Up Close and Personal with the NHS.
Ms Raccoon has been back studying the NHS at close quarters. What a fascinating animal it is.
It reminds me of Windows 8 for some obscure reason – a bulk package which drains the lifeblood out of its host, but produces very little of value to you, you have to take it on faith that the rest of it is there benefitting someone somewhere who needs their ingrown toe-nail dealt with and doesn’t speak Ubantu.
Arriving at 9.30am for a 10am appointment – the waiting room was heaving, something like 50 people. Could they really be running that far behind already, or does everybody get a 10am appointment? Two receptionists heads buried in their computer screens waved vaguely in the direction of the ‘self check-in machine’ at anyone approaching them. Good idea.
I inserted my appointment letter, and the screen showed up a series of questions. ‘Have you got an NHS number’. ‘Yes’. ‘Have you lived in the UK for the past 12 months’. ‘No’. Both receptionist’s heads shot up, wearing a joint expression of horror. Presumably some sort of alarm had sounded deep in the bowels of the NHS computer. Argggh! That occupied the next half hour whilst they consulted the ‘Overseas department’ for what to do. Presumably anybody not entitled to NHS treatment would have answered that question in the affirmative and saved everybody a lot of trouble…
Having ascertained that I hadn’t been having nasty private treatment anywhere, so there was no need to call security and have me thrown out, and that in fact the NHS had been paying for my treatment in France, and no, I wasn’t pregnant (???) and yes, I had a British passport without any restrictions on it – not that they actually asked to see it – I was allowed to join the expectant throng. And advised that next time I should answer ‘Yes’ to that question. Even though the correct answer is ‘No’. OK. Or Hocquet as we say in France.
I only got this appointment with Mrs Consultant because I had figuratively thrown a cat up her skirt on Monday – as advised by the palliative care nurses who had been consulted by my GP trying to treat me for something where it would have been helpful to know the result of my last scan five weeks ago and discovering that not only did I not know the result, but neither did the GP or the palliative care team; neither apparently could ‘request the result’ – I had to call something called the ‘Patient’s Advisory and Liaison Service’; they would make the request. I had to ask for the results to be put on the ‘ICE system so everybody could see them, and according to the NICE guidelines, I was entitled to a copy too. God knows how many people it takes to change a light bulb in the NHS when it takes all these layers of bureaucracy just to find out what one person knows.
Still it had the desired effect, cat squawking beneath her petticoats, Mrs Consultant discovered that just for this one opportunity only, she wasn’t on holiday, nor off sick, nor on extended leave. It makes a pleasant change; I worry for her health, given the amount of time she has off. In the event I got a letter Tuesday afternoon informing me of this Wednesday am appointment – and sternly warned that if I failed to keep it, I was liable to be struck off her list.
A mere hour and three quarters after my appointment time, a nurse appeared in the waiting room and barked my name. She neither greeted me nor asked me to follow her, and apart from the fact that she pronounced my name correctly I have no other reason to assume that English was her first language. She never spoke another word. Since she turned on her heels and headed off down the corridor I took it upon myself to assume that I should follow. I was right.
We ended up in a small consulting room where Mrs Consultant was busy scribbling in her notebook. Ms Nurse took up position on a chair by the door staring straight ahead. There she remained, like Lot’s wife for the next seven minutes of the consultation. What is the point of her? Why isn’t she delivering a bed pan to someone, or bending over to pick something up off the floor, showing her stocking tops to enliven some old boys last few hours? What was she trained to do? What did it cost? Is Mrs Consultant on day release from a psychiatric hospital? Is Ms Nurse there to attend to her?
‘How are you’ said Mrs Consultant.
‘Looking forward to you telling me’ I said. ‘Last time I saw you in January, you said you thought I had ‘a couple of months’, but that was four months ago, so -‘doing rather well‘ – I thought’. Desperately trying to keep the sarcasm out of my voice.
‘Yes, well, that was based on your physical condition as well as the scan’ she muttered.
‘Indeed, I am very grateful to you for spotting the Thyroid problem, I was magically better within days’. (Give the woman a compliment, might improve things) ‘So, where are we now, can I see the last scan’?
‘Your last scan was when’?
‘Five weeks ago’.
‘Ah, I’m afraid I don’t have that on my system here, but the Radiologist says’…pause…long pause…’mmn’….’yes, multiple lung tumours, they have doubled in size since December’.
‘So-o-o-o’?
‘Bilateral, so surgery is out of the question’.
‘So-o-o’?
There are a number of treatment options’.
‘OK’ (Brightening somewhat)
‘I could give you chemotherapy, if you request it, a different sort to the one you had in France, but I wouldn’t recommend it’.
‘No’?
‘It has a less than 30% success rate and not many people tolerate it well, and when it does work, it is only for a matter of months’.
‘Fair enough, what are the other options’?
‘Radiotherapy, but I wouldn’t recommend it, it is unlikely to deal with all the lesions and may cause other side effects’.
‘You said three options’.
‘We could continue to monitor you, you can have another scan in three months’.
‘What would be the point of that? I left home at 7.30 this morning, it will be gone 2pm by the time I get home again – I could have been doing something useful with my time instead of sitting around here. You could have told my Doctor all that’.
‘You have the right to refuse treatment if you wish, but I must advise you’…[cut long dirge about patient’s rights].
‘I’m not refusing treatment – you’re telling me that you would advise against it’.
‘No, I’ve given you three options’ – pulls out piece of paper and laboriously writes out three headers – ‘chemo’ etc – and points them out to me with her biro. Lot’s wife continues to stare straight ahead.
‘Yes, OK, two options that you don’t recommend, on the grounds that they won’t work and will make me feel worse – and a third which consists of doing nothing but ‘monitoring me’ while you do nothing. I asked what was the point of that, its a beautiful sunny day, I can think of loads of better things to do with it than hang around here, wasting both of our time’?
‘You do have the right to refuse treatment…’. Ms Nurse got to her feet and opened door.
Now, I know some of our readers had excellent knowledge of the NHS. Can any of you tell me – does the hospital go on getting paid for ‘treating me’ when the treatment amounts to ‘do nothing’?
Does having another scan from the man in the car park in three months tick some sort of box for ‘delivering Gold standard cancer treatment in a timely manner’?
What is ‘Lot’s wife’ role in all this?
What is the point of the palliative care nurses who appeared on my doorstep within days of me being told that this was terminal (via a round trip in excess of 40 miles and involving a ferry crossing ‘cos they were too daft to figure out that if I was north of the river and they were north of the river, then a GPS directing them along a route which took them south of the river was probably wrong…) only work Monday to Friday 9am to 5pm – and they don’t actually ‘treat’ anyone, although they are all qualified nurses – their role is ‘administrative’ and so far consists of getting me to sign a ‘Do Not Resuscitate’ notice to ensure that no one gets sued for doing the wrong thing.
I don’t have a particular problem with my diagnosis, I’m reasonably grown-up. I don’t like it obviously – but I can live with it – or not – as the case may be. It is really getting to me though, how many people are involved in ‘doing nothing’, getting paid to ‘do nothing’ and making an absolute meal out of ‘doing nothing’.
I’m told that only 30% of the NHS staff are involved in ‘treating patients’, and I’m seeing a high proportion of that 30% – like Lot’s wife – whose ‘treating patients’ work seems to involve getting lost on a 20 minute journey or sitting on a chair saying and doing nothing. Does anybody know the proportion of NHS staff that are actually delivering bed pans and other useful functions?
On Wednesday, we were told that the NHS was overspent by £800 million – even taking into account the extra £900 billion that was given to them over the past year. Labour has promised them an extra £2.6 billion ‘in the first 100 days’. That won’t even allow them to stand still.
Where does it go – and why? What is the point of it all?
Ms Raccoon is off to spend the day in the garden, replanting my daff bulbs. Our friendly neighbourhood seal is sunning itself on the river bank opposite. There are so many good things to do with a day like today. I think I shall be washing my hair, or getting my toe nails painted, definitely not ‘refusing treatment’ in three months time…
I shall be back this evening to see if anyone can tell me the function of ‘Lot’s wife’.
Your starter for ten…
- Chromatistes
April 24, 2015 at 10:32 am -
It sounds as though you should be planting biennials.
- Moor Larkin
April 24, 2015 at 10:52 am -
Throwing yourself in the river and drowning seems to get them interested.
“The Ombudsman Service recommended both Trusts apologise to the woman and tell her the lessons they learned from her complaint. They were asked to submit action plans to meet their obligations under the NHS Mental Health Crisis Concordat – a set of standards patients should receive in crisis care.”
http://www.itv.com/news/anglia/2015-02-05/norfolk-drowned-author-was-let-down-by-nhs-trusts-investigations-finds/ - Joe Public
April 24, 2015 at 11:01 am -
Your self-motivation of keeping your readership amused is obviously having a positive effect on prolonging your life-unexpectancy.
” … and no, I wasn’t pregnant (???)” – at least you’re visibly the correct gender.
My 96 year-old father was last week expected to confirm the same, when signing up to a new dentist.
- windsock
April 24, 2015 at 11:15 am -
Lot’s wife is there to to learn about you and procedures and also, more likely, to protect you and the consultant if she has to examine you physically and intimately.
I have two consultants I see regularly. One is for my HIV/AIDS condition and I have been seeing him since 1990. I’m still here, so obviously he is doing something right (despite some close shaves), but for a the first part of this diagnosis, there was no treatment, except for individual infections, but not for the underlying cause, so monitoring was all he could do.
The other condition means I see another consultant every three months and have biopsies for cancer possibilities from a very -ahem – intimate part of my anatomy. Every time he examines me, he has to call a nurse in – we are on first name terms now while she stares at his hands to make sure I’m not being assaulted.
It’s daft – I trust him completely, but, you see if the NHS didn’t protect it’s staff and patients this way, all sorts of allegations could be made (and have been, by various patients in other departments). Part of our litigation society these days, Anna. It’s probably cheaper to hire watch nurses than pay off settlements in or out of court.
As for your consultant, she is probably doing her best within an inefficient system (I could tell you a few stories when I have got downright stroppy because of it), and at least she has been honest enough to tell you the possible consequences of treatment options, instead of pushing you into one or the other.
Enjoy your day. Daffodils and a good lunch are probably better options for you today!
- FrankC
April 24, 2015 at 10:04 pm -
Anna, the three options your consultant offered :- chemo, radio or nothing, and basically recommending nothing, are probably what she would think were she in your position, and being medically trained would go for option 3. I’ve read that doctors in general don’t want to go the chemo or radio route since they’ve seen the progress or lack of it in their patients.
- FrankC
- Ancient+Tattered Airman
April 24, 2015 at 11:27 am -
A brilliant piece Anna. You are an inspiration to us all. Continue to confound the critics (and the NHS!). I send my love as I’m sure all your devoted readers will, as you are the dear friend we have never actually met.
- Frankie
April 24, 2015 at 7:38 pm -
It seems to me that the NHS is very like the lucky dip tub that one used to get at kids parties… Some of it is berilliant. The rest, well… it is said that it is impossible to polish a turd.
You get massively constrasting staff as well. Some are brilliant, others you would not pay in washers. Our local hospital is a case in point. Terrible reputation. Go twenty miles away and the same NHS can provide a fabulous hospital with well motivated staff. Go figure.
Would it not be a good idea to get a second opinion – like from a Consultant that actually cares? We need La Raccoon in the present, not the hereafter…
- Frankie
- Binao
April 24, 2015 at 11:28 am -
Sad to hear of your experience of the nhs, Anna.
It sounds very much like the experience my late wife had when exposed to the nhs; 15 years of private treatment, but when this was done in an nhs hospital there seemed to be a determination to be unpleasant (at one particular hospital). Treatment at another NHS hospital for other problems and my own treatment too seemed disorganised, with little disengagement with the patient, & poor housekeeping.
But that was four years ago. My local hospital has been transformed. Over the past two years I’ve had a lot of visits, the odd stay, & I was helping a friend with his visits too. Most of mine were Cardiac, & last November I was bluelighted in to A & E, followed by an overnight in AMU. The difference with four years ago is staggering; meticulous cleanliness, courtesy, care, engagement, a feeling that the place is efficient & staff go the extra mile. And no, I didn’t wait long in A & E, minutes only, or wait for a bed in AMU. When I’ve an appointment I get seen on time, arriving early sometimes means being seen early too.
OK. One hospital, but it is quite big. My experience has been mostly Cardiac & Outpatients. The point is though that it can be done and I reckon it’s a damn sight better place to work in too. Not a sign of negativity.
Somebody knows how to do the job.- Wigner’s Friend
April 24, 2015 at 4:09 pm -
“Somebody knows how to do the job” Obviously it won’t be long before somebody else important in the NHS gets him/her thrown out for failing to toe the union line.
- Wigner’s Friend
- macheath
April 24, 2015 at 11:34 am -
Re Lot’s wife
A friend had a scan done over some baffling but apparently minor symptoms; she then received a bald summons to the hospital – no further details – and was ushered into a room where, standing beside the consultant, was a large woman with a conspicuous badge pinned to her chest saying ‘Cancer Support Nurse’.
That was how my friend found out – entirely unexpectedly – that she had cancer. The nurse stood there in impassive silence – “Like an Easter Island statue” – throughout the interview and my friend, being somewhat preoccupied, didn’t think to ask about her role. However, someone she later met during treatment told her that, in that hospital at least, nurses are instructed to ‘sit in’ on all such serious consultations.
Though the ‘support ‘ badge suggests they are there to deal with a possible panic attack or severe emotional reaction, my friend reports that consensus among those on the receiving end of hospital bureaucracy is that they are actually present to intervene if the patient goes for the Consultant’s jugular. Clearly the NHS was taking no chances with a determined Raccoon.
- The Slog
April 24, 2015 at 11:49 am -
The NHS remains the victim of several things: jobs for the boys and girls (TUC white collar), lawyers and pc (Everyone’s a pervert and someone is to blame), political tribalism (Brown bollocks and Hunt bollocks), Whitehall imperialism (procedures must be monitored), IT (things go better with software, except when they don’t) and above all the gargantuan size of The Thing.
Nye Bevan’s original concept was for a network of local organisations to which an enormous amount of power would be delegated. We could still do this and mutualise each unit….thus keeping the good things about the NHS safe from the US insurance industry and the Westminster/Whitehall axis of football and crowd creation…and fire 80% of the “administrators”.
Either way, I long ago reached the conclusion that Ms Raccoon is the blogging equivalent of Japanese hogweed for all those opposed to common sense: she is indefatigable. Only silver bullets and a stake through the heart will ever do for her.
Hurrah!
- Henry the Horse
April 24, 2015 at 2:53 pm -
It still costs less than any comparable system.
- Peter Raite
April 24, 2015 at 4:58 pm -
This is true. On average Americans pay more in private health insurance and tax (the later paying for – until recently – the meagre public healthcare provision that most of the taxpayers couldn’t access), than we do for the NHS through National Insurance.
- Peter Raite
- CF
April 24, 2015 at 4:13 pm -
Originally, however, they worked on the basis that the service would cost *less* in time, because of course everyone would be healthier!
(Most of that was achieved by vaccination and other public health measures, and by antibiotics.)
Even before its official launch they had been disabused of this notion, because the cost projections were already worrying.
I don’t think it’s ever not been in a funding crisis, nor has it failed to devour any money allocated to it.
There was a great 1973 film with Lynn Redgrave “The National Health” that contrasted a US-style Dr Kildare fantasy with the reality of the then NHS.
Our local hospital is fine, but despite a huge IT spend during the Blair years, records, results and prescriptions continue in paper form to an astonishing degree, results don’t seem to be available when needed by the next person, and it is far from a modern experience.- Joe Public
April 24, 2015 at 6:25 pm -
” … they worked on the basis that the service would cost *less* in time, because of course everyone would be healthier!”
So who forgot to factor-in the escalated costs of greater number of survivors’ extended life-expectancy?
- Michael Adams
April 25, 2015 at 3:48 pm -
Life expectancy has NOT been increased by the NHS, so, no worries there. The average appears to be higher than in the partially free market USA, but that’s because of the difference in counting live births. The Americans count every baby who attempts to draw a breath as born alive, although an unfortunate number of such babies die in the first couple of weeks, in spite of all that advanced neonatology can do. These dead babies pull down the average. Many of us Geezer-trainees suspect that one reason for Obamacare is to shorten life span, eliminating the need for a lot of care for the old farts, and reducing the cost of Social Security payments.
- Michael Adams
- Joe Public
- Henry the Horse
- Rightwinggit
April 24, 2015 at 12:15 pm -
Windows eight?
I was thinking more of Windows M.E…
(Shudder)
- Moor Larkin
April 24, 2015 at 12:25 pm -
Windows ME? Is that the one where your computer is tired and listless but nobody can find any virus that might be the cause?
- Moor Larkin
- the moon is a balloon
April 24, 2015 at 12:30 pm -
It is all mad. Or maybe it just the new religion. Thou shalt spend more on the NHS is the new First Commandment, a tenet of faith rather than anything to do with medicine free at the point-of-use. If you don’t agree, you must be one of Those – naysayers, barbarians, swivel-eyed loons.
Inventing ways to spend all the cash must be a problem. But imagine being the Easter Island nurse. After how many hours or days would you become just like her? There must be tens of thousands of the poor sods chained to their mortgages, their iPhone contracts and therefore to their pretend jobs and salaries.
- Moor Larkin
April 24, 2015 at 1:13 pm -
Nobody’s irreplaceable…
http://notmytribe.com/2008/capitalist-medicine-and-the-turn-to-robotics-85009.html - Mudplugger
April 24, 2015 at 1:19 pm -
True – the only objective measurement of the NHS on which the politicos seem to agree is merely to count the amount of money spent on it, a public services principle enshrined by one G Brown Esq, late of the Downing Street parish.
Count the input, claim it’s a success, and forget the output (apart from ‘plastic job’ creation and mass immigration justification, of course). Trouble is, there’s more of it to come.- AndyM
April 24, 2015 at 1:49 pm -
Remember, that money wasn’t “spent”, it was “invested”.
As to Lot’s wife, rather than spend money on – oops, I mean invest in – training a nurse, if it’s for protecting the consultant why not employ security at presumably lower rates.
- AndyM
- Henry the Horse
April 24, 2015 at 2:55 pm -
There is no earthly possibility that the need for healthcare expenditure does not constantly increase in current circumstances. We have a population that is continually ageing and continuously proliferating treatments, many of them extremely expensive drugs. You can keep spending the same but that means telling many people that the drugs that will keep them alive cost too much or the care they need is not available.
- Moor Larkin
- James Sykes
April 24, 2015 at 1:49 pm -
Makes you proud to be British, envy of the world, apparently, what world in particular, I have no idea. Things can only get better, apparently.
- Joe Public
April 24, 2015 at 6:27 pm -
3rd?
- Joe Public
- Clarissa
April 24, 2015 at 2:05 pm -
£900 billion? I know our beloved (ahem) NHS is a money sink but that’s (presently) more the State spends in a single year in total.
- Henry the Horse
April 24, 2015 at 2:51 pm -
Stupid and frustrating but all born because someone’s notes got passed to the wrong person at some stage and the aggrieved patient(s) complained. I guess the aim is to make sure that you don’t suddenly find yourself with you GP telling you something unexpected.
I still doubt private healthcare would be any better. They might be a lot nicer (perhaps) but they will find even more reasons for you to come in and see them when their income depends on it. Certainly that has been my experience of living abroad.
- Carol42
April 24, 2015 at 3:03 pm -
My consultation after my scan last year was the first time there was a nurse present since I was given the Cancer dx, I immediately assumed the worst but no, it seems there now has to be a nurse present now. She didn’t say much but was very nice and smiled a lot. TrIcky one about your options, personally I would opt to do nothing as I have seen too many who suffered dreadfully with treatment and it ruined their last months on the other hand I have also seen some amazing successes when it seemed all was lost, usually from trials, have they suggested any? I can’t really complain about the treatment I have had, no long waits or delays, only good thing I have found with Cancer is they really check you out if there is anything at all wrong. I have a problem with a blocked salivary gland and when I mentioned it I got an immediate referral, the consultant not concerned but ordered two non urgent checks to treat it and both were carried out very quickly. I had to laugh about the car park scan that’s where I had mt PET scans too. Glad to hear you are enjoyable no your garden , stay well and keep posting.
- Daft Lassie
April 24, 2015 at 3:25 pm -
Some medics were famous for their lack of bedside manner, but were nevertheless good at diagnosis and treatment. This character has made its way into fiction, most recently with Doc Martin. What you don’t want is the miserable condescending sod who isn’t any good at the job, or the cheery, matey, pleasant character with the same defect even if the latter is slightly easier to bear. I sympathise with Ms Raccoon in her predicament, and there are probably a million similar stories that could be aired.
One of the problems that causes those packed waiting rooms is the issue of public transport. I drive to my hospital appointments, and moan about the lack of spaces and the rip-off prices. The unfortunates who have to go by bus have to deal with the vagaries of the timetable. It isn’t just getting there, it’s also going home. The waiting room may be the only place with seats in which to pass the time.
- Wiggia
April 24, 2015 at 3:52 pm -
A few years ago arriving tired after a long journey at our hotel in France, I put on the TV few awhile before going to have a meal, there was a hospital “soap” on and I laughingly turned to the wife and said they must on a shoestring as they cant’ afford actors, the hospital scenes showing side wards with a single bed a hardly any staff.
Later that evening the news came on and the main local news was a nasty multiple car crash, the cameras were at the hospital interviewing survivors, and guess what, the scene on the wards was the same as the fictiononal soap.
Here as Anna puts so well the way it is run has to change the French model and others do show a better way and the insurance factor part of it for all the reasons given.
WHere I am now in Norwich the hospital has in fairness been very good over the last couple of years we have been here, no waiting of any significance at the appointed , good staff, and no complaints on the service, how long that will last who knows as it seems to be working flat out in all depts.
The hospital is not the problem it is our surgery, never having had a problem with multiple surgeries (move a lot) it is a stark reminder that now we have a surgery as bad as those you only read about before, why I have no idea, but the fact that it has the same amount of doctors as my last with twice the amount of patients is obviously a factor and of those half are part time ? - Bill Sticker
April 24, 2015 at 3:58 pm -
Ah, more tales of the ‘wonderful’ NHS. The ‘Best in the world’. Never mind the care, feel the bureaucracy. Rather gives a new terror to being ill in the brave new UK. Clucking bell.
So, Anna. Radiotherapy and Chemotherapy are out. ‘Traditional’ NHS treatment options therefore seem a bit limited. May I, with my albeit truncated medical training, offer an alternative; Fresh air, sunshine (Rare but possible in the UK), gentle exercise, plenty of builders tea, more protein in the diet, (Steak rather than chicken), and the occasional large glass of Cabernet Sauvignon. Smoke ’em if you want (at this stage of the game, does it matter?). Focus on what is important to you. Keep writing and simply don’t give up on that which you love.
You might not live that much longer, but at least it’s a whole lot better than another miserable bout of cell killing drugs or ‘frying tonight’ as I once heard Radiotherapy referred to by an old school (1980’s) Consultant. Good luck.
- Peter Raite
April 24, 2015 at 4:51 pm -
The hospital would certainly get paid signifcantly more for actively treating you (i.e. chemo or radiotherapy) than for not doing so.
I can see from your perspective that it takes a lot of people to do not much for you, but generally those same people will be involved in the care of others for whom they are doing something, on a sliding scale of “a bit” through to “a great deal.” I think a lot of the problem is that most people, for example, would actually rather hear what the current state of play is from a doctor – and on a face-to-face basis – rather than a nurse, or even some lowly admin worker.
NHS Staff Census figures are here:
- Engineer
April 24, 2015 at 6:33 pm -
The current Health budget is about £120 billion a year. Some of that is for central admin and for such things as Public Health laboratories, but the bulk – let’s say about £100 billion – is spent on the NHS. There are about 62 million people in the country, so that works out at about £1600 a year for every person in the country. If you had to pay £1600 a year in health insurance for each member of your family, would you be satisfied with the standard of service the NHS provides? I’m not sure I would be….
- Moor Larkin
April 24, 2015 at 7:04 pm -
If the £120B figure is correct, then £30B is set aside for Litigation, so straight away you’ve only got £90B left…
http://www.telegraph.co.uk/news/health/news/11402075/NHS-sets-aside-quarter-of-its-budget-for-medical-negligence-claims.html
See how it gets cheaper and cheaper all the time?…..
I imagine it really only only costs us about a fiver in the end for the actual ‘health’ bit, so what a bargain we’re getting!!
Blessed are they who toil to make us feel so well.- Newmark
April 25, 2015 at 3:35 pm -
“If the £120B figure is correct, then £30B is set aside for Litigation, so straight away you’ve only got £90B left …”
I can’t see why they need to set aside £30bn for litigation, since they paid out only £1.3bn on medical negligence claims last year. That made only a small dent in the NHS budget – about 1%.
- Moor Larkin
April 25, 2015 at 7:11 pm -
The law firms in the Savile case so far seem on a 5X fees multiple. They are on £16k per claim, the only NHS claimant so far got £3K. That puts you up to £7B without anything fundamental changing. Given that we are regularly being told that claims post-Savilisation have shot up exponentially, then there is another chunk-a-money, and don’t forget we have an NHS dept solely existing to deal with litigation. It’s only to be expeted that they will need many more resources to deal with the exponential rise in claims fostered by the Savile NHS Reports, which have been overseen by Kate Lampard who commented herself thus: “”Much of the story of Savile […] is unusual to the point of being scarecely credible.” or in non-lawyer-speak: “Money for old rope.” and in lawyer-speak: “Free drinks at the Bar”
- Moor Larkin
- Newmark
- Moor Larkin
- Bellevue
April 24, 2015 at 7:17 pm -
My husband and I pay over 200 euros a month for our health insurance in France.
But it is worth every penny…… we have certainly had our money’s worth in the last 18 years. He has had cancer, twice; and now congestive heart failure. Exemplary treatment throughout.Trouble is, he is a retired NHS GP (left the NHS 20 odd years’ ago, so is not really aware of how things have changed!) and still thinks the sun rises and sets on the NHS.
Whereas, as a mere patient, I can see that the french system is soooooo much better. - AdrianS
April 24, 2015 at 9:08 pm -
A virtual glass of wine for you Anna to try and keep you in good cheer.
I greatly admire your courage and spirit in the face of adversity in a battle you can’t win.
I’m sure writing the blog helps in so many ways and helps keep us punters amused.
My thoughts are with you - Lysistrata Eleftheria
April 24, 2015 at 11:49 pm -
Hi Anna
Sorry I’m late reading and therefore replying to this – at length – today. Hmm. Shabby and wasteful treatment of you. I’m so sorry. It conflicts so much with my own NHS treatment up here in a backwater of West Yorkshire, which has been timely and exemplary.
I too, after the ‘incurable’ diagnosis, was allocated a consultant and given the same choice of chemo, and/or radiotherapy, and ‘wait and see’. Along with ample pain relief and steroids to build up my strength. Oh, and a team of 3 specialist lung cancer nurses with phone numbers, all of whom have been excellent. The consultant is one of a team based at the Oncology Centre at St. James’, Leeds, and they run satellite clinics and chemotherapy units both there and at local hospitals, which means mine is only 10 mins drive away at most.
Unlike you, I was given the choice in a compassionate and informed way, with plenty of time to ask questions, and to think, and to come back with my answers. I was also told that without treatment, on average I woud have about 9 months (that would have been last October). I opted for radiotherapy first, which completely cleared my spinal mets and left me virtually painfree and walking properly for the first time for months. Then for chemo, which reduced the original lung tumour to a quarter of its size and remained stable for a further 10 months. When it started to grow slowly again, they started a different type of chemo, which I’m in the middle of and has also knocked the tumour back. That should last a good few months. Then after that, there’s a daily tablet called Tarceva which prolongs active good quality life. And my consultant is also part of a research team, and has just enrolled me on the international Matrix Trial*, which is targetting new cutting edge drugs at 21 currently identified cell mutations. There are no placebo controls in this trial, we all get treatments.
This is all on the NHS.
I once had to wait an hour for a scan because one of their eleven working indoor state-of-the-art machines had broken (they in fact have twelve machines but rotate a permanent maintenance schedule) and they wanted to fit us all in on our booked day. X-ray and blood tests are virtually on demand, and are available instantly on the hospital and its satellites’ intranet system.
I do know from being a member of a cancer patients’ forum that my experience is not unique. Nor, sadly, is yours, Anna. It seems to me that money is not the overriding solution to good treatment; rather it seems to lie with good management and ethical leadership and staff who value their job and their patients.
If it can work well in one NHS geographical area, why not in others? I don’t live in a particularly affluent area, nor is it one that because of deprivation attracts extra funding.I’ll shut up now as this is a loser length post and I’ve said much of this before. Of course, I wish you all the best and may you be as well as you possibly can be, and may you enjoy every day of this glorious spring which they said you wouldn’t live to see.
Warmest regards, Lysistrata
* Being recruited to The Matrix Trial does not, disappointing as it is to Mr L, involve my wearing a long black coat and shades, walking upside down on ceilings, and learning how to fight and shape shift in slow motion.
- binao
April 25, 2015 at 7:49 am -
Something I forgot to mention about my transformed nearest nhs hospital- when I needed regular INR blood tests I could walk in off the street in the morning, no appointment needed, the result & advised medication level emailed to me at lunchtime.
I don’t know if that’s the norm but I think it’s fine.
And I have parked, walked in, blood taken, & back out within the ‘free’ (nhs car park) parking time. Mind you, a little later there are no spaces to get in to, but that’s a different thing. That 15 minutes or so is to exit free if no space can be found. - Jonathan King
April 25, 2015 at 9:24 am -
I’m in love with Lot’s Wife – I’ve been looking for a woman like that for 70 years. Incidentally, fellow drinkers, the Landlady and I have a deal we’re celebrating my 80th birthday together in 10 years time. She’s accepted my advice (“talk to your body; it’s far better than the NHS or any other medical expert”).
- Gloria Smudd
April 25, 2015 at 12:48 pm -
http://www.nice.org.uk/guidance/cg138/chapter/guidance
Section 1.5.9 : Offer the patient copies of letters between healthcare professionals. These should be in a form that is accessible to the patient and if possible use language that they will understand. Answer any questions the patient may have about these.
…
Make sure you ask to receive copies of clinical letters (every patient should be offered the option anyway). - Ms Mildred
April 25, 2015 at 1:32 pm -
We had a great kindness done by the eye consultant to have preop assessment tacked on to the end of an early morning fast user friendly consultation. We got part way through and found there were over 100 in the blood test Q ahead of our ticket and an ECG to be done as well. We opted to be sent the forms when the op date given and attend then. We were told the op date by phone but sent a letter to present at the desk for an assessment. No forms in the letter.
Innocently thinking all would be well we knocked at a door indicated. We were very rudely told we were too early and not to think we could jump the queue!!!!!! We were ordered by a gorgon in a blue meanie frock AKA as a nasty sister, to go to the waiting room and not to argue. We waited another one and three quarter hours more before I demanded to be listened to. The notes of our previous visit found. Forms for 2 tests handed overAnother 2 hours wait . A visit to have a moan at PALS.
. - Mike
April 25, 2015 at 3:58 pm -
The actual clinical bit of the NHS, particularly on the emergency side is OK. The problems come in the way that it is managed and administered. Everything is targets, that is process not outputs. 90% of patients must be out of A & E in four hours or some such. Result? Many hospitals have a senior and experienced nurse whose sole job is to make certain nobody ‘breaches’ . Next result, if in doubt, admit the patient to the Medical or Surgical assessment unit. No targets there. Result? patients can wait days to be assessed.
paper work. Everybody has to do paperwork, filling in computerised forms to collect data. Doctors, especially junior ones can spend 30% of their time doing, ditto nurses. They all feed the machine that requires more and more data.
Central management. Everything come from the centre. A new initiative is ordered on the use of say soft loo paper, it has to be complied with. That means that a hospital has to have a soft loo paper implementation officer, in an office with secretarial support etc etc, funded from the hospitals existing budget. Said officer produces more reams of paper (reading) and more computer returns, holds meetings and produces directives. Its no good a hospital saying we already use soft loo paper, orders are orders, they have to have a soft loo paper implementation officer.
Nursing. We used to have SRN nurses, three year course and SEN two year course, less academic, more hands on. The came ‘Project 2000’. SEN was binned and the new training was heavily academic aimed at making all nurses graduates (I know of one course that included a module on witchcraft). However, in the old days, student nurses were paid a salary because they actually worked on the wards for around 30 weeks a year. Now they do much less time on the ward, but still get paid. Good way to get a BSc. Then they all want to be specialists or best of all nurse consultants. Not surprising that the motivational levels towards actual nursing are not as high as they might be. Oh and who gets to actually run around with bed pans that SENs used to do? Unqualified and minimally trained Health Care Assistants. One Nursing Director told me that she was competing with Tesco’s for staff.
Anna, anything you recognise? - binao
April 25, 2015 at 7:57 pm -
Lot’s wife.
Thinking back there was one of these at the Nuffield Hospital my dear late wife transferred her treatment to for her last three years, finding private care in the nhs provided with inefficiency & offensiveness.
This Lot’s wife was a tall head girl of a Macmillan nurse. She seemed to be a force. Seeing a struggle to find a vein after years of treatment on & off, ‘you need a port’ she said; within three days, it was done. You might need this, she said & provided the Oromorphine. She was there when the crap ‘nothing more we can do’ conversation took place with the super oncologist. She called me to say if things get bad don’t let her go into hospital, it’s not a nice place to die. And after, she called to say be very careful, a lot of men remarry quickly, the women don’t.
No she wasn’t nhs, but she was a nice person. - Ted Treen
April 26, 2015 at 6:10 pm -
We are told – nay, indoctrinated – that the NHS is the best in the world, in much the same way that the poor unfortunates resident in the DPRK are told that they have nothing to envy, and their dear leader performed complex surgery aged 4, invented the jet engine aged 5, walked on water aged 6, etc., etc…
- Rob J
April 26, 2015 at 8:27 pm -
Speaking for myself, the NHS saved my life 5 years ago when I had a heart attack. I was in the cath lab within about half an hour having stents fitted and the whole process was rapid and impressive. Out-patients is a pain but tolerable.
When I worked in the NHS the problem was endless government initiatives and targets, which seemed to be the main reason for the growth of middle management administering it all. In fact clinical staff would get dragged into the admin, having to sit on various groups to implement the stuff. - DtP
April 26, 2015 at 10:36 pm -
Ta Pet
The fuck do I know of emojis? You have taught me to temper anger into humility. My heart adores you. If only there was apathy.inc un-elections not occurring.
They do seeem animated…
Taught me to think and taught me to care about stuff.
Cheers!
DtP
- Ed P
April 27, 2015 at 1:52 pm -
Just back from the USA, where I experienced their healthcare – all the latest gizmos and no cost spared, but only if the patient’s insurance covers it. If not, there’s a quite poor safety net.
Anna, I remember you said before that in France notes, test results, etc. are retained by the patient. As our dysfunctional NHS seems able to misplace most records, including large X-rays, I think it’s time it grew up and adopted the sensible French system.
- Lysistrata Eleftheria
April 27, 2015 at 4:30 pm -
@Ed P, yes, same in Greece where I lived for 10 years – the patient retains all their own records, which works wonderfully.
A couple of people who termed themselves “British expats” (oh no, not immigrants, not them…you know the sort) thought it was a stupid idea, what if you lost them? To which the only possible reply is that it would be your own bloody fault then, wouldn’t it?
And if the records are those of a child or wanderly person? Well then it’s the family’s responsibility or failing that – rare – the local municipality will make arrangements.
- Lysistrata Eleftheria
- Paul Widdecombe
April 27, 2015 at 6:34 pm -
Clicking on the first result from the following Google search will tell you everything you need to know about Lot’s wife’s essential function:
https://www.google.co.uk/#q=nhs+pillarcare - IlovetheBBC
April 28, 2015 at 9:21 am -
Sorry to hear you had such a ghastly time at the N&N Anna. And pretty incensed that they seem to be trying to cover their own inability to help you further by claiming you are refusing treatment! I don’t think these people have yet quite realised who they are dealing with, or they wouldn’t have made such an elementary mistake.
- Grandpa1940
May 3, 2015 at 11:36 pm -
I’m due to have a scan at some strange, indeterminate time in the future, for what I, nor the GP, seems to even guess.
But my problem is with the support network which is supposed to look after dependants.
https://mikecunningham.wordpress.com/2015/05/03/what-comes-for-us-all/
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