The view from a footsoldier in Stalin's army

[frustrated_doc]

I work in hospitals. I think it is important to realise that doctors and nurses are human and make mistakes, just like anyone. In fact, because most of the time we don't know what is going on (medicine is complicated), we make more mistakes than you would expect in say an airline or supermarket. From my experience, most people who use the NHS understand that.
What I, and most others, can't understand or forgive is arrogance or rudeness. It is very easy as a doctor to hide behind a crust of arrogance. If no-one is allowed to ask a question you can never be shown to be wrong, can you? We try to avoid this - at least I do - but I'm sure I get it wrong sometimes. Sorry. It isn't easy.
I'd like to explain a bit about what it is like for us working in the NHS. I happen to think it is doomed, though I will fight tooth and nail to preserve it.

We are living in a command economy, where the work we are expected to do changes at the drop of a hat (or a ballot card). I have enjoyed 7 chief executives in 18 months. In five years I have been told to increase waiting times from three to nine months (post election = save money), decrease waiting times to maximum 3 months (pre election = spend, spend, spend), relax waiting times to an average of three months, reduce waiting times to 18 weeks, prevent waiting times from being less than 14 weeks. These last two now imposed simultaneously.
Also, every letter your GP sends to the hospital is intercepted and checked by the Primary Care Trust management to ensure GPs don't send too much.
I have a friend who is a GP with the lowest referral rate in his area (he does a lot of minor surgery and investigations himself). He was visited by the PCT bosses who explained he should cut his referral rate by 10% for the next year.
Most of us in the health service now have to spend so much time and energy looking in and up to the bosses we have less and less time to look after you.
I am increasingly of the opiniion that the politicisation of the NHS has crippled it. Until the government butts out we are doomed.

[craigwalsh]

Hi, Frustrated Doc ---

First of all, welcome to the new forum. I'm delighted you've joined, and hope to read many more postings from you in the future.

I just read your first posting, and I could feel your pain. I think you're absolutely right about "politicisation" --- it seems, as a patient (and an unhappy one) to be run with an eye on statistics.

And your comments about arrogance and rudeness? Amen! I've had my GP tell me "this isn't a debating society" when he ignorned my information on what proved to be my problem, and prescribed an addicitive sleeping tablet instead. And I've had folks at the hospital call in the rent-a-cops when I simply, and politely, asked the Sister not to interrupt me.

When will more doctors and nurses learn that the patients aren't the enemy. We're the raison d’être for the NHS, and we're sure a lot frendlier when folks in the hospital or GP's surgery are friendly and kind towards us.

I don't know about you, but I find it difficult to snarl at someone who is calling me, softly, by my name, and saying, "There, there, I understand."

[NiceLife]

"Until the government butts out we are doomed"
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As a suit not a scrub I am always fascinated by the way the professions deal with the issue of "funding". Both Medicine and Law are professions where "customers" (criminals or cancer sufferers) could never pay for the service of the professions. Naturally our professions deserve a good wedge - (the lawyers get bigger one by the way. Cherie trousers £250,000 a year state funded out of Matrix Chambers, 1 Jermyn Street worrying about schoolgirls right to wear a hijab. Great value. )

I always used to say to Medics that want professional freedom from politics "no problem. Start your own Health Service - raise £80bn in voluntary donations, no tax-payer accountability, great.

The problem is that the government shouldn't butt out - it has every right to demand something in return. Wouldn't you?

[matab]

Whatever the issue of wages, it seems ludicrous to deliberately increase waiting times. Can no-one in government see the consequences of this slow, unhelpful system? Yes, they do tend to be very short sighted in their decision making but increasing the waiting times would seem only to cut one area of their budget and increase another - in sick pay and disability benefits. They seem to prefer to leave people that could be returned to the workforce sick and unhealthy and unable to contribute to the tax system that would support the NHS. Have they ever even considered the impact of a lack of NHS care for their workforce? Then there are all the carers who fall ill and have to wait long periods for help on the NHS while their relative or children are looked after by the government.
And yet, they sometimes force treatment on you when you do not ask for it. My daughter was referred for speech therapy when (age 3) she was reported by the nursery as having a slight lisp. My friends daughter who had severe speech problems was refused speech therapy and still can not get access to it. My daughter went to one intensive course for two letters and benefitted greatly. However, we went on holiday and she missed the second course for another two letters - but she grew out of the problem shortly after. Then there was the time NHS advised me to take her in due to suspected meningitis. A good call on the part of the NHS as she had little purple marks on her skin and I could not wake her. However, after a long sleep she woke up refreshed and laughing and I knew she was OK to take home. They wanted to do tests on her but it would have been a waste of time. They called next day though to see why I had discharged my daughter against medical advice.
I have had other situations when they would not help me at all but once I was in the system I had to discharge myself against medical advice - they had seen the end of the problem when I knew I was recovering. The beginning was really scary and I could not get to hospital on my own but they refused to send an ambulance for me. Once I was well enough to get there to be checked over and the drama was really over, they then refuse to let me go! I suppose I should have just dialled 999 and called an ambulance myself but I did not want an emergency ambulance. I did not want the responsibility of them coming to me, someone who was conscious and could wait an hour when someone elses life may be in more imminent danger. They wanted me to get a taxi but I could not have immposed the problems that would have caused on the taxi driver even if I could have found one that would agree to deal with the problem. So I stayed at home deteriorating rapidly to a point that I was unable to ask for their help. Luckily I started to get better not too long after.
Their cost cutting seems to have no logic to it. Provision that could make a big impact on peoples lives gets underfunded. Things that must make little difference to the majority of lives are activley promoted. The people that really need their help get turned away.

[Digit]

This is my first post as I have only just joined the forum so some background.
I do not work within the NHS, in fact I am retired but felt it necessary to add support to the 'foot soldier'.
I am currently recuperating from a radical prostatectomy? having been diagnosed in May as having a tumour.
I entered hospital on the 9 Oct for surgery that day. The staff at all levels during my stay were beyond praise!
I only wish I could respond towards the management of the hospital in the same manner! From the moment I entered the organisation began to fall apart. I was supposed to see the urological nurse before surgery, eventually I did so, 3 weeks later!
I was asked if minded walking to the theater as no porters were available, I responded that 'I had no objection to walking to the theatre, I simply hoped that should not have to walk back!'
The nurse replied that 'things aren't that bad - yet. But see us in a few months time!'
I was informed that the evening following surgery I would be given soup as a way of moving me towards solid foods. Not having eaten for 30hrs I looked forward to the offering. Nothing!
The following day? Nothing!
This continued for five days, as I was unable to open my bowels I assumed that this was the reason I was receiving no food.
Not a chance! The dietician was unaware of my existance!
With profuse apologies a menue of offerings was shown and selections made.
None materialised!
The staff nurse then informed that if I didn't start eating solids I was not going home the next day. I exploded as I explained that I hadn't been offered any solid food.
I received my one and only meal that evening.
The following morning, after a visit to the bath room, 'staff' found me leaning against the bathroom door unable to move, sweating profusely and with my vision greying out.
'You are not going home!' she informed me.
'Vertically or horizontally I am leaving today!' I informed her as I was returned to my bed.
Shortly after that my wife and son arrived to collect me.
'What are they doing here?' 'Staff' exploded.
I explained that the hospital had phoned my home the previous day to arrange for my removal any time after 10am. Nobody had thought to inform 'Staff'.
By this time I had again collapsed from what I knew was low blood sugar. This was confirmed by a registrar.
'Staff' said she was not surprised as I had eaten nothing. At this point I confess I was rather short with her.
My wife and the staff tried to convince me to remain, but I had had enough. My son searched the hospital till he found a wheel chair and took me home, where my wife, a MacMillan nurse and the District Nurse took over my care.
My incision was infected, as was the epidural catheter insertion point.
Due to a rather exciting life I have been an in patient on 8 occasions in half a century, and never before have I seen nursing staff under such pressure. That people should have to carry out their duties under such conditions apalled me.
2 days after I had discharged myself the government sent inspectors in to the hospital, where they found dirty towels and a kidney dish with blood in it.
I was spitting flames!
The government created the conditions that produced these results then publicly crucified the staff. It stinks!

[digger]

It's so true,I am utterly fed up with the way the NHS is run by small nazi quango's,that are fixated with target setting,and money saving.Until we fire the current regime,they will contiue to under fund training&development,until all your left with are butt kissing automatons,brainwashed by the incessant 'Trust' rhetoric.