Tuesday 24 June 2008

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.

Monday 23 June 2008

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

Friday 20 June 2008

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

Thursday 19 June 2008

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

Wednesday 18 June 2008

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

Sunday 15 June 2008

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

Friday 13 June 2008

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

Wednesday 11 June 2008

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

Monday 9 June 2008

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

Sunday 8 June 2008

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

Saturday 7 June 2008

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....

Friday 6 June 2008

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?

Wednesday 4 June 2008

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?