|
|
|
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
|
|
LET'S GET THE WAITING LISTS DOWN This week we have seen the start of a totally unacceptable situation. The NHS, once the envy of the world, has to resort to sending our patients abroad for treatment. The question is how did such a situation arise? One thing is obvious, we do not have enough doctors. Indeed in 1998 the Don't Waste Doctors report showed a 40% drop out rate from the medical profession over a ten-year period. I often wonder if those 40% had stayed in medicine, would we be in such a mess? Unfortunately the commonest reason for people to drop out was the long hours of work. The silly thing is that most senior doctors have the childish attitude of "I did it so you do it." In effect they have shot themselves in the foot as they are very much to blame for this . These are the very same people who complain of high workloads. It is a bit ironic if you ask me. However a few things can be done to bring down the waiting times. It is somewhat of a paradox that some people do not turn up for NHS appointments. This ironically wastes appointments and inflates the waiting lists. It would not be difficult to eliminate this problem. Most people who do not attend (DNA) simply forget and so a reminder letter two weeks before the appointment would go a long way to combat this. The hospitals should also phone the patient to confirm attendance. When I was a medical student I attended one clinic, which had a list of people who could come at short notice if there were any last minute cancellations. Why is this not universal practice? However there is one thing that would really combat this. I strongly believe that if people fail to attend, or at least re-arrange or cancel, given the above they should be discharged. Should they then want another appointment then they should go to the GP and be re-referred for which the GP should charge £10 and then the patient should have to pay the hospital £30 for a re-appointment. Although people may not be able to pay, these will be the same people who can afford vast sums of money for alcohol and cigarettes. These people who fail to attend are making life harder for others who want to be treated. My Dad is a GP. Before the 1990 reforms if he wanted to refer a patient to a specialist he could do some investigations and write on the form "please send a copy of the result to Dr X's clinic." By the time the specialist saw the patient all the baseline investigations had been done. Now hospitals don 't do this. They say that it takes too much effort. So the patient arrives in clinic, the consultant has to order these investigations himself and see the patient again. This wastes appointments. Having said that I spoke to the laboratory in the hospital where I work and they said that this would be no problem at all and they would do this with pleasure! In the case of my Dad he has to do these investigations himself. Get the reports from hospital and then photocopy them and send them back to hospital. This is silly but it is indicative of today's poorly run NHS. Another issue is bad surgical practice. Let me give you an example. There is a common condition called a ganglion. It is basically a swelling on the back of the hand. It only needs to be treated if it is causing any problems or if not, it is left well alone. When I was a medical student I did two orthopaedic attachments. One consultant would see the patient and if he decided to operate he would list the patient and not see the patient again until the date of surgery. Others however would keep seeing the patient needlessly between the first appointment and the operation, wasting appointments. What a waste! I remember several patients seen four times between the first appointment and the operation and on each letter to the GP it said "no change, will see in three months." There should be some sort of set of guidelines on this. Maybe some consultants are doing this to artificially inflate their waiting lists so people can go private. I do know of one consultant who does this. It is very common for patients not to be given any detail about their condition, needless to say unless they understand what they have got and the treatment needed then they won't comply. One physician I trained under would write to the patient afterwards with a personalised written treatment plan together with leaflets. He'd send a copy of the letter to the GP. His patients used to comply better and as a result needed fewer follow-up appointments. Why don't they all do that? The above measures will take a lot of effort to implement and their implementation will encounter much resistance, especially for the doctors. However they will free up appointments and will reduce the waiting times for all. Isn't that worth something? More importantly why have the authorities not implemented them? Ultimately the people who are suffering are the patients, yet the authorities are happy to let the situation continue, if anything, they are getting worse. I ask the reader to print this off and send a copy to their local MP for his comment. Then please send a copy of the MP's response to NHS exposed. Dr Sushant Varma Dr Varma is a junior doctor in the National Health Service.
|
|
|
|
|
[Home] [NHS Exposed] [Patients] [Health Workers] [NHS in Crisis] [Legal Issues] [Media] [Helpdesk] [Public Views] All copyright remains with original authors unless otherwise stated. |
