How could the NHS save money?

[reallymadwoman]

I have to agree with some of the previous comments, the NHS have badly let down both me and my son. Had I been treated within a reasonable time following a very nasty assault, I probably would not now have PTSD and agoraphobia which are so deep-seated that all I can do is 'manage' their effects. I was also told twice by my GP that there was nothing wrong with my back - the implication being it was all in my head - only to find when my husband paid for me to go private out of sheer desperation that I had two fractured vertebrae and was in imminent danger of losing all function in my right leg.

My son has an hereditary condition, which I passed on unfortunately, which our GP practice should know all about, but when he kept going back with standard symptoms indicating the need for surgery, he also kept being told there was nothing wrong. We ended up taking him to A & E where he was treated conservatively in order to try to avoid emergency surgery and was discharged with the expectation that he would have elective surgery in 4-6 weeks. 4 months on and earlier this week I went to the GP with him as we've still not heard anything and all the GP can do is refer him to the surgeon, but there is currently a minimum wait of 22 weeks just for the out-patient appointment. The problem is getting steadily worse and we all know that he's likely to end up back in A & E within a month and have to go through the same emergency surgery that I did, which carries far more risks and long-term complications.

 

That said, no doubt our GPs are under enormous pressure to keep costs down by only referring people at death's door.

 

One thing which never ceases to bother me is that because I have a life-threatening condition which requires life long medication, I get free prescriptions. Fair enough, no one wants someone to die because they can't afford their prescription, but why not just make the essential drugs free rather than absolutely everything I am prescribed?

[reallymadwoman]

I rarely remember to add rep for fabulous posts, but think about it deserves it - since this whole 7 day opening thing started, I've been asking where all those extra hours are going to come from - perhaps the government expects my surgery to close one day during the week so the GPs can work at the weekend instead. It's already difficult to get an appointment in less than 2 weeks, unless they get more GPs, opening an extra 2 days a week won't change that.

 

My surgery has 5 GPs, but only 2 are full time and they're both 'getting on a bit'.

 

Bottom line is that GPs simply don't have enough time to do what they need to do already, so giving them more to do is just going to make things worse. Going back to an earlier post of mine, had the GP had a bit more time to read my son's history, she may well have picked up his current problem before we ended up in A & E, saving at least 4 appointments with her plus 3 days in hospital. Presumably, he would then have received the treatment he needs a little bit earlier and wouldn't now be having to go back to A & E 3 times in the last 4 weeks when the pain got unbearable. There's now also a distinct possibility that by the time he's waited another 22 weeks to see a consultant and then however long it takes to actually get to the operating theatre the operation will have already been done as an emergency, which we all know is both hugely more expensive and a lot more risky for the patient.

 

A lot of problems are bound to be due to delay - if someone can't get to see a GP for two weeks, either by then they'll be better or they'll have got worse and be in A & E.

 

I can't now see any alternative but for the NHS to become means-tested, not free. I'm a bit vague on details, but the French system is that a proportion of your treatment is free, varying according to the type of treatment, but you can buy insurance to cover the rest. I'm not sure how it works, but overall it is also means-tested, so the poorer you are, the less you pay, in some cases nothing at all.

[reallymadwoman]

I also have concerns about the 111 service. In my experience, the initial call takes far too long as the handlers can't/won't skip any of the script even where it's obviously not needed. The last two times I used the service we knew exactly what the problem was and what was needed - stronger painkillers plus a visit to the GP the next morning for antibiotics - but I expect to try to avoid anyone suing them if they get it wrong, we still had to go through the whole 20 minute interrogation only to be told someone would have to call back.

 

Well before the call arrives, the pain is so bad that my son is rolling around on the floor ended up taking him to A & E. On each occasion, the call back has actually only happened at least 4 hours later, by which time we could have just spoken to our own GP anyway. Of course the obvious alternative to all this is to give us a couple of doses of oramorph, but that would be far too easy! There does seem to be an assumption that any young person given a morphine based medication is either going to abuse it themselves or sell it, along the lines of guilty until proven innocent.

[reallymadwoman]

By coincidence we currenty have both our fathers needlessly taking up hospital beds whilst appropriate care packages are put in place so that they can return home. Both have now been in hospital for well over 2 weeks for no medical reason whatsoever, but this is apparently how long it takes to organise these things.

[reallymadwoman]

Our current situation also highlights some of the issues elsewhere in the system. My mum, who is herself not well, has been back and forth to their GP since before Christmas saying something was very wrong as my Dad had basically stopped eating or drinking amongst other things. It took until 2 weeks ago when he collapsed for her to be taken seriously, but by then of course he needed to go to hospital whereas perhaps if someone had listened earlier, that could have been avoided. After a couple of days treatment he was pretty much ready to be discharged but Social Services are adamant my Mum can't cope on her own so they won't let him be discharged until they've organised home carers to call in at least twice a day. Mum accepts she can't cope on her own for long, but she and my sister were happy to manage for a while between them if that would have got Dad out of hospital quicker, but I suppose if something had gone wrong the hospital and social services were worried that they would have been blamed for discharging him too early.

My father in law also collapsed, but in his case there is no family able to care for him at home (I'm too disabled and my husband works away) so there was no choice but to keep him in hospital. Again, though he lives in supported housing, apparently no one noticed that he'd not been around for a few days - at least 4, possibly more - which makes me wonder what the point of supported housing is and why we're paying for it.