"Well, there is only one piece of advice I can give you," said the wisest of wise men. "The secret of happiness is to see all the marvels of the world and never to forget the drops of oil on the spoon."

('The Alchemist' Paulo Coelho)

Saturday, July 07, 2012

Doctors, nurses - oh, and patients

Once upon a time, there was an 89 year old man (let's call him Mr Smith) who lived in a place where there was a huge, shiny, expensive surgery with about 20 doctors and numerous other staff. This surgery had started out as  a four-doctor outfit sixty odd years ago and, because it was now so big, it had, along the way, swallowed up all the other local surgeries so that it is now the only one for the whole area. Mr Smith and his GP got on very well and he always felt he got the care and support he needed, but one day the GP was taken away to fill his days with endless paperwork and, truth to tell, seemed rather disillusioned with the way his job had developed over recent years, so Mr Smith would have to be allocated another GP within the practice. And they gave him a new doctor, and then another... and then another. In fact by now, he wasn't quite sure who was his GP, and neither was anyone else,  which might explain why a referral from his optician to the surgery for an appointment at the local Eye Hospital took over two weeks to be acted on.
Now Mr Smith had developed an illness which required him to have  injections and blood tests every twelve weeks but, although the big shiny surgery also had a big shiny computer system for patient records, it was too difficult for the people at the surgery to remember when these dates were due, so Mr Smith had to remember and book appointments each time and then a family member would have to arrange time off to take him there, not that they minded doing that at all, but Mr Smith thought that, as he was also just getting over an attack of shingles and still wasn't feeling terribly well, maybe he could have the blood test and injection done at home.
He had also been asked, via an anonymous letter, to make an appointment to see his GP about his blood pressure. As we know, by now Mr Smith was none too sure who his GP was and had to ring the surgery to find out. Nobody seemed to know but the receptionist said she would get Dr X to ring him. Dr X did ring him a couple of days later and told him to double up on his BP medication for now but his next prescription renewal would be at the new dose, so now Mr Smith has to remember that, when he gets his next prescription, he has to stop doubling up.
As for the blood test and injection, by now these were a week late and Dr X said she would 'Speak to the district nurses' about a home visit.
The next day, a nurse rang him and delivered a short lecture over the phone about home visits only being for the housebound and he had to point out that, at the moment, he is recovering from shingles and does not feel able to make a trip to the surgery. The nurse muttered something about 'speaking to the doctor' and rang off.
The next day, a package plopped through Mr Smith's letterbox. It was a syringe and a dose of medication. As he didn't know why it had been delivered with no-one to administer it, he rang the surgery again. 
"Oh the nurse will come and give it to you next week," said the receptionist.
Mr Smith was so surprised that he didn't think to ask what day or to point out that, by the time he received his injection, it would be TWO weeks overdue.
Mr Smith thinks that they don't want to be bothered with him because of his age. Others might say that's not true, that the nurses are 'ever so busy' as they keep telling everyone, or that it's 'the system' that's failing patients. They may blame the increase of paperwork or the politicians who, just as in the world of education, have a constant need to make their mark on the system and score points off the opposition.
Whatever the reasons, the end result is that Mr Smith and many others like him are being failed and so, when the time comes, will we, unless something is done to sort things out properly.


Daphne said...

Fury! Things like this make me SO angry. A lot of it is caused by thoughtlessness and poor communication. I'll be showing this post to medical students next term, thank you for writing it.

Jennyta said...

You're welcome, Daphne.

GaynorB said...

At least it looks like Mr Smith has someone interested in his well being. How poor is a system, whether local or national that gives this sort of care to anyone, let alone an elderly person.

My roots are in Tredegar, South Wales, the home of the National Health Service as promoted by the late Nye Bevan. No doubt he is 'turning in his grave' as we type...

Good luck, Mr Smith!

Jennyta said...

I think you're probably right, Gaynor. Pity he isn't still here to oversee it. ;)

Shooting Parrots said...

I understand where you're coming from - family health services are in a real mess right now. Part of the problem is that while it is NHS funded, it isn't NHS run. GPs are small businesses and they aren't too keen on taking on overheads - ie staff - because it eats into their profits. And yet these are the same people that the government wants to trust with whole NHS budget. The future looks beak!

Cro Magnon said...

An all too common tale, I don't doubt. I always had good service back in the UK, but I believe my surgery is going the same way. Amalgamation, shiny new building, and unknown faces. At least here I do know my doctor, but I hate handing over cash every time I visit.

Jennyta said...

I think you've summed it up in a nutshell, SP. As you say, the future looks bleak.

Jennyta said...

I think most people would prefer to hand over cash, assuming they are in a position to do so, than endure terrible service, Cro. And the NHS and GPs conveniently forget is that we have actually paid for their services through National Insurance contributions.

Yorkshire Pudding said...

I thought it was a bedtime story until I realised that, thanks to Andrew Lansley and the ConDem boot boys, there could be no happy ending. In breaking the NHS, they are inviting in a market-driven monster whose route cannot be foreseen. In the meantime, advisers, consultants and trainers will be sticking their snouts deep into the trough and gobbling up money that should have been spent on health care.

Jennyta said...

Sadly, not a bedtime story, YP but a true one.


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