My family is generally healthy and doesn’t have much cause to need hospital or doctor’s services, but recently both my wife (bless her) and I have had to interact with the NHS. And it has not met my expectations.
In my case, I needed to get two things checked out. First step, get a doctor’s appointment at our local surgery. The surgery operates an online appointment booking service, but to use it, you have to register with the website. To do THAT, you have to request access, visit the surgery in person to show them an official document (a passport or driving licence say) and then wait for the access code to be sent to you. When I visited the surgery with my passport, I could book an appointment, but the earliest would be three weeks away (so if you’re planning to be ill, get booked up in advance). I can phone up each day in the morning to join the queue for one of the few appointments they keep back each day – I’ve done this in the past: waste of time. You’re on hold / redial for so long that it’s totally impractical. Of course, the receptionist says, “if it’s urgent, we’ll see what we can do”. The appointment you book isn’t to SEE a doctor, oh no: it’s for a doctor to CALL you to discuss the problem. That’s great for diagnoses isn’t it: stick out your tongue and say “aahh” on the phone. The doctor will then decide if he or she needs to see you in person, so that’s another appointment that needs to be set up. To be fair, my in-person appointment is only a few days later. Meanwhile, the access code hasn’t turned up and it’s been three weeks, so I contact them. Apologies, apologies, must be a problem with the IT provider. It turns up another week later.
Now all this palaver is before you get to find out what might be wrong of course, and to do that, I have to carry out the inevitable tests – in this case, blood and stool. The doctor provides me with a plastic bag containing a form (for official use only), a small vial in which to deposit a sample and instructions on how to do it. The blood test though is a different matter. Luton operates a “hub” for blood tests in the town centre and I’m told to book with them. This is done online (they won’t take telephone bookings) and their website shows they are fully booked for the next four weeks. A few days later, I produce what seems to me to be a beautiful stool worthy of being used as my representative sample (if you’ve never done this, a word of advice, lay off the sweetcorn and sundried tomatoes for a few days). I pop in to the surgery to drop this off and mention the blood test delay at the “hub”. Oh, she says, you can do a blood test here – I’ll book you in for tomorrow. Why didn’t the doctor tell me this tell me that when I saw her instead of telling me to use the “hub”?
Results of the tests will take – I’m told – a week to come back and then I can phone up to get the results (or the Doctor will phone me up to tell me the results). Ten days later, I ring up to be told that my blood sample was normal, and my stool sample was “normal” (which I was quite disappointed about: after the care I took with choosing the sample, I expected at least an A+, or a description of “impressive”, but there you go). Two days after that, the Doc phones me and tells me they can’t find anything to be concerned about in the test results. I can stop worrying, but it’s always best to get things checked out. All in all, from me contacting the surgery to actually getting the verdict, it’s taken five weeks.
The second issue is a dental one. I saw my dentist in January and I was told I’m developing leucoplakia. This appears to have resulted from the gap where I’ve had a tooth taken out completely, and the change in my chewing causes me to bite my cheek and tongue every so often. Nothing urgent to worry about, but these things can develop into more serious conditions. I’m told she’ll refer me to a specialist at the hospital. 6 weeks later, my appointment letter comes through: to see someone at the local hospital at the end of May. Five months from referral to appointment is not good, but I’ve been back to my dentist and she’s confirmed it’s not getting any more serious, so I’ll just sit and wait for May to come around.
My wife’s experience was more urgent. So urgent we rang 111, the NHS phone line. The person answering the phone is a call-centre flunky reading off a script – nothing more than a glorified message taker. My wife was in severe pain (the sort where, when asked to rate it on a scale of 1 to 10, you say “11”). The flunky on the phone asks a few more random questions – what’s your weight, when did the pain start, what’s the air speed velocity of an unladen swallow, that sort of thing, and then announces that she’ll get a call back from a doctor within the next 300 minutes. No, that’s not a typo: 300 minutes. Useless, she gasps. We ring 999. More questions. She’s told she needs to be in Accident and Emergency, but we’ll have to make our own way there because there’ll be no ambulance available for the next 8 hours. I get out the car keys.
At A&E in Luton, the place is full. We have to speak to a receptionist who takes our details, and then wait to be called to actually tell someone what’s wrong, and then wait to be called again when someone can actually take a look at her. 10 minutes in, my wife is in so much pain that she faints on the floor, but that does at least bump her priority status up so that a trolley is rushed in and she’s heaved up onto it and whisked away. I wait, reading my Kindle. I’m standing because there are no available seats. I’m in earshot of the area where people tell the nurse why they’ve come, and I hear one person tell her that they’ve bumped their hand on some furniture and it’s “a bit swollen”. Another woman says she has a rash on her leg that she wants someone to take a look at. These are the sorts of ailments that one normally goes to one’s surgery to discuss with the family doctor, but because you can’t get same day appointments, everyone heads off to A&E. Three hours later, my wife (on significant pain relief) phones me to say they’re keeping her in overnight, so I can go home.
She’s better now after 7 days in a hospital bed getting the matter under control (it’s related to her Crohn’s). Visiting was only possible with a prior appointment, one at a time, for a specific hour, on production of a certificate for a negative Covid test, so we communicated by Zoom during that period.
The NHS is fantastic once they know what’s wrong with you: all the services spring into action and treatments are planned, organised and delivered. But the process of getting to the stage where they know what’s wrong should not be taking so long. Conditions worsen over time, serious illnesses need quicker diagnoses by a medical professional (rather than via Dr Google). It’s easy to blame Covid or Brexit for creating circumstances where delays become inevitable, but those are smokescreens. It’s no surprise then that a recent survey showed the satisfaction rating with the NHS to be an all-time low of around 30%. Some of this is our expectations: we want to be seen quickly, and we want to know what’s wrong quickly, but this is a consequence of there being too few qualified staff in place to do the meet the demand and do that initial diagnosis – in person – and the NHS doesn’t have enough of them. It’s not just throwing money at hospitals, it’s not just setting targets that are impractical to insist on. And it’s not rocket science (or even open heart surgery) for Governments and “managers” to get the right resources in to provide the service.
Martin B Lewis 