Saturday, July 24, 2004
NHS
The National Health Service, now there's a topic for a moan.
I've always had exemplary service from the NHS (for those of you outside the UK, the NHS is the system that provides free healthcare in the UK) and have always defended it against the "knockers". However, my recent experiences have been somewhat different.
First let me say that like many men I do not seek healthcare until there is no other option. I realise that this is not a sensible way to deal with ones health but it does reduce the burden on the health service.
I have had a back problem since last November, which turned into sciatica in February. By the end of March this was so consistently painful that I was unable to sleep for a couple of weeks, leading me to make a doctors appointment in early April.
The doctor prescribed some (supposedly) heavy duty painkillers. After two weeks these had made no impact on the pain and I was still unable to sleep. I was so worn down that by the time I went back to the doctor he sent me directly from his surgery to the hospital's emergency department, where after approximately six hours of writhing in pain, crying, on the floor of the A&E department I got to see a consultant who prescribed some even stronger painkillers and said that if the problem didn't sort itself out within about six weeks then it may be necessary to operate.
After another couple of days it was clear that the latest drugs were not working and, at my wits end, I got an emergency appointment at my doctor's surgery (although seeing another doctor) who said there was only one place to go now and that was the opiates. i was delighted to hear this as I felt I was finally going to get a painkiller of a strength that may help. Although he wanted to check me into the hospital for a day or two to start this process (not sure why, perhaps because it's easy to abuse or accidently misuse these very powerful drugs) we compromised and he allowed me to self medicate at home.
Finally, I at least had a drug (morphine) that allowed me enough relief from the pain to be able to sleep.
After this it felt as though the NHS forgot about me for a while.
I was simply left on the morphine awaiting an appointment with the surgeon/consultant. This finally came through sfter a couple of months, by which time I was well and truly hooked on the morphine. Not only was I having to take more and more of the drug to have the same effect but if I experimented with reducing the dose or missing a dose completely not only did the pain return but I also went "cold turkey", the symptoms of which were not unlike having flu. So now I had a drug habit to go along with my back problem.
Anyway, this is the bit where my gripes really start.
When I finally got to see the surgeon, he was able to identify exactly where and what the problem was in about two minutes (prolapsed L5 trapping the sciatic nerve for the record) but said I'd need an MRI scan.
Now apparently, this is par for the course. As I understand it, everyone who is referred to the surgeon has to have a scan, but only the surgeon can refer you for it. Given that it took the best part of three months to get to see the surgeon and then potentially another four months to get a scan, wouldn't it make sense that when the doctor referred you to the surgeon you went on the waiting list for a scan straight away. In fact there would be no need to see the surgeon until you'd had the scan.
Now apparently MRI scans effectively have a 'use by' date. They are literally a snapshot of what's going on in your body on a particular day and from the surgeon's point of view the older a scan is potentially the less accurate it will be and therefore the less use it is. So imagine my surprise when I ring the surgeon's secretary to make a post scan appointment and am told I'll put you on the waiting list, we are not currently allowed to see any post scan patients because of the government's target requirements for pre-scan waiting lists. I didn't even have to get angry on my own behalf, the surgeon's secretary did it for me, pointing out how ridiculous it was.
So, because the pre-scan waiting list is not allowed to exceed 17 weeks (remember that my opinion - formed by my own experience of the system - is that this appointment is unecessary as everyone has to then go for a scan) the really important post scan appointment is currently impossible to get.
She did qualify this by saying that the scans were at least looked at and if a situation was deemed an emergency then action would be taken. Other than this what on earth is the point of having the scan at all. It's incredibly expensive, it takes up valuable resources, it's of no benefit to the surgeon because you can't even get to see him once you had it done, and if you do ever get an appointment then the scan is likely to be so far out of date as to not be useful anymore. so then what happens, presumably the surgeon says you need another, up to date, scan and the whole circuitous process begins all over again.
How ridiculous!
This whinge has three other related whinges which I shall list separately. these are about my doctor, my private healthcare company and the MRI scanning process.
I've always had exemplary service from the NHS (for those of you outside the UK, the NHS is the system that provides free healthcare in the UK) and have always defended it against the "knockers". However, my recent experiences have been somewhat different.
First let me say that like many men I do not seek healthcare until there is no other option. I realise that this is not a sensible way to deal with ones health but it does reduce the burden on the health service.
I have had a back problem since last November, which turned into sciatica in February. By the end of March this was so consistently painful that I was unable to sleep for a couple of weeks, leading me to make a doctors appointment in early April.
The doctor prescribed some (supposedly) heavy duty painkillers. After two weeks these had made no impact on the pain and I was still unable to sleep. I was so worn down that by the time I went back to the doctor he sent me directly from his surgery to the hospital's emergency department, where after approximately six hours of writhing in pain, crying, on the floor of the A&E department I got to see a consultant who prescribed some even stronger painkillers and said that if the problem didn't sort itself out within about six weeks then it may be necessary to operate.
After another couple of days it was clear that the latest drugs were not working and, at my wits end, I got an emergency appointment at my doctor's surgery (although seeing another doctor) who said there was only one place to go now and that was the opiates. i was delighted to hear this as I felt I was finally going to get a painkiller of a strength that may help. Although he wanted to check me into the hospital for a day or two to start this process (not sure why, perhaps because it's easy to abuse or accidently misuse these very powerful drugs) we compromised and he allowed me to self medicate at home.
Finally, I at least had a drug (morphine) that allowed me enough relief from the pain to be able to sleep.
After this it felt as though the NHS forgot about me for a while.
I was simply left on the morphine awaiting an appointment with the surgeon/consultant. This finally came through sfter a couple of months, by which time I was well and truly hooked on the morphine. Not only was I having to take more and more of the drug to have the same effect but if I experimented with reducing the dose or missing a dose completely not only did the pain return but I also went "cold turkey", the symptoms of which were not unlike having flu. So now I had a drug habit to go along with my back problem.
Anyway, this is the bit where my gripes really start.
When I finally got to see the surgeon, he was able to identify exactly where and what the problem was in about two minutes (prolapsed L5 trapping the sciatic nerve for the record) but said I'd need an MRI scan.
Now apparently, this is par for the course. As I understand it, everyone who is referred to the surgeon has to have a scan, but only the surgeon can refer you for it. Given that it took the best part of three months to get to see the surgeon and then potentially another four months to get a scan, wouldn't it make sense that when the doctor referred you to the surgeon you went on the waiting list for a scan straight away. In fact there would be no need to see the surgeon until you'd had the scan.
Now apparently MRI scans effectively have a 'use by' date. They are literally a snapshot of what's going on in your body on a particular day and from the surgeon's point of view the older a scan is potentially the less accurate it will be and therefore the less use it is. So imagine my surprise when I ring the surgeon's secretary to make a post scan appointment and am told I'll put you on the waiting list, we are not currently allowed to see any post scan patients because of the government's target requirements for pre-scan waiting lists. I didn't even have to get angry on my own behalf, the surgeon's secretary did it for me, pointing out how ridiculous it was.
So, because the pre-scan waiting list is not allowed to exceed 17 weeks (remember that my opinion - formed by my own experience of the system - is that this appointment is unecessary as everyone has to then go for a scan) the really important post scan appointment is currently impossible to get.
She did qualify this by saying that the scans were at least looked at and if a situation was deemed an emergency then action would be taken. Other than this what on earth is the point of having the scan at all. It's incredibly expensive, it takes up valuable resources, it's of no benefit to the surgeon because you can't even get to see him once you had it done, and if you do ever get an appointment then the scan is likely to be so far out of date as to not be useful anymore. so then what happens, presumably the surgeon says you need another, up to date, scan and the whole circuitous process begins all over again.
How ridiculous!
This whinge has three other related whinges which I shall list separately. these are about my doctor, my private healthcare company and the MRI scanning process.
