Saturday, 24 January 2009

ND went to the Barber . . .

ND went to get their hair cut today. As ND was not working, ND indulged in a bit of conversation not having to think about every word that was being said. During the course of the conversation we talked of matters medical among many other subjects and of the hairdresser’s experience of medicine in this country and abroad.

The barber made a very interesting personal observation that he sees his GP perhaps once a year. He says he is peed off by the number of old people sitting in the waiting room that look so well and keep him waiting and obviously from working and earning money. “They are retired and could go any time” he remarked.

They do go any time, ND replied, and come into the extra Brown shifts (remember the f in shift is silent) that GPs here have to work to cater for the busy commuting pensioners and children. ND made the point that this happens in the USA too where pensioners are known as “frequent flyers” as they don’t pay and so go round and land in various physician’s waiting rooms there.

The barber then contrasted his own experience while in the USA when involved in a car crash in the middle of nowhere. He was conveyed to a hospital the like of which he had never seen in the UK. His observations were there were 7 CT/MRI scanners all waiting and he just went straight in. He could not believe the service compared with that at his GPs or when he last went to A&E. Granted he had to sort out the insurance but he was impressed and highly critical of the UK.

That same afternoon ND went with a relative to an oncology clinic. There was the possibility of a recurrence of a malignant tumour and the relative was assured that they needed an urgent CT scan and MRI scan which the doctor said would be done in less than 2 weeks.

ND walked with the relative to the CT booking department where we were told it is 6-8 weeks for CT or MRI scans by a clerk you could just see above the desk whose disinterest was only overshadowed by her poorly bleached blonde hair. On our way out the only CT/MRI scanner we saw was a portable CT scanner in the car park hired from a private company lying idle.

ND was reminded at that point of a patient who recounted their experiences in South Africa where the patient had a car crash. He went to see a local GP who referred him to an orthopaedic surgeon who arranged a MRI scan of their neck and then sent him to see a physiotherapist. This was all within 3 hours of the accident and, as the patient was so proud of, for £200 which he was to claim back from his holiday insurance. Anyone in this country able to beat this in terms of a) cost and b) time to see so many healthcare professionals and get a MRI scan?

What a contrast of first world medicine (USA and South Africa) and that in the United Kingdom. ND’s relative still has not got their “urgent” CT and MRI scans but they do still have a cancer that may or may not be growing.

The same day while between the barber and the oncology clinic ND listened to the radio where patients and doctors were saying that, because of the 18 week wait rule, in order to get quick follow up treatment (and improve hospital finances) patients were being re referred at the behest of their consultants in order to get follow up treatment quicker. There is an 18 week target from being referred as a “new” referral until treatment. If they are already a patient then there is no target and so they are a low priority for treatment as there is no target for follow up treatments and so new referrals get priority.

While there may be a 2 week wait target for patients with suspected cancer whereby they should be seen within 2 weeks of being referred this clearly does not apply once the diagnosis is made.

So ND’s trip to the barber, listening to the radio and the oncology clinic had showed how bad the current NHS system is. As targets and attracting money for hospitals are high priorities the patient isn’t in the UK. And yet money is a priority for doctors and hospitals abroad but somehow the market there leads to a better service for the patient in contrast to the NHS “market”.

ND was (and is) confused but at least ND now had short hair and feels better for that. ND did not have to wait for the hair cut but ND’s relative is still waiting for their “urgent” follow up scans.

Perhaps if ND takes the relative to see their GP then the income that a new referral will bring to a hospital will speed up the scan in the same way as going private would? Now ND understands how the NHS works. Profit not patient.

Meet the target and don’t treat the patient unless the target is met and income is made.

Praise be to the Party for creating the market that is the NHS. It works so well for patients, sorry managers.

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