An NHS rant

[Grandad]

I am always the first to defend the NHS from any unfair criticism. We have both had excellent service over many years and we thank NHS and its medical staff for that.
What pee's me off is when 'so called mangers' make changes from a business point of view giving little or no consideration to patients. My wife and I have a case in point, both being sufferers with AMD.
The clinic at our local hospital is overstretched, nobody can deny that. However we do find that many patients at the clinic come from all around East Kent, some travelling 20 miles or so. In their wisdom, the 'managers' have decided to close the city hospital AMD clinic and set up clinics around the county.
Canterbury is plumb centre in East Kent and although the change will benefit people living nearer to the new units, ALL patients from the city will now have to travel anything up to 18 or 20 miles to a new facility. We will have to travel about 7 miles to our nearest unit.
I have tried to argue against the changes but I am told, 'the decision has already been taken'. No consultation, no consideration for patients, and as I have said when making a complaint, the clue is in the title "Age Related Macular Degeneration". Most patients are over 80 and this presents them with real travel problems especially as most do not have a partner who still drives.
We could use public transport but it is not frequent or convenient so it will be a taxi at about £40 per appointment, and between us appointments happen quite frequently.
I will now get off my soapbox.

[LovelyLadyLux]

There is complaining for the sake of complaining but I think your complaint or issue is very legitimate and well worth singing from the rafters to NHS. The clue IS definitely in the name and obviously if/since "vision" is the issue it should go hand in hand that transportation is a primary concern.

I'd guess it is a young Administrator with no real understanding of the dynamics involved and who has a task of reducing $ so isn't concerned with the human element.

[Kiya]

Grandad, Have you tried to get the Taxi Card Vouchers that would help you both going any distance ? with price.

Or do you get them at all in England ?

They are for the disabled and I would say that you are with poor eye sight now.

Check out in Gov.UK

[Ruby Slippers]

Wouldn't hospital transport be of any use to you, Grandad?

[Grandad]

Never heard of taxi card vouchers Kiya but I will check that out
RS there are ways to get assistance for appointments but it is not the cost of taxis that is my real gripe. I agree with setting up clinics around the county to spread the load and to be more convenient for people living nearer to those clinics than the central hospital. Where I object and can see no reasoning is the complete closure of the facility at the hospital when moving many patients around the wider area would completely reduce the load on the hospital.
I just can't see any logic and feel that decisions are made without any analysis of where patients live and how changes will impact on patients. I would think that, within a small radius of the city, there would be a significant percentage of all AMD patients, ALL of whom will now have to travel our of the immediate area.
I expect it is now too late but I intend to make my views known even further. The big problem is how and to whom do you complain. So far I am finding brick walls and little girls who are not allowed to give names or telephone numbers.

[Grandad]

I emailed a very long and detailed complaint yesterday to the PALS office which I understand is where all complaints are dealt with.
I doubt if it will have much effect but what I don't know is how many other patients have similarly complained.
I have now learned that the clinic is not at the hospital that I first assumed but further afield. A return taxi could now be up to £50. The infrequent bus service only runs in the morning so it is not exactly convenient.
I have been in contact with CHEK, the local patients action group and am still considering talking to the local newspaper.
I have not been driven to submission.............yet.

[LovelyLadyLux]

I wouldn't let this go as an issue. You could very well be talking for many others who are possibly too elderly and feeble to complain and the NHS planning on this does not seem sound

[Grandad]

I have now received a detailed response from the hospitals complaints depatment 'PALS'. It does contain an admission that patients in two areas are most affected by the changes. Those being Dover and Canterbury. The letter also advises me that plans are in hand to open AMD clinics in both those towns later in the year, so, whether that is as a result of mine and no doubt others complaints, our problems should be resolved in due course.

BTW. I did send a copy of my complaint to our local MP. Whether she has had any influence or not I do not know, but if I didn't get an acceptable response I was going to the local press.

[Mad Dilys]

Good for you Grandad!

[LovelyLadyLux]

Good on you Grandad! Glad you took action. You never know how many others also wrote or if you were the only one but if nobody ever says anything the "powers that be" will never know there is an issue or problem.

[Grandad]

Not a rant but a few general comments about the NHS.

I had mentioned in another thread that at a doctors appointment yesterday I intended to ask him to examine my prostate, which I did.
He first asked my age, '84 next birthday' I said. He said that at that age, unless there were any symptoms, they do not do a DRE (Digital Rectal Examination). The examination is only an indicator and not certain. With the absence of any symptoms, if a problem were to develop, the likelihood is that at my age I would probably die of natural causes before a prostate cancer reached a serious level.
I accepted that as a reasoned judgement but it did set my mind thinking that, with the NHS under extreme pressure, there are probably unwritten guidelines to reduce the treat ment of patients in older age.
It has always been my understanding that many medical conditions can be more successfully treated when detected early......

On another matter I do believe that there is a lot of waste in the NHS both in procurement and in management of resources. The grandson of a friend is a radiographer. He often works a late shift until mid night and, as there are no specialists on duty to review scans and xrays, these are sent to Australia and specialists there review the scans etc and return a report at a cost of £800 a time. He also tells us that locum doctors who work the unsociable hours are paid up to £400 an hour. One in particular comes from the USA for a few days and then returns home. It is worth his while to do that......I bet it is.

So just a couple of observations. BTW I DID have a cortisone injection in my shoulder and that feels better already

[Horus]

Grandad regarding the prostate examination, I was told a similar thing by a medical person. Basically if you lived long enough and didn’t die of some other medical problem then most men would develop this cancer in old age, but few would actually die from it, it would be from some other cause.

[Mad Dilys]

Right Grandad, You've inspired me to pluck up courage and ask for a cortisone injection in my shoulder. I have very restricted use, the pain wakes me several times a night in spite of tramadol at bed time. I have had no treatment for it, but when I saw a specialist he smirked at his colleague and said "If you were younger, I'd give you a new shoulder!"

[LovelyLadyLux]

The crisis here and I don't have a specific percentage but many many people here do not have a family doctor as we do not have enough doctors. This means if you have a sliver in your bum you go to ER - ok that is sarcastic but if you have a sore throat or something minor that you'd go see your doctor about you have to go to ER. Last time I was there which was my appendix rupturing I got there at 10am and emergency surgery was at 1am some 15 hours later. Lots of stories in the papers about Canadians dying in lines waiting to get into the doctor and most recently one man who died in some third world country somewhere as Canada refused to take him home as there was no bed space for him in any of the hospitals.

I do believe though that because of these pressures many routine procedures are being reduced and care for the elderly (us) isn't going to be the same as for those 30 to 40 yrs younger.

That being said we also have several children's health issues that have gone viral and are being broadcast all over as the children have been diagnosed with rare conditions requiring very expensive medication and our system is refusing to pay. One child is something like $20,000CDN/month....YET we seem to be able to give away literally BILLIONS to everywhere else. None of it makes much sense to me.

[Horus]

The amount of money spent on foreign aid is a big cause for concern here too. I appreciate that we need to help others out less fortunate, but surely we should be putting our own house in order first, after all its our tax money.

[Grandad]

@Mad Dilys

Right Grandad, You've inspired me to pluck up courage and ask for a cortisone injection in my shoulder.

Why do you need to pluck up courage MD? My guy gives a light anesthetic injection first then the cortisone. Didn't feel a thing.

Having said that, many years ago I had a problem with acute pain in my left elbow. I assumed it was Tenosynovitis or Tennis elbow but was never sure. My doc at the time gave me a couple of cortisone injections in the elbow and OMG that really hurt. But, as he said with a smile, I think I got the right spot.....Bl**dy Monster

[LovelyLadyLux]

Here they actually resist giving cortisone saying that if they give it it will become less effective over time. Same argument goes here for antibiotics.

I've bought that antibiotics will become less effective if you take mega antibiotics for minor matters but I'm not too convinced that cortisone is the same.

AND @Grandad - Doctors treat women much differently than men. A man going into the doctor will have his issue taken seriously whilst many doctors tend to pooh pooh the concerns that women have so sometimes women really have to work up to demanding a procedure from a doctor.

[Mad Dilys]

You're right LLL! Surgical procedures and injections don't worry me, but the patronising attitude of doctors and being fobbed off as I was recently by a new doctor at my local practice is irritating at best.

The other thing is "On a scale of one to ten how severe is the pain?" Is treading on broken glass with bare feet the same as putting a fork through your boot and foot? Are either of them comparable to slamming your fingertips in a heavy door? Is a dislocated thumb more painful than gout in a finger joint. It's all subjective.

A cat has smaller teeth than a big dog, but I find the bite of an angry cat hurts far more and for longer than that of an angry dog - and I've got the scars to prove I should know.

Perhaps it would be preferable to ask what the patient would compare the pain with in their past experience. Any better idea folks?

[Grandad]

My shoulder, like severe tooth ache but several times worse.

When asked to describe pain it is difficult and you certainly can't compare with shutting your fingers in the door if you have never SHUT your fingers in a door.

To me on a scale of one to ten, an eight is seriously debilitating, a nine I am crying, a ten I pass out. One to seven are just degrees that can be described by estimating where they fall on the scale...All subjective but I don't think you can mix types of pain or compare say, putting a fork through your foot and neurological pain that I get in my left lower leg.

Im once cut the ends off two fingers, didn't hurt at all....

[LovelyLadyLux]

As an aside - Doctors here no longer ask you to give a 1 to 10 re: pain. They actually have nurses bring you a whole series of these type faces and you have to point to one that reflects your pain!!

I guess the response of "You're shi**ing me. You want me to study and point to a face?" whilst looking directly at the nurse isn't exactly the expected or kosher response when an appendix has ruptured (although the nurse was very nice).

I do however agree that pain is subjective. Dentists can grind away on my teeth and I don't feel much but have known others to cringe when getting the numbing gel put on.

It is also a very interesting issue - when I had both my daughters the medical profession here expected you to have a natural birth. They offered absolutely NO pain meds and assured the episiotomy (if needed) would be done during a contraction I guess going on the theory that the human brain can only ever feel so much pain so a bit more isn't going to (ahem) hurt one way or another.

I delivered both my daughters without anything here - (and thinking on it now I dunno why since I did it all without anything I bothered going to the hospital at all in the first place) and the PAIN was considerable. Nothing to be taken lightly and in my day ALL women here experienced it.

When the daughter had the twins it was a scheduled caesarian with full meds and when she went in to deliver the granddaughter they gave her a spinal block. I'm really not sure what that is but it apparently blocks the pain during delivery.

Am kinda wondering now "when" the medical profession decided to stop this natural childbirth aka doing it ALL on your own totally and completely to giving medication & procedures for the pain?

Begs the question - could a MAN suffer the pain of childbirth?