Tuesday, 5 August 2014

It’s free so why not?

One of the great things about socialized medicine in the United Kingdom is how it has gone from treating patients’ needs for treatment of acute illness to treating patients’ wants and more recently, and most importantly, the ill-informed wants of the politicians and the Party. You will note that all three big Parties in the UK are mutually inclusive regarding healthcare policy as they all believe private profit good, NHS bad, sod the patient.

The patient can wait for treatment for acute illness, the Party tick box (QOF) cannot wait to be ticked for illness is in the UK now defined by the Party not the patient. Tick box medicine = Party control of physicians’ profits and cares only for the diseases that the Party defines - not the patient for any non Party prescribed disease. 

Take last week’s typical instant access surgeries for politician’s wants for patients to be seen within 48 hours not for acute illnesses but for whatever (crap) the patient wants. So on one week’s Party Generation Game conveyer belt of want that your average highly trained GP primary care team has to deal with in order to pander to the pathetic (Scottish) politicians’ wants we have had the following: 

“I am paying an absolute fortune for paracetamol”. (Not in Scotland, Northern Irleand or Wales only England we are after all a “National” Health Service). 

Paracetamol is a painkiller for mild/moderate pain available from most supermarkets, local shops and even chemists without a prescription for about 1p a tablet so I want a prescription for it as I don’t have to pay. (GPs get the same for dental problems where patients pay to see a dentist for a prescription for antibiotics but same day GP appointments are free a resounding Party policy success is UK NHS dentistry). 

Can I have a month’s worth as I am off to the caravan? 

(For those not from Northenshire a caravan is a trailer usually parked by a coast in a so called park where there are rows upon rows of such trailers, sorry caravans, which are often state funded where many NHS patients decamp to at weekends and during the summer in order to partake of the benefits of the sea air. A trip there is always an emergency same day appointment especially before a weekend break when a drug resupply and a sick note are required to fund their extended sea air break). 

The smart phone chucked on the desk with their car keys was worth at least £ 300 or a minimum £ 40 a month contract hire and yet a month’s worth of paracetamol or 224 tablets at 1p a time comes to £ 2.24. The Range Rover Sport keys on the desk cost a lot more.

Cheap compared with the cost of a GP appointment let us say £ 20 and a dispensing fee for the freebie of say £ 5.00 a shot for £ 2.24 of drugs a month.

The next one on the conveyer belt of want was the same.

I am pregnant . . .

Pregnancy is in the UK is a supercharged NHS AmEx gold platinum card that will do nicely card which means together with multiple tattoos and kids trashing the surgery toys means I want and I want it now, IT’S AN EMERGENCY, I’M PREGNANT.

The punter went to A&E yesterday but because they had to wait more than 20 nanoseconds (I am pregnant you know) the punter took their own discharge (it was doing my head in there were loads of drunk tossers and wasters there . . .)

Taking ones own discharge when pregnant is clearly a near fatal act of potentially catastrophic proportions akin to falling on your own sword and disemboweling yourself designed to evoke unremitting sympathy from a GP when added to the now wounded (pregnant did you know that Dr?) patient crawling unaided to a taxi to get home from A&E and then with their kids in tow (and trashing the waiting room toys) crawling the next day to an urgent same day GP appointment.

The punter continued for they alleged they had had piles which during their stupendous 20 nanosecond wait before leaving A&E had mysteriously got better but as they aren’t causing me a problem (now) my midwife (allegedly) said I ought to see a doctor (immediately) and that was 3 weeks ago so “can I have a prescription for somemit just in case it happens again as I am off to the caravan”? 

(The alternatives to the above are “I am running low” or “I have just run out” all acute medical emergencies requiring same day urgent appointments not a degree of common sense or a small amount of thought or planning which would cost the patient more than a free NHS same day appointment the cost being having a brain). 

Emergency department attendance, same day “emergency” GP appointment totaling close to £ 100 for a minor pharmacist treatable problem. Except that Pharmacy First schemes don’t do problems, or diagnosis, especially in the pregnant or children just what they can peddle for a fee to “reduce” GP workload (not) and there are around 813,000 births a year in the UK.

When it comes to the healthcare game of Top Trumps there is a clear cascade of winning cards that patients play for free daily and it is as follows:

Hospital consultant > hospital doctor (A&E) > GP (one time hospital Dr.) > nurse (opening gambit for getting a better card the nurse said I should . . .) > paramedic (they have blue flashing lights impressing the neighbours when called to your trailer) > pharmacist (they have a degree but there is a 1 in 10 chance they might cost so best avoided) > NHS 111 (DoH? Call an ambulance or see a GP within an hour which is a top trumper waste of everyones’ time but the last resort to try for a better card).

All cost nothing at the point of abuse but patients always want to play the top trump card and for free. If they don’t get the top trump card they want they will simply play another card. 

Next on this weeks’ conveyor belt of want was: 

The extra on top of the 15 alleged emergencies that HAD to be seen that day for a test result.

The punter already knew what the problem was 10 years ago when they had been offered treatment and in their infinite retardation knew better and so demanded a same day appointment after 10 years because their condition had got worse (totally predictable). They were sent for a test the result of which was already known (10 years ago) - but it is free.

So although told to come back after a few days to allow for the transfer of results and for these results to be triaged as doctors have done for years into what needs to be seen now (life threatening/urgent but rare), what needs to be soon (a few) and what can wait to be seen (most) a complete waste of space but the punter knew better and they HAD TO BE SEEN NOW.

When challenged about their free at the point of abuse misuse of the NHS they got nasty and said it was an emergency because they were going on holiday in a few days’ time (can you guess where?) and couldn’t wait (for another 10 years). 

And to complete the week’s conveyer belt of NHS misusers’ wants the last emergency surgery free at the point of abuse and more importantly completely free of any real urgent illness (thank you Tony Blair and Gordon Brown) of the week the Friday afternoon “something for the weekend” surgery (before the caravan) saw Thick attending with Thicker to complain that they had lost a job just seconds before.

Thick and Thicker repeated their story 10 times between them just in case the first world educated doctor hadn’t got the fact that this was nothing medical and when Thick and Thicker were advised this was nothing medical they retorted but we “HAD to DO something and see someone” as they didn’t know where else to go (for free). 

The crux of Thick and Thicker’s attendance was a legal matter not a medical one but then you usually have to pay to see a lawyer but seeing a GP on the same day within seconds of something non medical happening is our right and free at the point of abuse.

Thick and Thicker were told this and when they heard the words "no win, no fee" were out of the surgery like a shot and even stopped playing the cracked record as it went round for the 11th time (just in case the GP hadn’t heard why they needed a same day appointment for nothing medical). 

Praise be to the Party for providing the NHS with public school educated Scots and allowing them to reform the NHS for the better for they see what doctors cannot see namely WMD and saving the world from a financial crisis they created.

Unfortunately some of us live in and see the real world daily and it is not big and it is not clever especially at holiday times. So if you can't see a doctor when you are ill you now know why.