to help advise on how to manage their prostate patients, GET MORE FUCKING SURGEONS YOU CUNTS AND STOP FUCKING AROUND

The decent thing would be to tell the patient early "look the NHS has not get the resources to help, like they claim to have, they will let you die, do yourself a favour and sell your house and go private" that would indeed be best medical advice in the circumstance of this disease, especially in the early days

Answers on a postcard on how to deal rationally with a system so obviously failing

Letting people die, failing to provide any of the recognised treatments, and then just managing their pain, is that what the NHS calls medicine these days? Is anyone over 60 fair game for withholding of treatment and being left to die?

Really I don't know how the staff hold their heads up and look people in the face

CUNTS

I have had to smile at the TV doctors telling folk to go to their GP at the first sign of prostate problems, like why? the NHS is only going to let them die anyway

CUNTS

Is this what I spend so much tax on? Give me strength

Dying in the NHS

So what exactly do you get "free at the point of use"?

I've just spent the weekend with a nice old bloke dying in agony at home in modern Britain

He has obviously had prostate cancer for around 6 or 7 years, as the consultant who told him 6 or 7 years ago that he would have to come back for an operation has long since retired, and what's happened to him since? Certainly no operation that's for sure

He can hardly walk, cancer attacking the spine, again I deduce from the letters and symptoms I see, no honest diagnosis to the patient

He probably needs a new hip also, although the modern NHS will never come to this conclusion as it costs money doesn't it? At least be honest about that you lying bastards

Been significantly worse the last few months after a steady slow decline, And he has been loosing a stone and a half per month for the last 3 months, he will die from weight loss in the next few months even if no other medical issue

Probably got some form of gastro issue too, but the gastro consultant has cancelled his appointment on his waiting list as "we have identified a prostrate issue and have referred you to the urologist" no shit Sherlock, we fucking knew that, and since when did prostrate patients develop some kind of immunity from gastro problems simultaneously?

So the NHS after 6 years has finally got round to doing a CT scan and a whole bunch of other tests

But what active intervention apart from tablets for pain relief and to help him pee better is he getting? ABSOLUTLEY SWEET FUCK ALL

This guy who is gentle and modest, was brought up to think of medics as gods

So yea the NHS is free at the point of use, if you call being left to rot to death and die of curable conditions, and wasting away

THIS IS A FUCKING DISGRACE

ALL YOU CUNTS IN THE NHS SHOULD BE ASHAMED OF YOURSELVES

When he dies I may well scan a few of the letters from the so called consultants up on this site, if I don't go round and find these evil cunts working in the nhs first and ask them to account for this

You tried sleeping when the guy in the next room is crying in pain all night?

He probably is being allowed to die 5 to 20 years sooner than need be, for the lack of a prostrate op, some intervention to help him keep his weight on, and a few other bits of routine intervention

Too old to be worth the money? Says who? He worked all his life contributing handsomely to the NHS and this is what he gets?

He will be wasted away soon to the point where he wouldn't be able to survive an operation anyways, and the NHS is hardly a shining example of somewhere able to help put weight back onto ill patients

How do people in the NHS sleep at night? How do you live with yourselves?

You may as well be putting a gun to his head, and taking our taxes from us to pay for it

A Gentlemen's Agreement

Well Oh Well

I woke up this morning to "The Today Programme" on "Radio 4" that bastion of politically correct middle class biased but thinks its impartial coverage of the nations political life

And what was their top story?

The Government says in many areas GPs have a "Gentlemen's Agreement" to restrict the patients ability to choose a GP! Well what do you say..? As previously reported in this blog and elsewhere patients often in practise have no choice of GP and it looks like the Government has finally cottoned on

And all those medics who kept telling me that I'm wrong and that choice is alive and well in GP land have been left with a big fat family fortune X X X as they are shown to be wrong

Let me repeat some truths

i) In many areas, many urban, when you move there and try to select your GP based on convenience of their opening hours, their reputation with their patients, the general cleanliness of their surgery etc in many parts of the country you will be told by all surgeries apart from the very closest one that you are "outside our catchment area", other tactics are adopted such as "yes we release spaces on our list but you have to come and wait in person every third Tuesday when there is a full moon" (slightly exaggerated but not much) SO PATIENTS HAVE NO CHOICE OF GP thereby encouraging the lazier more useless GPs as they have guaranteed patients press ganged onto their lists

ii) Your ability to use the NHS relies too much on the ability of your GP, in the "GP as gatekeeper to all other care" model of the NHS you depend on having a decent GP, if your GP is one of the worst in the country and you cannot move GP you are fucked, big time fucked

iii) The public were never going to put up with this long term, and medics who do not believe this is going on in this country really need to get out more and see why people like me report this

So there you have it, reported here first, on Radio 4 much later

Lets hope the patients are given some genuine day to day control of where they take their health spend, force the GPs and others to need to attract individual patient transactions in a much more competitive way, this is the only way to drive improvements in opening hours, punctuality of docs, cleanliness etc etc

Come on docs smell the roses you cannot continue to believe your comfy status quo is going to stay much longer?

Or do you like seeing crap service provided by your peers?

Deserves to be repeated

And so here is a comment from a reader again:

TNA said... Hi. I always make it a point to be early or on time for my doctor/nurse appointment, but always find that these people really have no respect for other people's time! It's very frustrating. Twice, I had a 9am appointment at the hospital with one of the staff, and both times she came an hour late. The third time, I got wiser and made an 11am appointment instead, to avoid having to wait for her to arrive. But surprise surprise, when I got there slightly before 11am, she had just arrived and had people waiting since 9am. Because I am not timid and quite adament about my time, I approached her and reminded her that I had a 11am appointment. Another nurse asked if I could wait and let the lady who's been waiting since 9am to go first. Hell NO! I have to get back to work. It's not my problem if their staff cannot get to work on time, and I know well enough that this is not a one-off case.
And then, there was another time when I had to see a consultant, 3:30pm appointment. I only got seen 10 minutes to 5pm, and was told that the doctor needs to leave at 5pm for a meeting. Like...wtf? So, I only got 10 minutes with him, by the time he even pull my records, we only had 5 minutes to discuss my health. He hastily prescribed me new medication that we did not even have much time to discuss about ie how to use, dosage. Even the hospital pharmacy was closed before I got out of the room, I had to go to the hospital again the next day to get it dispensed (because it was issued at the hospital, the local pharmacy said it has to be dispensed there)Another 40 minutes wait over my lunch time. Found out a week later that the dosage told to me for my new medication is way less than it should be, hence why my health had turned for the worse!
And again today, I had a 9am appointment with a local doctor. She walked in at 9:40am. Overheard another patient complained and the receptionist said 'oh, yeah she's usually late'
Like? Not an ounce of respect of other people's time at all.
Back when I was working in an Asian developing country, if things like this happen, you get up, walk off and go into the next clinic. No need to be dependant on the surgery only near to you. No need to fork out hundreds just to be seen. Private doctors open 24 hours, you pay just a little bit more but worth to be seen when you need it most.

Prostate Cancer

Private/Rest of Western World Approach:

Prostate brachytherapy

NHS Approach:

Wait and see or Brutal surgery

Dont get an unfashionable cancer in Browns Britain or you will be filling up a box under the ground

In the Dentist waiting room

Moved to new area a while back

Made an appointment with a new dentist for a check-up, nothing urgent, made it weeks and weeks ago, private appointment

For 8.30 on a Monday

Turned up at 8.15 first patient in the surgery

Made myself know to the reception staff

Waited...

Watched as a few dozen other patients who arrived after me, mostly for routine checkups also (funny what you can overhear), mostly for appointments after me

At 9.00 made myself know to reception staff, asked ever so politely what time I was likely to be seen

"Oh sorry its cos we only squeezed you in since you were in pain", er no I wasn't, after which they try again "er sorry there were lots of emergencies which we let in ahead of you" er no you didn't I was sitting there listening "er that's the way our computer did it" er bollocks I can see you running the appointments on bits of paper

"don't worry it wont be long" they said

Waited half an hour and then walked out

Now I wouldn't actually have minded waiting a little extra if there were some genuine emergencies turning up

And I would have probably hung around if they had been honest with me and just said they made a mistake

But I am not paying out my own good money to be lied to and waste my whole fucking morning

Fortunately I know I can take my money to lots of other dentists, they don't give a shit where I live, they just want the money

Shame I cannot take my business elsewhere in GP land

Why are medical receptionists so fucking useless in the UK? It's the only fucking country on the planet with such shit service

More Obstacles in the Way of Seeing a GP

Trying to register after moving address

Not only do they want passport, they also want utility bills "to prove you live at that address", for fucks sake the patient has only just fucking moved in how the fuck are they supposed to have utility bills

They will be wanting me to prove I'm not Jewish and that I'm of pure blood soon, DONT THEY FUCKING UNDERSTAND HOW SHIT THIS SERVICE IS

A day off work to let them see a utility bill? Give me fucking strength

Useless tossers

No choice and shit service - that's the NHS in 2008

Where exactly in the NHS rules does it allow them to demand utility bills before registering or seeing a patient? Oh sorry I forget they make the rules up as they go along

For those who put words in my mouth

Re "So wait a minute, you want doctors to prescribe antibiotics for every cough and ear ache that comes in the door?
Hey, that's a great idea! Oh, hang on, didn't we used to do that? Oh yes, and that's what caused MRSA...
Idiot."

Er NO not at all

I want poor people (using the NHS), folk too far away from a private GP etc, to be able to see a GP THE VERY SAME DAY when they are in agony as for instance the most extreme cases of ear ache can be

I do not think it is appropriate to wait 3 days to see a GP if you are in so much pain that you cannot sleep, and you therefore struggle to do your job

This is basic humanity as per the entire rest of the Western world

AND

I want some consistency so that similar conditions get similar response whether you see an NHS GP or a private one

Now extreme ear ache from private GP you get Clarithomycin and Gentisone (hope I've spelt that right I'm not a medic and don't pretend to be) where as similar presentation to an NHS GP tends to be come back next week if it still hurts (normally in the cases I know about it does) , and when you go back you get a cheaper antibiotic as Clarithomycin seems too expensive for the NHS?

Now I do not want to be the arbiter of what the best response from the doctor should be in these cases, I just observe that on a fairly large sample of friends and family the average response from the medic is along those lines

A cynic would imagine its just cos the NHS is penny pinching

I just want some fucking consistency, so the poor people get what the folk seeing the private medics get, and both get the best advice - whatever that is?

I really do not see how you can defend lack of access to a medic when you are in extreme agony especially when you are in another part of the country to your home GP

Earache maybe minor to the average GP, when it's dominating your existence, and stopping you sleeping it sure feels more important than that

As a simple example of a common condition where the NHS is way behind the private and rest of the world in its response

No I do not want over prescribing, and no I do not want to define what best practise prescriptions should be, I simply want fair access to good quality care, especially in parts of the country where there is no competition to the NHS

MRSA is more to do with 110 % bed occupancy and fucking dirt and shit allover the walls

Other ways of massaging your waiting lists

Phone the patients up at home (including the deaf ones) saying "we are just ringing to confirm that you want to keep the appointment, if we had not been able to get through we would have assumed you did not want to keep the appointment" to a patient THEY KNOW IS HARD OF HEARING AND CANNOT HOLD DOWN A CONVERSATION ON THE PHONE

And those famous appointment cards through the worst postal sorting offices where 2 % of cards go missing, leading to 2 % of patients never getting their appointment before we start on the other corrupt practises of the nhs

Ever tried to ring up to chase an appointment you have not heard about for 3 months? The NHS staff SCREAM AT YOU IN RAGE for having the nerve to ring with such a query

So customer focussed the NHS isn't it?

sms text from a friend

from someone who knows nothing of this blog, or my views on the nhs

"the nhs really is 3rd world isnt it"

from someone trying to see a doctor in the modern nhs

how proud you all must be

Oh "self-indulgent numb-nuts who want antibiotics for their viral cold because they are "99% sure" they "need an antibiotic"?"

The NHS Way:

1 Get Ill
2 Wait a few days to see if it will go away on its own
3 Make an appointment to see a GP, get given an appointment 3 days away minimum
4 Wait 3 days, during which it gets worse, you are in pain, unable to sleep, life in tatters, unable to work due to lack of sleep etc
5 See GP in a rush who says it's viral come back if it gets any worse
6 Go away give it a few days to get better
7 It doesn't, it's getting REALLY bad, ring for GP appointment, 3 days away again
8 See GP, get given antibiotics
9 First day or two of antibiotics it's fixed, miracle of modern antibiotics, and fuck all to do with the GP
10 Time from initial symptom to appropriate drugs 10 days

The Private/Routine elsewhere on the planet way

1 Get Ill
2 Wait a few days to see if it will go away on its own
3 It doesn't, so walk in off the street and see a GP there and then who gives appropriate antibiotics immediately
4 Time from initial symptom to appropriate drugs 3 days

NHS leaves you in pain and bad symptoms for 10 - 3 = 7 days longer than the rest of the world on average minimum (excludes weekends etc)

Of course its even worse if you have moved to a new area and have not been round the houses to register with a GP, or you are away from home

It is no wonder folk try to see an NHS GP speculatively at the 1st sign of an illness cos they know how long the cycle is

Now

Presenting with the same symptoms at one of the private GPs in London will routinely lead to antibiotics versus crap nhs GPs will delay antibiotics until you have been around the loop a few times and their pet viral theories have been well and truly disproven, now where is the proper scientific evidence supporting either practise?

Given the difficulty actually getting to see anyone in the NHS about chest infection (yes I mean INFECTION) or severe ear ache, to name but two of the most common complaints ordinary folk have to deal with occasionally, it is hardly surprising that folk demand antibiotics of NHS GPs cos they know it will be so hard to get to see a GP the next time

Really we need private fee paying access everywhere, and proper minors clinics fronted by docs in all towns and cities for 24/7 cover where A & E is clearly not appropriate but simple pain relief or antibiotics or advice is needed

You think this is bad, try being diabetic, many only kept alive by advice they get from consultants in Belgium as access to consultant in UK is fucking impossible

Catchment areas

Ah so another tale from a patient

Letter from GP telling her that she cannot register with their surgery, as she is "outside their catchment area"

Which since they are the second nearest GP means that she has NO CHOICE WHATSOEVER IN WHICH GP SHE GETS

Don't you just love the NHS?

So much competition for the providers, the GPs in this case, (err none at all) and so much choice for the customers (err none)

So there you have it in Browns Britain you have no choice of GP, you just get the one the apparatchiks at the PCT and their wombling GPs impose

All the easier for the crap GPs to continue for evermore

Like the schools in this country we only have choice if we are prepared to, and can afford to, move address

Shambles

The Begging Letter Continued

So a letter hand delivered 22 nd May requesting consideration as a potential patient on the GPs roll, several phone calls, 3 in person visits to chase up with the receptionist

Total response from GP surgery...

Nothing, other than a snotty receptionist saying that theres nothing she can do and its up to the practise manager (who you cannot speak to)

Been round a few other GPs too no luck

Shambles absolute shambles

What other business wouldnt reply to a potential customer? even if they have no spaces it would be nice to have a reply

This is your NHS medical card.

"It is proof you are entitled to NHS treatment"

No facts in this statement at all. You are not ENTITLED to anything from the NHS. If you were you would be able to sue for none provision of treatment, you cannot. You only get what the NHS decides to let you have, there are absolutely NO entitlements.

"If you need to see a doctor take this card with you so that your doctor knows that you are entitled to NHS treatment"

And then if you look foreign they will also demand your passport and visa to prove you have leave to be in the country, like the fucking SS guards

"You may have to pay if you do not"

Oh you will need to pay, a lot, in tax for a GP service you cannot access, and for the private GP you end up seeing instead

"If so, get a receipt from your doctor, this shows you how to recover the fee"

Which doctor ever issued these receipts? You sure as fuck cannot recover your Medi Centre fee when all the NHS doctors receptionists have refused to let you see a doctor.

"Emergencies, try to get to your own doctor first"

So what is this mythical emergency that they allow immediate access to the GP surgery that day?, without waiting for 3 or 4 days? There ARE NO CIRCUMSTANCES in which the NHS GP down the road allows patients to attend on the same day - I know the receptionist told me when I was standing in front of her in agony this morning

"or a doctor covering for them"

Most docs routinely have locums standing in. I have not seen the doctor named on any of my many medical cards since the age of about 6.

"If they are not available, you can get treatment from any NHS family doctor"

Yep if you are i) more than 50 miles away from the GP you are registered with and ii) you are prepared to wait an absolute minimum of 3 days to get seen

"Local primary care centre"

What's one of these? I am genuinely interested?

"Minor injuries unit"
What one of these "nurse led" places? I already know there is a 99 % chance I need an anti-biotic, why the fuck would I queue for hours to have someone who has not clue on choice of anti-biotic tell me I need to see a doctor, I knew that already!

"or A & E"

ha ha ha ho ho ho, how we laughed, so you're in agony with a minor infection (say) why the fuck should you be queuing in A & E when they have road accidents to deal with etc? You will never get seen. And if you do you will be sitting next to a big police prisoner guarded by a little chocolate teapot of a policewoman, boy will you have fun when he inevitably starts acting up

"Failing that dial 999"

What for a fucking painful infection?

"If you cannot find a doctor to accept you please let us know. We will find a doctor for you"

Err no you wont, you will tell me to take a day off work and queue in person a one clinic, and if they don't accept me after a day of waiting to take another day off work to queue at another clinic, and so on, and yep you will force me to use the crap doctor in town who none of the locals who have been here years will put up with, thereby giving the worst doctors in the country guaranteed income from press ganged patients

What a waste of taxpayers money

Begging for your fucking life in the NHS of 2008

A genuine email from a diabetic friend trying to register with a GP after moving house, getting pretty short of blood strips and insulin:

"It's just really rubbish all this, it's been 2 weeks, and they can't even give me a yes or a no."

(To whether or not they will allow registration with their practise AFTER being forced to write them a begging letter, cos they only accept patients "if you write to the practise manager")

"In the meantime, my stock is depleting what do you think? I've given the reception a call and she said the best she can do is leave a message with the practice manager. He, is obviously rubbish. I asked for his direct contact, she won't give it to me. She said he's not around, so you can only leave a note. I got annoyed, and was starting to explain my situation, then she cut me through and said adamantly there is nothing SHE can do. They are crap. I rather pay for a decent doctor then pay thousands in tax to not get a decent service."

Begging for your fucking life in the NHS of 2008

Fucking disgrace, all these fucking GPs need a big dose of reality

Other ways of manipulating your waiting lists

In the old days your GP referred you to a consultant - you got seen by a consultant

In the brave new world of Zanu-Labour if your GP refers you to a consultant you get put on a waiting list to see a NURSE

If you get to see the NURSE and she thinks it's a particularly extreme case she can call in the consultant to come and have a look (presumably she also sends cases back to the GP as not serious enough)

If the (dragged in by the nurse as very much an exception) consultant there and then at the first appointment agrees it's a very serious example what do you think happens? Yep you go on the same next waiting list to see a consultant that you would have done if the NURSE had not been concerned enough to interrupt the consultant for his second opinion

You then wait some more (is this the official "wait" that is published in the stats?) the nhs will usually send out appointment cards to a few wrong addresses to delay you a bit more "human error at re-keying we are very sorry" WELL WHY THE FUCK DO YOU KEEP DOING IT YOU USELESS FUCKERS?

Eventually you get to see the most junior consultant in this field in the county (you know cos you've asked around)

He says "yep you need the operation, but you also need to have the associated condition XYZ operated on by me at the same time, and its not really worth the risk of two separate operations for these two conditions as you would then be getting two sets of anaesthetic etc when really you only need one".... "But you have only been referred for the original condition, you need to go back to your GP and get referred for the associated condition also"

So then you go back to your GP and end up on a list to see.... the NURSE again (having at this point already had the consultant say you needed the op)

So yep the nurse appointment delays it a lot, the sending back to the GP for a common ancillary condition which the surgeon should dam well be able to sort out routinely, all adds to the delays

The nhs knows the longer it can delay people (while keeping the official wait bit within the generous parameters tolerated by the nhs central commissars) that more and more will i) die ii) move to another nhs areas forcing them to start waiting again iii) give up and go private and/or abroad

While the "offical" wait figures look almost reasonable

So bigger waits lead to less work needing to be done

Or more work for the poor patient who ends up with an even more extreme case needing an operation by the time they get to the day of the operation

And lots of misery

Life on hold waiting for an operation

Reduced ability to be part of the working population and pay the taxes to fund the NHS

How the NHS gets away with this shambles is beyond me

how to manipulate your waiting lists

OK so you live in a big community of students

You personally know hundreds of students

You know that the French and German students routinely go home for operations these days as they all know how long the waits are in the nhs, and how dirty the hospitals are, its amazing within a week of being told by the GP they need to see a surgeon they have been home and had the operation and are often back in class

Compare and contrast with the poor British students, who wait and wait and wait, often past six months for the simplest of procedures

Any complaints about the length of wait are usually met with "oh sorry we sent the appointment card to number 121 big student residence rather than 131 big student residence" which apart from anything else we know for certain to be outright lies because we all see whats in the pigeon holes for all students, and of course there are never any real sanctions against the nhs for such long waits or mistakes

Now when dear readers do we think the biggest peak of appointment cards, inviting the large student population to have their operations, arriving is? Probably something like over 40% of appointment cards all arrive in the same week or two...

Would it surprise you that there is generally a large influx of such cards a week or two into the summer holiday, just when most students have disappeared for 3 months, large percentages to return living at a different address in the student community, and many off to pastures new, but the vast majority never around to see these mythical appointments arrive

Any arriving back to the same address after 3 months will of course have missed these mythical appointments, any moving address will in practise end up having to start the wait from scratch again, many will cry themselves to sleep for months for lack of treatment

Now this large peak of cards arriving, do we congratulate the management of the nhs for manipulating the numbers on their waiting lists down magically, or do we realise that this is just more proof that a top down Stalinist nhs with poor statistics and no patient power is always going to be a shambles?

Of course the nhs looks a bit better in the stats cos their published numbers of the waiting list all go down over summer....

Discrimination in the NHS

OK so you attend hospital for some tests

You fill in the politically correct registration form, and hand it over, do you think its acceptable that the nurse or admin staff write your social group in big letters on the back of the form? What purpose would this serve?

Would it be acceptable to write BLACK ? would it be acceptable to write JEW? would it be acceptable to write WORKING CLASS ? After all the NHS is supposed to be equal access to treatment for all?

Well there is one pretty large social group that routinely gets their status recorded on the back of these cards in big letters

STUDENT

They write

Now why do we think that is acceptable? And what other process and procedures do we think the NHS follows when its recorded this bit of information?

The prescription conundrum

OK so you've taken another day off work to see the consultant, who failed to turn up to your last scheduled outpatients appointment, you get seen by a none consultant stand in doctor, at 6.30 in the evening cos he has been running late and has missed your 3.00 slot (ok to be charitable he may have had a few tough cases and maybe its not his fault or piss poor organisation at the hospital) he does his stuff, and magically hands over a prescription

Written on hospital stationary which can only be redeemed at the hospital

And of course the hospital pharmacy shut at 5.00

Which means yep you have to take the following morning off to travel a few hours to the hospital to queue up at the pharmacy

Why oh why is the prescription form not the same as the one you take to regular pharmacists?

You go to your private GP, he hands out a private prescription, which you can redeem at your regular chemist but have to pay more than if you had waited a month to see a nhs GP? While you paid the same tax, and saved the nhs money by not bothering their poor over worked GPs?

While at the same time your private dentist has no problem issuing prescriptions on nhs forms which you have no problem getting redeemed at nhs rates at the pharmacy, why different to docs?

Why the %^&* is the nhs and its crazy rules so messed up, why so many prescription forms types, why so hard to redeem them, why cannot any pharmacy not redeem any form, and why no sense to the subsidy?

Answers please?

the nhs is a failed experiment

discuss?