Monday, 16 May 2011

Behind the Seductive Veneer of the NHS

Think about the NHS and what do you think of first? Chances are that if they are not the first thing you think of then they are the second or third.. What am I talking about?

Nurses of course.

Nurses (other than this one) are lovely. They are often young and attractive. They wear nice clean white and blue uniforms, they smile sweetly and sympathetically as they glance at their upside-down pinned on watches and they care. How could anyone ever have any negative thoughts about these lovely people?

They couldn't. And that fact gets in the way of people realistically appraising the performance of the NHS. When people think about the NHS they think about nurses and their critical faculties fail.

When was the last time you heard a politician evoke a round of applause when he or she talked about our 'wonderful nurses' often referring to our 'beloved NHS' in the same breadth.

Let me tell you. Smiley, happy nurses are about the only thing that the NHS has got going for it. Over the last 18 months or so, I have plenty of opportunity to observe the NHS at close quarters. Beneath the smiley nursey veneer it's a diabolical mess.

I can't go into all the obvious failings in this blog post but here's just one to start with. GPs failing to diagnose cancer (and other things) correctly.

In early 2009 my Mother started complaining of pain in her arm and shoulder. Her physical health declined over the next few months. She was suffering a lot of pain and her general well-being declined to the extent that it became obvious to anyone who knew her. It started to cause us all (her family) a lot of concern.

Throughout this period she visited her GP who, for some strange reason, didn't connect the fact that she had been treated for Breast cancer 12 years later with the problem. In retrospect the possible connection should have been obvious; the secondary cancer that develops from breast cancer occurs in four main areas of the body; brain, lungs, liver and bones. He should have noted her history from her file and investigated this possibility by referring her to the local hospital for a simple scan.

Instead from some unknown reason he decided that there was no underlying major physical problem and prescribed some physiotherapy.. This went on for some time and she got steadily worse. All the time she was visiting the GP and he still failed to make the connection. Trusting in his abilities and seduced by his reassuring manner my parents went along with his prescribed treatment.

In October 2009 my Mum was suddenly in so much pain that she went to bed one day and was unable to get out of bed. The pain had become excruciating. My father called the surgery and tried to arrange for a doctor to come and see her.

A whole series of phone calls over the next 2 days resulted in lots of fobbing off and no doctor. Returning from a wedding on the Sunday I got involved, raised the temperature a little and demanded a doctor come out. Still no doctor. My mother was by this time in bed, in severe pain and had no way of getting to the toilet as it was too painful to move.

Eventually the next day, quite some hours after he had finally agreed to visit, my mothers GP arrived. I asked him where he had been - with some annoyance as my mother had been in bed for some days without any serious pain-relief and with no understanding of what had happened to her.

He retorted that unless I was going to speak to him more respectfully he was going to go away again without seeing my mother.. I then briefly manipulated his enormous ego and he finally agreed to see my mother and made his way to her bedroom. Frankly I should have punched him and called an ambulance - for my mother not for him.

At some point he must have realised his error. The agony that my mother was suffering finally got through to him and he finally realised that she and we were not making it up. She wasn't making an unnecessary fuss and unnecessary demands as he had foolishly assumed.

So finally he gave her some pain relief and she slept. A day or so later she was taken into hospital in an ambulance and assessed. A scan revealed that she had a cancer tumour wrapped around her spine and her spinal cord. The tumour had grown untreated for so long that it had snapped a vertebra - the cause of the sudden vast increase in agonising pain.

It should never have happened. By the time the cancer was diagnosed it was inoperable - too dangerous to operate. Her chances of short-term survival were very, very slim. The oncologist acted quickly and she had an intensive course of radiotherapy - the only option open.

Miraculously, and beyond realistic expectations it shrank the tumour and she was able to walk again. She was home for Christmas 2009 and we had a great year in 2010 - we went to France together in the summer and she spent 2 idyllic weeks in the hills above Nice with her two loving granddaughters.

This year the cancer has come back. We knew it would. So now my Mum and we are faced with a whole series of new challenges.

Her GP has become indignant. I very politely questioned some of the things he was saying today which conflict with some of the things the specialists have said and he loudly and in a staggeringly unprofessional way (I will not go into it here) complained that he was affronted at being questioned. He really must be deluded if he thinks that is going to inhibit me from pursuing my questioning and checking - particularly given his track record.

So next time your GP offers a diagnosis. Question it. And if the doctor gets indignant, ignor it and keep questioning anyway. The NHS simply is not a miracle cure. The GPs and every one else makes mistakes, and some of them don't even learn from them.

If you abdicate your responsibility for looking out for your family to those who you believe are all knowing professionals you may wind up regretting it - long after the shortened life of your loved one.

There's an article in the Telegraph here that reports that GPs miss 1 in 3 cancer cases. If you don't stay vigilant and ask questions you might be one of those 1 in 3 and by the time you find out it may be too late to do anything.


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