Philippa asked a very good question about why I still like the NHS, despite recent experiences.
Well, as a midwife, I trained and worked in the NHS and saw many good things. It was a wonderful concept to have medical care free at the point of access, and in common with all my colleagues, we worked really hard to provide a high standard of care to "our" clients. On the whole, we succeeded really well, despite obstacles in our way.
Perhaps it is nostalgia, but I still believe in the dream of the NHS. Unfortunately, the reality is quite different.
I do have to say that I also saw at firsthand the way that even 10 years ago, bureaucracy was beginning to strangle it.
I remember one memorable day, when we had more ward clerks doing clerical work on our ward than we had qualified midwives, and we were looking after women with major complications of pregnancy, women in early labour and postnatal mums and babies......
We were perennially shortstaffed because there was not enough money to employ more staff.
I remember being on my own in charge of a ward with 12 pregnant women , four postnatal women and four babies for an 8 hour shift.
I also remember when there were only two qualified midwives and me (as a student) providing care for a full labour ward, and I was looking after three women on my own simultaneously..
It does beg the question whether I would want a pregnant daughter of mine being cared for under those circumstances, and the answer is a resounding NO !!
On the other hand, we have the superb skills and dedicated care given by many excellent doctors , midwives and nurses, who often face verbal and physical aggression from the very people for whom they provide care. They show enormous courage and determination to provide health care even to people who treat them badly.
We have a system where emergency medical care is on the whole easily available. At our local hospital, I have never has to wait more than one hour to be seen in A&E (the ER for readers across the Pond), although if you are just "unwell", you may face a wait of several days in some parts of the UK. Priority is invariably given to those brought in by ambulance, for obvious reasons.
If you need referral to a hospital consultant, that is where the entire system falls on its knees.
Once I had to wait 14 months for an appointment . There are simply too many patients and not enough doctors to even up supply and demand.
The government sets up all these wonderful guidelines and targets, but it costs money just to publish the wretched things, let alone implement them. Hence a system where lip service is paid to the targets, yet the reality is that people still have to wait just as long. The bureaucracy is becoming more important than patient care, with paperwork taking more time than patient care.
At my daughter`s recent stay in hospital, my mother was appalled to find that any actual nursing was limited to staff doing routine observations and administering medicines.
Not once did nurses observe to see that children were eating and drinking or not, and the overwhelming majority of routine care was expected to be done by the parents- who, of course, are not on the whole, qualified nurses :-)
The nurses were mostly found at the nurses` station, sitting down at the computer terminals and doing paperwork. Not to mention that there were many clerical staff also on the wards.
It can only get worse, I fear, but there aren`t any other options for those who are not lucky enough to work for an employer who subsidises private health cover.
Depressing but true.
3 comments:
The longest I have waited for an appointment has been just over 10 months. That was just to get a bit of barium up the backside after I had been hospitalised with acute, mind-blowing pain. This resulted in cautious diagnosis of IBS (as in, "er... well... we don't really know what you have, but the best guess would be irritable bowel...). I suppose I was fortunate that it wasn't colon cancer or anything else best not left for 10 months.
More recently, I was referred in October or November to a dermatologist for an irregular spot on my face. In February I made it onto the list to ring for for an appointment in April. This was subsequently cancelled, but I was offered an appointment to pay for it privately from the same doctor later the same week as the cancelled appointment. After a bit of wrangling, I managed to get a different time on the original day on the NHS. Six months for what will probably take 15 minutes.
As for childbirth, when Mrs H had Aidan, she went into labour on Tuesday, got sent home because there wasn't anyone to take care of her, and went back Wednesday morning. She was induced and the induction failed, but Thursday they couldn't give her a caesarian because there wasn't enough staff to provide aftercare. Friday they tried another induction, until she had an emergency section in the wee hours of Saturday morning.
Sorry for rambling - I should have posted on my own blog. But then I'm always whinging about the NHS.
It is the general concept of national health care that I like. The availability of good care for those who cannot afford it. But unfortunately, it fails in practice, as noted by yours and David Holford's experiences. I am of the mind that if you can't make it work, then don't do it. Reinstitute private health care and do something else to keep the exhorbitant health insurance costs, office visits, and malpractice insurance down. How that would happen, I don't know. But it is obvious NHS doesn't work. It would be interesting to conduct a study of those whose diagnosis was delayed with long waiting periods, to see how many were diagnosed with cancer or some other tragic disease and they died because of medical care that was implemented too late in the game.
Just my .02. YMMV.
Philippa,
The issue of delayed diagnosis of terminal illnesses is raised regularly by various newspapers and other journalists. And we haven't even touched on what is called the "post code lottery", where some local NHS trusts will pay for certain medications and others won't.
Mrs H's grandfather was preliminarily diagnosed with cancer by his GP, but didn't follow up getting him specialist care. After two years, her grandmother noticed a spot on his chest, but he had to go private to see a specialist, which cost £150. Because her grandfather has acquired a serious leg injury many year before (he had a open wound on his leg from the age of about 20 where the injury had infected the bone and a resultant locked knee), he lived on disability benefits, so paying to go private was no small matter. He had breast cancer. He fought it, even after it spread to his sternum and beyond, for many years until he succumbed just before Abby was born. But if it had been followed up in the first place, it probably would have been treatable.
Thanks to the NHS, the UK has the worst survival rate for cancer in western Europe.
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