Tuesday, 28 December 2010

How does our healthcare system stand up to the festive test?

How do you define good service?

There can be no dispute that the basics for a good healthcare system, whether state or individually funded, should involve good service. Good service in healthcare terms means timely access to appropriate, quality treatment and advice. Any service-based industry will be put through it’s most stringent paces during a holiday period. Add to that some extreme weather conditions and you have an excellent benchmark to measure the basic services required for your health and wellbeing.

I am a self confessed insurance junkie. I have policies for electrical wiring, plumbing, heating and pest control (the joys of living in the country) along with the other essential household cover. Three days before Christmas, my central heating broke down. The charming lady at the call centre first checked my personal circumstances. Was there anyone elderly or infirm on the premises? Did I have other means of heating? Did I require urgent assistance?  Despite my reassurances that no, I was not elderly and infirm (although after trying to keep me upright on the icy pavement the next day my daughter, who likened me to Bambi, may have disagreed) I still received a visit by the heating engineer within 24 hours. My grocery delivery also arrived in time, even though he van driver had to park at the end of my long and impassable driveway and carry all the Christmas provisions some distance. My friend’s dishwasher repair man was similarly tenacious, parking two roads away from where she lives at the top of a steep hill closed due to icy conditions.

If only it were that simple to see a GP over the festive period. A close friend of mine was suffering from a nasty chest infection which started in Christmas Eve. By Boxing Day she was feeling a pain in her left lung. As a nurse, she was pretty sure that she didn’t need a trip to casualty but really should get some antibiotics to avoid pleurisy or even pneumonia. She called her GP practice and as expected, was advised by automated message to call the out of hours service. What she didn’t expect was that the GP practice was closed from 24th to 29th December.  Five days. The call centre operator was unhelpful and unsympathetic, advising that a doctor would call back within 3 hours but if my friend’s condition worsened, she should ‘go to casualty’

I suspect that a high percentage of the costly visits to casualty over the past few days could have been avoided through timely access to appropriate, quality primary care.

Interesting that the ‘betes noires’ of Andrew Lansley’s NHS, the hospitals, will of course have been providing round the clock care to patients. Even the PCT’s and NHS administrators, all facing the grim reaper’s scythe, will have ensured that each department has, at the very least, skeleton cover in the period between Christmas and New Year.

So… you can get your boiler and dishwasher fixed, you can get your groceries and go shopping to your heart’s content, and you can even have emergency surgery or a minor injury fixed, but see a GP? Not so easy with many practices closed for the best part of a week.

In the foreward of ‘Liberating the NHS – Legislative Framework and the next steps’ the Department of Health intends to ‘liberate professionals at every level to take decisions in the best interest of patients’. Is the best interest for patients to close local practices for such a long period of time?

Let’s hope that some of the £80 billion that the government is handing to primary care can be spent on the reintroduction of the basics - good old fashioned care, provided by local practitioners when and where it’s needed.

In the meantime, if you have a minor ailment or healthcare concern, just make sure that it doesn’t happen over a bank holiday and hope that your condition doesn’t worsen until the next working day.


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