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’.
‘Bilateral, so surgery is out of the question’.
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’.
‘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…