Soapbox… part 2

Firstly- thanks to everyone that commented; It’s nice when people get all responsive.  Having read them- I do understand where a number of you are coming from.  Here are my continued musings on the topic….

In a conversation over lunch at the weekend, my mother pointed out the problems that people have getting to their GP especially, like has been said, for long term illness.  My views are probably very biased in that I have been fortunate enough to have GPs where you can still book appointments in advance, and those in my acquaintance who have to see their GP regularly are lucky enough to work for companies that allow them the time off…

We’re getting into territory about which I know very little, but lets go there anyway- Why should the NHS take the economic fall for other businesses? When I mentioned before about long term illness, I didn’t actually mean using holiday time- I meant using sick time, which is different. I appreciate this would be very hard for small businesses and people who are self-employed, but surely it should be mandate that people are allowed time off work for health problems, no matter what those problems are. Is it not already?

As I said, I’ve been very lucky- at my GP practice you can ring up on the day, and you can book in advance. They even have evening appointments.  Which makes me wonder why this is not possible everywhere…

I really feel that the general public should in some ways feel at least slightly accountable when it comes to using the national health, which was really the fire behind the last entry I posted.   Perhaps there should be some sort of education in how to use the NHS; I’m guessing anyone posting here is unlikely to be the kind of person who rings an ambulance because they have a headache, and no, they haven’t tried taking paracetamol to make it better…
That sort of this happens all the time and although I couldn’t actually find how much that is costing the taxpayer, it’s pretty depressing. 

It’s not that I don’t think General Practice provision could get better, or be better organised, or that it shouldn’t change…. I do however think that there would be better ways of achieving this than the general bitching that seems to go on in the press on how rubbish the hours of service are- because it’s about more than that. 

Thoughts?

Medicgirl xxx

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5 Responses to “Soapbox… part 2”

  1. no one Says:

    a simple 1st step would be to allow patients to genuinely go to any GP they liked anywhere

    the current system where a PCT can impose only 2 or 3 GPs to choose from (based on your home address) encourages the lazier GPs

    like much of the rest of the NHS the system fails to recognise that many of the working popultation live a very mobile flexible lifestyle, moving constantly from one project at work to another, one job to another, one part of the country to another.

    GPs need some real competition to drive up standards, and that for me means only getting paid when they actually see people. Getting paid to have people on your “list” while making it very hard to make a real appointment should not be rewarded.

    GPs and the patients need to be treated like Pavlovs dogs, and trained to up their game, and constantly improve, by putting in systems which support more realistic approaches

  2. Bendygirl Says:

    I think no one thinks it’s all about market forces to effect change (or at least that’s how it’s come over to me) but I take a more holistic view. I think as you touch on education is key, we’re spoilt by having such a good (even though it has many problems) health and welfare system and so take it forgranted and many abuse it not realising what it would be like to have nothing or a totally private system.
    I think people don’t seem to know how to self care and self diagnose these days, though only in my very early 30’s I was taught as a child how to recognise and treat at home common illnesses and injuries. We all knew the difference between mumps, measles, chicken pox, colds, flu etc and when it was and wasn’t appropriate to see a GP, all of which seems to have now gone. I think educating from primary level onwards in basic first aid, home medical knowledge etc would improve the situation in terms of inappropriate attendance through ignorance.

    Time off to attend medical appointments isn’t as far as I know mandatory, or certainly wasn’t when I lost my job (within the NHS as admin) for health reasons, ie too much time off around 3 years ago. Sick time is finite for everyone, and has to be or would be too great a burden on employers. I think this is where organisation becomes important, there needs to be perhaps a different kind of protection for those with chronic conditions who despite what those making policy on welfare benefits think are actually ill with unstable conditions making collaboration between employer, benefits and health vital as there are better ways of managing than we currently have.

    I personally don’t think the hours of service for GP’s are rubbish, but I have an excellent GP (although I previously had appalling to the point of negligent GP’s) and I don’t think that’s what needs sorting out. OOH care is a problem, but should be only for emergencies. I can phone on the day or pre book at my GP, but even so with a chronic condition I could not work and manage to order and collect medications each month (just posted about that issue) attend consultant reviews, phyiso (when lucky enough to get it) and various other appointments as well as cope day to day without any support since social services slashed that, it’s all too time consuming, tiring and difficult before factoring in the time off I’d then have for more major dislocations, flare ups and illnesses. It makes me (and all those like me) unemployable, and I can’t earn enough money to support myself say in a freelance manner, which the benefits system would make near impossible anyway.

    It is I think the tie up between health, social services, welfare benefits and employment law that needs to change, but from the perspective of the person with the disability/chronic condition otherwise it’ll just get worse.

    Bendy Girl

  3. Paranoid Pupil Says:

    Hi MedicGirl,

    I am totally with you on the whole thing about usage of the NHS – people need to learn to use it more effectively. If we are very mildly ill we have no business cluttering up the waiting room as these days there are plenty of non-prescription medications available, and one can ask the pharmacist’s advice on what is best for your headache/sore throat/congestion/aches etc.

    The doctor’s surgery is, yes, for ill people! I think that my local surgery has it about right. They do not allow appointments to be made other than on the day. This is not terribly convenient, but it sorts the wheat from the chaff – if you are ill enough, and you can’t take the day off work, then turn up at 8am and wait outside the surgery. You will be first in line and when the surgery opens at 9am you will get the first appointment, so should be on your way to work by 9:15. You probably end up being an hour late for work, which seems reasonable to me if you are indeed ill. It also means that if you are ill enough to take the day off then you are pretty much guaranteed to get an appointment THAT DAY, which seems like a good service to me.

    I accept that this kind of system may work less well for those who have restricted mobility, but I suspect that alternative arrangements need to be made for such people.

    Anyway, I think that the system in my local surgery works really well and could be a model for other practices. When I go in my GP always has all my records open on the screen and has taken 2 minutes to remind himself of my history so that he can bear it in mind when he is listening to my symptoms (I have a rather complicated list of chronic rheumatic conditions and am on tonnes of medication so without bearing history in mind he could make some howlers!). It is way better than consultations I had with specialists when I went private briefly. System falls down when it comes to appointments with specialists on NHS – have to wait 3 months for anything “non-urgent”.

    BendyGirl – your experience sounds familiar to me re living with a chronic condition. Poor you. Re medications have you tried the Boots prescriptions service? They can get your repeat prescriptions from your GP and you just need to come pick them up – saves loads of time. I need to pick up a whole bucket load of meds every few weeks, as GP won’t prescribe huge amounts as he wants to monitor my bloods etc (he is v conscientious) which is great but I was taking half a day off sometimes just to get things processed.

  4. no one Says:

    paranoid,

    you are happy, great for you

    boots prescriptions service only works when your surgery can be trusted to get a repeat prescription correct most of the time, many cannot

    your preferred appointments system does not work for everyone, folk who are constantly travelling need to be able to book a slot next week, they may well only be in town one day next week – thats not so unusual in the current world of work

    and you underestimate the number of times someone with a condition such as being diabetic needs to see a doc (depends on complexity of case obviously), especially as more management by GPs is being pushed rather than by consultants, these people are not “ill” in the immediate sense you have in mind, and they sure as anything should not be wasting hours all the time queuing to see a GP, but lack of good access will lead to them dying early and going blind etc

    so in summary you are in la la land

  5. Bendygirl Says:

    Paranoid pupil, thanks for your suggestion, but as no one says, the problems I’m having with prescriptions are actually with using Boots collection service. The issue is always at the GP practice, they either forget items, lose them, don’t get done because CD’s have to be done seperately etc and it takes hours. I’m lucky to have an excellent GP as well.
    I think the system you describe at your local surgery for queuing outside for an hour to wait sounds horrific and for people like myself with mobility issues absolutely impossible. I suspect if that were to happen more often the practices would be sued by someone under the Disability Discrimination Act before too long and quite rightly so when so many practices like my own offer both a majority of appointments that have to be booked at the start of each session, so either 8.30 or 1330 and a handful or pre bookable appointments for each day.
    The easiest example to give is that I had to see my GP this week for a skin problem, I’m not ill in anyway but it was something that had to be seen by a doctor, I’d already self treated with OTC and had caused more harm than good. This is the kind of thing that people with chronic conditions see GP’s for every day, complications of the condition or flare ups, nothing to do with acute illness.
    Bendy Girl

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