You know how TV programmes like Casualty and Holby City present the NHS as over-worked and under-funded, with brave, exhausted medical staff dashing from one patient to another in their desperate attempts to save lives and warm the hearts of the nation?
I've been in two different hospitals this week, on both occasions to accompany sick relatives, on both occasions for several hours. On neither occasion did I see any member of staff look tired, over-worked or even in a hurry. In our local hospital, there were plenty of staff thronging the corridors, usually walking in pairs, mostly looking as though they had somewhere to go and something to do, but certainly not in any hurry to get it done.
In the other hospital, a major teaching hospital twenty miles away, they didn't even bother to look purposeful. While patients sat and waited for their appointments (which were all at two o'clock in the afternoon but didn't actually happen until, in some cases, four o'clock) nurses, orderlies and administrative staff had plenty of time to wander aimlessly around, chat, joke, sit and drink cups of tea
I've no complaint about the treatment eventually received, and wouldn't be so churlish as to suggest that people should not have a cup of tea and a chat in their workplace. Of course they should. I just couldn't help remembering who was paying for all this
Anyway, one or two interesting developments in the NHS lately:
NHS database creaks into action
Intimate details of the first 100,000 patients have been uploaded to the controversial new NHS database despite a mounting revolt by doctors and campaign groups. Around 20 GP surgeries have added individual records to the scheme, which will contain details on patients' medical history, current medication and allergies.
But more than 200,000 people (including me) have requested documents that allow them to demand their personal medical records are excluded from the system, which will "go live" in January. There is growing concern about the security of the £12bn IT programme - the biggest civilian computer project in the world - which will ultimately contain the details of 50 million people.
A poll showed that more than three-quarters of doctors are either "not confident" that data will be safe or "very worried" that it will leak once the system is up and running. Some senior medics are now encouraging a campaign of disobedience against the database by supporting a campaign to urge patients to opt out. Activists in the British Medical Association (BMA) have produced a letter that people can send to their GP to stop their records going onto the database.
The letter can be downloaded from the website of the Big Opt Out Campaign.
Campaigners highlight the Government's "appalling" record on data security, which saw the personal and banking details of 25 million child benefit claimants lost last year. Nine NHS trusts were forced to admit losing hundreds of thousands of health records.
So far, more than 550,000 patients in Bolton, Bury, Dorset, south Birmingham and Bradford and Airedale have been asked to register with the new NHS IT scheme. It will be rolled out across the country later this year, once the pilot sites have been evaluated. Patients were initially told they would have no choice over whether their information would be included on the database. But ministers were forced to offer concessions because of concerns over privacy and security.
Patients can now choose to opt out altogether - though they are warned this could compromise their NHS care. Alternatively, patients can choose only to allow access to NHS staff who have their explicit consent. But NHS manager Helen Wilkinson, who is masterminding the opt out campaign, said patients were not being told of their rights. She launched her campaign in 2006 after discovering that she had been wrongly labelled an alcoholic after seeing a consultant about routine surgery. She has now forced the Health Department to wipe all of her records from NHS files.
"My concern is that patients' records are being uploaded without their consent," she said. "The Government says every patient should be getting a leaflet setting out their options. But the reality we are finding is that many are not. Even when they do, we are not satisfied that the literature is clear about the risks associated with this database. The Government has demonstrated only too clearly that it cannot be trusted with this sort of personal information. Its record on keeping data secure is frankly appalling."
Joyce Robins, of the campaign group Patient Concern, said: "Our main problem is that they are doing it on an opt-out basis - we think they should ask for consent before records go up."
Medical confidentiality is at risk from this new database, as over a million NHS employees and central government bureaucrats will have access to not only your medical records but also your demographic details-name, address, NHS Number, GP details, phone number (even if it's ex-directory) and mobile number.
There is no opt out whatsoever for your demographic details. You can only have them hidden in special circumstances if the police or social services request it - if, for example, you are a celebrity or on a witness protection scheme. Many public and private sector workers will otherwise have access to your address and phone number, from social workers to pharmacists.
You will eventually be allowed to 'lock down' some of your medical details (though the security mechanisms haven't been built yet). But although you can keep some of your medical details confidential from some of the doctors involved in your care, they can override this if they think it's necessary, and there is no way for you to keep your information confidential from civil servants. You will no longer be able to attend any Sexual Health or GUM (Genito-Urinary Medicine) Clinic anonymously as all these details will also be held on this national database, alongside your medical records.
Which bit do you want treated first?
An Email from a Grumpy Old Sod visitor
New Years day, I took my lady friend to her doctor's surgery, Ansdell Medical Centre, Lytham St Anne's. As patients checked in at the reception desk, they received this pamphlet
how come a doctor who spends 7 to 10 years learning his trade will become confused if you give him more than one problem per visit? Just imagine if you hobble from your seat in the waiting room to his office, with help from a friend, explain your problem - and then have to get up and hobble out because your 5 minutes are up!
It's really just another example of NHS establishments (like the hospital above which gives all patients the same appointment time) that appear to organise things for their own convenience, rather than that of the patient.
And just how do they expect patients to ensure that they only ask the doctor about ONE problem? An old person may have arthritis, a dicky heart, a cataract in one eye and a hearing-aid. How can some dithery old dear decide which problem she wants to discuss today? They're all important, and she's worried about all of them.
One can imagine her working all out as she puts her coat on and waits for the taxi: "Now, my heart might kill me, but my hearing-aid won't, so I'll put the heart first. But then, because I'm deaf I won't be able to hear what the kind doctor tells me about my heart, so perhaps I should get that sorted before anything else.
"But then, if my arthritis is bad I can't actually get to the doctor at all, so maybe that's the most important thing "
This is the email that Captain Grumpy sent in reply
Hi J****, thank you.
Mrs.Captain had a nasty turn with her heart last year and spent some time in hospital, and then quite a long while recovering - we aren't convinced that they've got her drug rιgime quite right even now.
What struck us both quite forcibly was that none of the doctors and specialists seemed interested in treating her as an individual. You could tell from their questioning that all they were concerned with was ticking boxes, and they seemed determined to make her fit into one of their pre-prepared holes. I imagine once they can look round the ward and think to themselves "That patient's in that box, and these two are in this box, and the one down the end is going upstairs tomorrow to see if they have a box that she'll fit into ..." they can go home with satisfaction with a job well done. Except, of course, it isn't.
I suppose this is what the modern world of targets and job descriptions and performance reviews brings us to. I'm sure all the staff on Mrs.Captain's ward were wonderfully well trained and qualified, that they had a comprehensive set of targets, a tight job description and satisfactory annual performance reviews, but sadly none of those included helping the old lady across the ward who couldn't reach her dinner and would have gone hungry if Mrs.Captain hadn't got out of bed and fed her.
Not at all bitter, of course, but that'll be me in a few years ...
Great-grandmother sues over MRSA
Reported in The Times on January 16, 2008
A great-grandmother who contracted the MRSA superbug in hospital is suing NHS Greater Glasgow for £30,000, in a move that could pave the way for hundreds of other sufferers to claim millions of pounds in damages.
Legal arguments began yesterday at the Court of Session in Edinburgh, where a judge is to decide whether the case brought by Elizabeth Miller, 71, should proceed to a full hearing.
Mrs Miller, who was not in court, told The Times last night that her life had been devastated by weakness and breathlessness since she acquired the infection after a heart operation in the Royal Infirmary, Glasgow, in 2001. The case is believed to be the first of its kind in Britain. Mrs Miller, from Kilsyth, near Glasgow, had MRSA diagnosed nine days after an operation to replace her aortic valve. Her legal team blames the infection on staff not washing their hands, a lack of soap and paper towels and faulty sinks and taps at the hospital. They say that a nasal swab taken from their client proves that she did not have MRSA before her operation.
Mind you, not all Times readers were sympathetic. Jane from Birmingham wrote
I hate this, if the NHS had more money to employ extra staff and better epuipment rather than having to spend it on the legal costs etc. this kind of thing incurs then they might be able to make improvements. Lets be fair she would have been ill without the operation anyway!
Oh, that's all right then, Jane. If you're ill you just have to take what comes, is that it? If you're ill you surrender all rights? If you're ill you needn't imagine you're going to hospital to get cured, rather than coming out worse than you went in?
Tosser.
And finally
Our Wankers of the Week recently were the South Tees Hospitals NHS Trust and the Department for Health, because when cancer patient Colette Mills offered to pay so she could have an extra drug they threatened to withdraw all her treatment and make her pay for the lot at a cost between £10,000 and £15,000 a month.
Their reasoning was that it would mean she was getting better treatment than the lady in the next bed, and that wasn't fair.
Well, the dispute has now been resolved, and not very well. Colette has been told that because of the delay in getting the new drug, her condition has now worsened to the point where there's no point in having it at all.
So the South Tees Hospitals NHS Trust have won, really. She's going to die. And since their other cancer patients are going to die as well, that's fair. So they're happy.
I don't think Colette Mills feels too pleased about it, though.
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