Tales from the Gulag revisited 003.

The NHS must according to the so called Nicholson challenge find £ 20 billion of savings to make for the billions squandered by those in the bottom third of the UK’s state education system who are employed as NHS managers. Failed IT systems, PFI financed hospitals et al means the billions of waste increase every day so it is down to these same idiots to find petty savings as they don’t deal with patients. 

Our relative’s recent and late in the day “emergency” admission for a routine scan showed another couple of ideas that will have no doubt emanated down from on the Staffordshire or Nicholson heights of clinical (NHS management) excellence where the target always top trumps the patient.

We have talked about how much more expensive it is to get an urgent scan than in any first world country where you would get such a scan as an outpatient the same day and get the results that day not 4 weeks later but in the third world that is the UK’s socialized medical system you are lucky to get a bed not a trolley or floor to sleep on (the later two are the preferred option as they are cheap and so help meet the Nicholson or Staffordshire® Care challenge). 

Now most peoples’ beds usually have some items on them to make them more comfortable. Things like bed clothes and a pillow to rest ones head on. But not in Sir David’s Staffordshire® Care where in order to get something done urgently you are lucky to get a bed but this was a bare bed for several hours until the data inputters got off their backsides and found some bed clothes.

However they could not find a pillow. Fortunately some lateral thinking and a mobile phone call to the local branch of Pillows ‘R’ Us™ resulted in a pillow for our relative for the night.

Another great saving that hospitals have introduced is the take all your drugs into hospital scam. This is allegedly for the illiterate doctors and nurses to see exactly what medication you are taking by looking at the boxes. The drugs dispensed usually for free are taken off you and rarely if ever returned to you on your discharge instead as yet another example of NHS efficiency gains they are sent to landfill.

If you are lucky you might get a week, or two, supplies back on discharge. You are then expected to go back to your GP who issued the prescription for the drugs taken from you in the first place which have been sent to landfill to get another prescription from the same GP for the same drugs that were sent to landfill. More NHS efficiency gains double the GPs' work and double their drug expenditure.

While a guest in the Gulag you might, if you are in pain, dare to ask for pain relief. Of course regardless of how intense your pain is you will only get a paracetamol tablet. Pain relief on NHS wards is rationed more closely than penicillin was in the Second World War and there are many excuses for the non-administration of pain relief.

These range from we can’t be arsed (to get the keys to the drug cupboard, find another trained nurse ( if there is one) on a ward to check the drugs, to the we are waiting for the pharmacist (technician) to check the stock, to we only get one pack of 16 paracetamol for the whole hospital from the local convenience store every other month.

Dare to ask for more or something stronger and it is like the scene in Oliver Twist where Oliver dares to ask for more.

Now there are many reasons for this but when controlled drugs (opiates) are involved it might be a BOGOF scam. Patient gets one the nurse gets one free if two are written up to be given at once. Don’t laugh it has happened or perhaps nurses have been told that opiates stop patients breathing the bit about they also stop pain is omitted in today’s data inputter’s advanced “degree” level training which omits basics like pillows, bed clothes and pain relief.

So despite our relative being in pain and asking for the same dose of a drug that our relative takes at home only half the dose was administered throughout our relative’s stay so saving the NHS billions as a result of retarded efficiency gains. After all pain is cheaper for NHS managers than pain killers isn’t it comrade and we all must suffer for the Motherland of today’s NHS for the greater good of the Nicholson challenge so big (retarded) it can be seen from space (Quarry House’s downstairs' windows when the staff look out of them on Friday afternoon to complete their weeks' work)?

So our relative’s recent stay in the Gulag demonstrates how billions are wasted by the inefficiency use of expensive resources to get investigations while pence are saved by not providing patients with pain relief, pillows and bedclothes. Remember comrades this was an alleged first world teaching hospital centre of excellence anywhere else it would have been much worse.

Still the private sector did well for our relative lost their pillow deposit from Pillow ‘R’ Us™ for when they went for a comfort break they found that someone had had the time to remove the pillow case from the one bed occupied on the ward and no doubt as an efficiency gain to ensure that the next inmate to the ward would, eventually, after several such trips get a full set of bed clothes.

And after the next comfort break no doubt a pillow as well thanks to the ever efficient private sector and a huge Nicholson challenge saving as well.

Praise be to the Party and its managers for ensuring that all its patients are this well cared for all the time. You might think our Tales from the Gulag were made up they are so farcical but none of this is made up it all happened recently for real in today’s NHS. 

 

 

 

 

 

Why you should not ask your doctor for a letter to support your appeal for rejected benefit claims.

One of the great things that the founders of the NHS never anticipated by the law of unintended consequences is the concept of the continuing and almost universal abuse of the NHS free at the point of care.

Anyone who works in the NHS on the frontline will recognize this but the fact is that no NHS patient ever misuses or abuses the NHS which is why every home visit patient without fail always says “I never have the doctor out”. And no patient every misses an NHS appointments.

If they do they just ask for another emergency one now, tomorrow, next week whenever – its free it won’t cost me nuffing and I just have to lie to get one. Hear that on every home visit and every day and it makes one a tad cynical.

The other great thing about the NHS being free at the point of the abuse of care is that it gives every clerk in a council office, benefit office, bank, travel agent etc. the ultimate get out of jail free card of how to remove an awkward punter. It is called the “we can ONLY help you IF you get a letter from your doctor”.

Using a Star Trek universal translator tool this means we will tell you to get lost and waste someone else’s time and we get you out of our office ASAP SUCKER and you still won't get a thing but it will be your doctor's fault not ours.

Now for any UK patient having a 5 year old’s Tesco’s till tantrum along the lines of “I want my sweeties now” at any such institution, and there are thousands of such tantrums in the UK by so called adults every day, this get a letter from your doctor get the clerk out of jail scam, combined with the 2 Scottish moronic former prime ministers “let’s make sure that all patients are seen by GPs within 48 hours (with any crap whatsoever)” scam  means that if you are acutely ill you can’t ever get seen by a GP blocked by sheer (Scottish generated) crap.

So when GPs were once allowed as professionals to define emergencies as illness not politically retarded want to appease we used to see genuine acute illness not QOF crap or the urgent letters scam for the Rab C. Nesbits of Scotland.

A recent piece in the GP rag Pulse shows just how valuable these letters from GPs actually are.

Now there is always a glass is half empty a glass is half full argument to apply here.

One argument is that if you are lucky enough to be the 2.9% of benefit claimants who blag a winning letter then that is well worth your while wasting a doctor’s time especially if you can blag it for free. There is a wealth of reports on how the highly flawed benefits system has generated extra work for a GP service with decreasing resources and now apparently decreasing returns.

The other argument is that for every successful appeal there will be 33-34 letters that have completely wasted a doctor’s time, blocked appointments for real illness to achieve nothing so if you can’t get to see your GP ask them how much time they spend doing benefit appeals letters?

Read the article in detail and see what the major cause of success is for successful appeals. It is the successful oral evidence (41.7%) which is 14 times more successful than a letter from your doctor. However this approach means patients doing something for themselves and for nothing. Now that isn’t what the NHS is about is it? No self care here is there? Far easier to waste your doctor’s time for nothing isn’t it?

Many of those in GP land know which letters work and which don’t because they have have over the years met and talked to those who deal with these letters for benefits, housing, insurance etc. and many GPs do not do the letters that don’t work. Does that make these GPs bad doctors? 

More information is here and remember who provided this information? It is the judges (lawyers) who have reviewed cases and determined that the initial assessments were legally wrong. Doctors who take the time to read the reasons why appeals are successful, when patients ask you to tell them (translate legalise) why they have been successful from the letters they have, see that it is down to legal reasons rarely if ever medical letters. The law has been misinterpreted by the (private) companies doing the assessments who are costing UK taxpayers a fortune for doing their job incorrectly as 40% of appeals  are successful.

Praise be to the Party and its politicians for realizing that whatever is provided for free will be abused for free for any reason whatsoever and the abuse is always as an emergency.

The Police have better protection from time wasters than the NHS for there is a crime of wasting Police time while wasting NHS time is a god given right free to all at the point of abuse of care with no come back whatsoever. And that is just for those doing the assessments wrong . . .

  

 

 

 

 

 

 

Tales from the Gulag revisited 002.

Our relative’s recent admission to the local alleged first world Gulag showed once again how “good” the NHS is in terms of “caring” for its patients. Our relative was admitted for an investigation at a late hour which required complex equipment and time and having had said investigation was returned to their cell block where they had missed the food round.

They had been in hospital for almost 24 hours by then and the only food they had had was a chocolate bar they had put in their “just in case” admission bag. So they felt hungry. 

When they asked for food the computer data inputters caring for them, sorry we meant nurses, sorry healthcare assistants, told them they had missed the slop round and so our relative now had three options:

1) to starve (the Nicholson/Staffordshire preferred option for all NHS comrade patients),

2) they could have a sandwich

3)  or the data inputters could, if they could be arsed, which was heavily hinted at as being an inconvenience to their primary function namely chatting through the night, request a hot meal from a nearby hospital but that would mean the data inputters doing something other than sitting at a desk chatting about how busy their job was. It would also involve asking for a taxi to transport the meal which couldn’t be heated up on site from the big hospital and that was so expensive and so much trouble for them to do so when they had so much to write into the modern care plan/Kardex to say that all cares were given except at this stage feeding one patient.

So the sandwich option was selected no duress in this Gulag comrades.

The sandwich was a sight to behold. The bread was condensation covered under the cling film while the contents were dry which suggested that this an NHS “emergency” sandwich (probably from when the Cold War was still hot) which had been in the ward fridge for a while probably decades. It would be interesting to see if it could have been carbon dated so the default Nicholson option was therefore selected by our relative via the process of NHS Choice®. 

The private/public debate will continue but the cost of the taxi for the hot meal option declined by our relative out of a spirit of public good could have be more than offset by a 5 minute walk by a relative to a series of excellent local takeaways. A small amount of time spent waiting for the food to be freshly prepared would have been more than rewarded by an NHS patient having true Choice and a good meal after a day of starving something that Comrade Gulag Commissar Nicholson will not 

understand for he expects only Staffordshire care for “his” patients and a modicum of expenses for his bowl of rice a day subsistence living expenses. 

This was not to be for clearly there was a Health and Safety issue and an infection control issue of preventing takeaway acquired infection to the ward bay where our relative was confined which had 5 empty beds occupied by those patients who were on weekend leave.

Over the weekend there would be no whitewash deep clean of any imported takeaway meal ingested by our relative who would be discharged 2 days before the return of the weekenders so any moron who is not an NHS manager can see the infection “risk”.

The takeaway would have been from a heavily used student part of town and has numerous certificates to attest to their high hygiene standards but remember Staffordshire may have had the same or less so you can see why NHS staff were cautious. You can’t be too careful. The takeaway may also have been edible and contain calories something that an unappetizing emergency sandwich may have contained if anyone could face eating it.

Compare that with the experience of some NHS patients who landed up in a private hospital as part of the waiting list initiatives a few years ago who when they said they didn’t fancy the menu (it was in French and there were no chips only pommes frites) were invited to speak to the chef to ask what they would like to eat. And they got what they wanted – before the young enthusiastic nurse was taken aside and told they were NHS patients and not to do it again.

Praise be to the Party for ensuring that British POWs were probably better fed by Red Cross Parcels in the Second World War than UK patients are fed now if they miss the slop round. Criminals in the United Kingdom get more spent on their food and spend less on their TV television than NHS patients.

POWs at least have the Geneva Convention to protect them, criminals are well served by Human Rights law,  British patients however only have Sir David and don’t forget the joke of the NHS Constitution to do the same  . . .