Tuesday, 10 January 2017

A humanitarian crisis in the NHS? Surely some mishtake

Frissons of incredulity spread the chattering classes this week when the British Red Cross suggested parts of the NHS were in such a Godawful mess the situation could be described as an humanitarian crisis. Compared to the crisis in Syria this probably something of an exaggeration, but we are talking about one of the world's wealthiest countries (at present at least; watch this space for updates) where patients are indeed being subjected to some appalling abuses: being kept on trolleys in corridors for up to 36 hours, waiting times for ambulances going from the ideal of 8 minutes to more like 40, A and E departments overwhelmed by patients waiting far beyond the target of 4 hours. The list is long, and deeply depressing for a country like ours whose NHS used to be the envy of the world. No longer. The health services of France, Germany, the Nordic countries to name just a few far outstrip ours in terms of the quality of service, and the situation is worsening by the day.
          Three years ago I stopped being a provider of health care to a consumer of same, just another NHS punter you might say. And I soon began to learn what has been common knowledge amongst the general public for a long time: it's hard to get to see your G.P. In my practice my wife and I have, along with a considerable number of other people, adopted the practice of waiting outside the surgery from about 7.30 in the morning (and there are usually half a dozen who are already there waiting) and wait until the doors open at 8 am. That way you are (almost) guaranteed to get a slot that day. Don't bother trying to phone when the lines open at 8. They are continuously engaged at least until 8.15, by which time the appointments have already been allocated. Getting advance appointments is no easier. But, we have both wondered, what if you are too old or infirm, or plain ill, to wait outside in the cold and rain for upwards of half an hour? Ask for a house call. Gimme a break. You need to be seriously incapacitated to warrant one of those. And I mean seriously.
          I used to be scathing about people who took their non-urgent or relatively trivial complaints to A and E departments. Not any more. Now I can see that it is really a response to the near-impossibility of getting in to see your GP that has caused this fundamental shift in the way health care is provided.
          I blame the G.Ps themselves, for not opening up more slots (we used to have appointments for 18 patients per doctor per surgery; the practice I attend allows only 15), and successive governments for being slow to react to this growing crisis. Immigration is part of the problem, because often they arrive with a range of complex and hitherto unaddressed maladies to contend with, but it is only a small part. A far larger part is the failure of the systems designed to provide health care strategies to see what's happening in front of their noses and acting accordingly. Shame on them!

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