Wednesday, 26 October 2011

National Self Service

Here's little tale of one person's interaction with the NHS -  mine.
  • Went to optician (which strangely enough isn't free at the point of use) for an eye test.
  • Referred by optician to my GP
  • Received a letter asking me to make an appointment at an eye clinic. Instructions contained online booking instructions.
  • I go online and fill in all the fields on the online booking system... only to be told at the end of all that that this particular clinic doesn't take online bookings and I need to call them direct.
  • I call clinic and they tell me in order to make an appointment they need to pre-register my request for an appointment and that I need to call call back in a week's time to actually book it. We arrange the day for me to ring.
  • A few days later I get sent a letter telling me that they don't deal with my condition after all and I'm being referred to a clinic in High Wycombe.
  • Clinic in High Wycombe sends me online booking details, login ID and password... for a woman who lives in High Wycombe!
  • I get sent new instructions to make an online booking using my original login details.
  • When I log on to the website and put in my details I'm told that the login has expired.
  • I go back to my GP who re-refers me.
  • I get sent new login details.
  • I book an appointment for Monday 24th at RBH.
  • A week later I get sent two identical first class letters telling me that my appointment for the Monday has been cancelled and it has been moved by them to Friday 28th.
Phew! It was a bit of a marathon and it took over a year but I got there... or did I?

Today I get letter from the RBH eye clinic telling me that I have another appointment next Tuesday at less than a week's notice. Identical letters were sent by first class post - to be sure, to be sure.

However, unlike the previous notification there is no letter telling me that the Friday appointment has been cancelled. Do I assume that Friday's appointment has been cancelled? I have no indication that it has been. This means that I will have to ring them to confirm it is actually a change of date rather than a referral appointment. If I'd booked a day off work to make Friday's appointment and unable to change it to next Tuesday I'd be screwed. So much for putting the patient first.

I know of one constituent who has been denied a hip replacement because she is "too young" to qualify, she is in constant pain can't walk far and would get a longer term benefit from any operation done now and require less prescription drugs. It's nuts even for a cost-benefit analysis nut.

The one common denominator in this. Our GP. At no point have we been let down by him. He knows what the patient requires and the process works well up until that point. It's when "the system" takes over and starts rationing care and resources without focusing on the patient and outcomes that things start going wrong. Basically, I trust my GP to look after my health and to know what's best. I do not trust Trust managers who are bean counters who can only count human-beans

If you believe Labour, they left the NHS a perfect system, state owned and free at the point of use. Stop laughing at the back.

We have an expensive online booking system that may as well not exist. Hospitals owned by private companies under expensive PFI contracts. Many of the services already contracted out by Labour. Their market system forcing PCTs to stop services and close wards. A £20bn cost for a failed IT system that one of the consortium consultants was sacked for having the temerity to tell Labour that it would never work. I'm sure you can find other websites detailing all their "successes".

They left a shambles. Whether promised or not, something has to change. The current structure is clearly not fit for purpose and for all the good things it does, it has its fair share of failure which affect real people.

I'm a big believer in the NHS and the core principle behind it - health care free at the point of use. I refused to join my previous company's health plan because I felt that we would all be better off it they paid more in National Insurance than private health plan subscriptions but for Labour to continue the fiction that the coalition government inherited a system that in places isn't verging on a basket case is disreputable.

However, clearly the Conservative remodelling went too far. You have to watch these Tories like a hawk or before you know it a new NHS baby-eating unit will be opened. It's why I'm pleased to see Nick creating his Signal Passed at Danger team. We spotted this one just in time and have made significant changes to the original proposals and clearly our team in the Lords will be making more changes to ensure that the Tories don't acheive the same objectives of their baby-eating units by simply replacing them with baby-out-with-the-bath-water units. It's why Lib Dems in Government are important. Labour had 13 years of "understanding" ordinary people and failed them at almost every level imaginable. It's up to us to prove that unlike the other two parties we are on your side.

I certainly have more faith in Dame Shirley William's making amendments to the health bill in the Lords than in any amount of Labour health ministers suckered by consultants selling them snake oil.


Jonathan said...

The interesting thing is that the one bit of the NHS that actually works, your GP, is actually a private contractor who provides services to the NHS. You are free to leave him and go to another GP, and if you do, he loses the funding he gets for having you as a patient. It has always been that way ever since the NHS was first set up.

When ever anyone proposes that secondary care should be done on a similar basis, lots of people complain and say it will make patient care worse. Why?

Was said...

I've never understood that either.

The crucial tests for me are funded from national taxation not personal or company insurance, free at the point of use and to each according to clinical need.

So much has been privatised so far that any scaremongering talk of creeping privatisation has to be laughed at. It was happening under Labour with no complaint from the unions. After all if they really did object they only had to withdraw Labour party funding to get their way.

Personally I think a GP driven NHS would actually protect local hospital services. It's in their interests to have excellent local services.


Clearly a lack of vision.

Was said...

Fair point Gideon. I am now on the waiting list for surgery.