Tuesday, 24 March 2009

Home visits a rant

“Course we are easy to find Doctor it is 2 miles past the Red Ferret, everyone knows the Red Ferret and then 100 yards past the Witch’s Coven the large white building in the middle of nowhere then past Crippen the Butcher on the High Grumble Street you know the one just past the Ward 87 boutique and turn left at the Ben Bradsham health spa we are right next to it.

I enclose a photo of the house from me mobile but can you be quick as I have to remove a load of copper wiring from a railway to pay me kids fees at school and the kid is really ill as she came home from horse riding this morning in the Range Rover . . . "

The team at ND hate home visiting. It is not first world medicine and is widely abused. What really pees us off is that while patients know where to find and ring us we often do not know how to find them.

We are, as far as the ND team knows, the only country in the world stupid enough to provide this useless service for free. You only have to listen to a pathetic parent of a child who insisted on a home visit from a doctor in America for a sore throat and listen to their bemoaning the $150 call out fee and $ 50 medicine fee for a self limiting illness to realize how essential this service is.

“And can you sign my insurance claim form while I am here . . .”

“Yes but there is a fee for wasting doctor’s time overseas”.

Someone once said it is easier to get a home visit from a doctor than a takeaway pizza.


You have to pay for the pizza.
However have you ever tried to find a house at night on a Northernshire council housing estate?

In the fog?
In a powercut?
In the wilds of darkest rural Northernshire?

The town planners who design such instruments of torture called housing estates will be asleep on their various design awards (until they are demolished 40 years later) but many Northern Docs will be flummoxed by these planners’ idiot ideas on a regular basis.

Frequently roads will be blocked by barricades to stop joy riders meaning a few hundred yard detour to get to the house the other side of a barricade. All the time the frequent stop starts and torch reading of maps or house numbers alerts the local druggies and villains to the fact that there is a druggie’s “Fortnum and Masons” hamper aka a doctor’s bag in that vehicle full of drugs, blank prescriptions and sick notes for the taking as the occupant is unarmed, possibly female and on their own.

Now we are sure that the more articulate will say “get a chuffing sat nav yer rich b*stard” but does that work in these circumstances?

No it tells you where you are not how to get there. Assuming of course that tower blocks enhance transmission of GPS satellite signals to the point that in a dark unlit tower block with most of the door and floor numbers missing it will point to Doris at floor 18 flat 1100 with pin point accuracy.

The more articulate will also say we need home visits because they save lives.

So home visiting means that we are at the top of any health league table while countries without home visiting are at the bottom? Granted the odd life may be saved but if there is generally anything serious wrong with a patient they should dial 999 and get a far better equipped and faster response from a paramedic.

We rest our case for pandering to the pathetic winging well who always insist that they can’t get to the surgery even though we then see the same ill patients in the surgery car park crossing the road to get their (issued at home) prescriptions because they were too ill to park in the surgery car park for an appointment - rant partially over.

ND would respectfully suggest that on behalf of all those who need to locate houses in the UK in the dark that there be a mandatory requirement for house numbers/names to be visible from a car traveling at 20mph without the need for a torch from a distance of 30m.

Not a hugely expensive idea given street lighting but one that just might save lives.
Looking for a Swan Cottage at 70 High Street (hidden down a passage off the main road) where all the house numbers are complete and there is only pedestrian access from the main road may in daylight not seem difficult but when the speed limit on the road is 70mph and you are having to do 20mph to find the target in the dark in the rain then it is a slightly risky procedure not only to the doctor or ambulance driver but also to other motorists. Especially as Swann cottage is 70A rather than 70.

The fact that pedestrian access to Swan cottage is via the main road down a narrow passage while vehicular access is off a roundabout 800 yards from its location on the map on a track unmarked on the map off a minor road which doubles back on the main road to its map location is never ever told to the visiting doctor. Neither is the correct address.

Relatives even move ill patients to their own addresses before requesting home visits for patients and not telling doctors about the movement of the “unable to come to surgery” patients. You go to the patient's house and no one is in.

Of course after 30 minutes of valuable time to find the “emergency” sore throat at Swan cottage there will be the inevitable “did you not see the notice/number at the end of the drive”?

No because it was never there.

Praise be to the Party who created the home visit as used worldwide due to its proven effectiveness in healthcare. Good medical ideas are adopted worldwide.

The Party does not do good ideas or good medicine. Just sound bites which achieve nothing but waste everyone’s time bar the idiots that think of them and that was in 1947. Rant over.

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