Posts Tagged ‘nhs’

Last week, Venla had what appeared at the time to be a seizure (she’s totally fine by the way, in case you’re worrying!). So, taking no chances, the daycare rang for an ambulance. It’s standard procedure for under-twos to be taken to hospital. Here are a few observations.

The NHS staff were lovely

At every step, we ran into nice people. It started with our paramedic who I loved, not just because his name is also Chris, but also because he too could make a passible career as a Ross Nobel impersonator.

Everyone was good with kids and happy to see Venla. Now, you might think that was a given, given that we went to children’s A&E and then the children’s observation unit. But, when Elina gave birth to Venla, one of the pediatric consultants came around to check on her and he was completely flummoxed by her clothing fastening system, complaining he always got it wrong. Apparently, you can work with babies for your whole career and still not really know what to do. None of this this time.

Hospitals are ill-prepared for healthy curious children

Venla was pretty unhappy at daycare and in the ambulance (constantly switching between crying and excited yelling “in a nee-naw!”) but once we got to hospital she quickly returned to her usual self.

This was okay in the waiting room where they had toys and walls to contain her. But once we were in an examination room, or worse the ward of the CAT unit, she couldn’t care less about the toys. All she wanted to do was touch every expensive medal device and open every draw she could find.

She could easily do this because many of the draws were placed at an excellent height for a toddler. Worse, many of them were open-sided to allow medical staff to grab items quickly in an emergency. It also allows toddlers to grab things.

It occurs to me that hospitals are used to dealing with docile sick children who cuddle up with their parents. Or maybe who feel well enough to push some buttons or do a bit of colouring. But a curious child like Venla, who feels back to her full strength. That has trouble written all over it. After five hours of chasing her up and down hospital corridors and around hospital wards, we were both exhausted.

There is a lot of inefficient beaurcacy

At least it feels inefficient. Maybe it is there for a reason. But I was ill prepared for the whole process.

When we got to daycare, the daycare staff were telling the paramedic what had happened. I assumed the paramedic would be taking notes and these notes would then be handed on to the rest of the hospital staff.

But we were asked to describe what had happened. Even though we weren’t there. When I was getting a brief summary from the paramedic and the daycare staff, I didn’t realise that I should have been taking notes because I was going to be tested on it later.

But apparently, I was. First by the nurse in A&E, then the A&E doctor, then the A&E nursery nurse, then the CAT unit nurse, then the CAT unit doctor. Even though neither of us had witnessed it. Why the notes weren’t simply handed over is unclear.

The whole thing was free

It was nice to be left with a bill of £0, which would have been tens of euros in Finland, or tens of thousands in the United States. Which, for a Friday night out as a family, seems like a cheap win.

I’ve been working with the NHS to deliver a new homepage for the site that will replace NHS Choices. At the Health Expo this month, we launched the new homepage on the NHS’s beta platform. You can check it out here.

Catastrophic Care: Why Everything We Think We Know about Health Care Is Wrong is a book by David Goldhill about the American healthcare system.

Their healthcare is comparable to that provided by the NHS. However we rank better because we spend only a third of the money the US does. Someone told me they spend more tax money than we do, even before the insurance costs, though I do not have a source for that.

Goldhill points out a number of problems, some common across all healthcare systems, others specific to America:

• Holistic care, phsycholical factors in recovery and control of infections are often overlooked – for example making the ward look nice, keeping records electronically and emptying the bins before they overflow.
• Insurance systems do not make sense because healthcare is not a risk, it is an inevitability.
• There are incentives to take medication – you can take statins to lower your blood pressure, or you can lead a healthy and active lifestyle. Your insurance pays for the former but not the latter.
• There is little focus on cost in insurance-based systems.
• 68% of hospital beds in America are provided by non-profit hospitals, yet they do not produce better results than for-profit ones.
• Medical errors, hospital-acquired infection and over-treatment kill as many people as many major medical conditions

His solution is to crap the insurance system and replace it with a loan based system. A typical American will spend around $1,300,000 on healthcare over their life-system so Goldhill suggests giving them that as fund, with a small insurance system for catastrophic conditions that cost more (though he argues nobody would charge more in a market-based system).

On a tangent, he also talks about how state assistance to buy a house actually helps rich home-owners rather than first-time buyers. I blogged about this in June.

Reading it, it made me glad we have the NHS. Of course, it may be a case of the grass is always greener where you live (which is now a thing) as the NHS is proving highly ineffective for me at the moment. Overall, as I said at the start though, we probably get the better deal spending far less on health care for a slightly better life expectancy.

On October 20th I had an appointment with a specialist. He prescribed me a new medication and told me to hand the form in at my GPs (Colton Mill). I duly did this.

Unfortunately, having a job and all, I had to be at work the entire time the surgery was open, and so asked them to send the prescription to their sister surgery, The Grange, who had a 7am start on a Monday.

Having BT turning up at my house on the next Monday, meant that I couldn’t actually get there that Monday, so I had to go the Monday after, which was then the 10 November. When I got there, they said it had been sent to the wrong place, and I had to come back a different day.

This meant that I had to wait until 17 November to go back. At which point they said they had sent it to the wrong place again. This time I put my foot down and told them they had to sort it out. After a lot of messing about, they eventually got a doctor to write out a new one.

Finally I had my prescription 28 days after I was actually prescribed it.

Of course you could argue that had it been more urgent I could have taken emergency time off work and gone there every day. And you’r right, I could, and this would have got me it faster.

But is this the healthcare system we deserve? A healthcare system where you have to choose between being healthy and being unemployed? Such a system would be damaging to society because it would mean you would have to choose between being unhealthy (high costs further down the line for the NHS) or being unemployed (high costs for society paying out in unemployment benefits).

If Stephen Hawking were British, he would be dead. That is what one critic of Obamacare said.

You can probably safely assume then that the author did not consult the latest World Health Organisation rankings of the world’s healthcare systems. It was getting increasingly out of date, with the latest rankings being published in 2010. However, even back then it could be seen that Britain ranked a reasonable 18th while the United States could only manage 37th, equal with Costa Rica.

However, a new study by The Commonwealth Fund has ranked the NHS at the top.

It is quite a selective list. No Spain or Italy for example, both who ranked excellently in WHO’s 2000 report, along with many very small nations such as San Marino that arguably do not count. But does include a health selection of systems including France (the 2000 first place) and Sweden and Norway that you would expect to do very well in all things quality of life.

In fact Britain does so well that it comes first in every category but three – equity (joint second), timeliness (third) and healthy lifestyles (tenth).

Click for a larger view.

Not everyone agrees with the report though. The Euro Health Consumer Index (EHCI) produce rankings also and their 2013 report puts Britain a lot further down the list.

Click for a larger view.

However, as I will almost certainly lead a happy life in the belief that I do have the best healthcare in the world, I’m going to choose to believe the former. Go NHS!

The UK currently has an opt-in system for organ donation. That means that unless you have specifically opted-in to donate your organs after you die, the NHS cannot have them. Sort of. Actually, whether you are signed up or not, they just ask the family. The NHS advice that making your views clear can be helpful. But actually, it is fairly irrelevant.

So a graph like this might look pretty scary:

But actually, it is not a complete disaster, because they will just ask the family anyway. I still think it would be worthwhile for the UK to switch to an opt-out system though. In general, you get higher donation rates in countries with an opt-out system.

If they also just ask the next of kin, it is not immediately obvious why this should be the case. Perhaps the relatives are less likely to say no if they do not feel the individual felt strongly enough to opt out, or perhaps there is just a general culture of that being the done thing. I am just speculating, I have no idea.

To me though, I wonder why there would be an opt-out at all?

What is the point? I cannot think of a good reason why the NHS should not just have a free right to help themselves to my organs after I am dead.

Perhaps you could make the argument that the family don’t like the idea. Or that it makes some people uncomfortable with the idea that their organs will be removed after they are gone. But organ donations save lives. Are these the reasons that are worthy of condemning someone to death? I would argue they are not.

Last Wednesday, I was out with the Humanist Action Group doing our usual feed the homeless bit, when we found a man who looked rather ill.

When we spoke to him, he said he was suffering from septicemia. He was clearly in a bad way, one foot was swollen so much you could see how much bigger it was than the other and he had some nasty holes in his legs which were slowly oozing puss. It really wasn’t something I enjoyed looking at.

When we asked him whether he had been to the hospital, he said yes and they had given him some antibiotics. However, they were about to run out and now he couldn’t afford any more.

Now, you would assume that a) he is clearly in need of medical treatment and b) he doesn’t have a job so doesn’t really have any means to pay for prescriptions, you would think that the supposed free healthcare system we operate in the UK, would provide.

But it doesn’t.

If you take a look at the NHS website, it explains that there are only a handful of exemptions to prescription charges and unless you’re on income support or income related job seekers allowance, you still have to pay. Of course, homeless people rarely are on these schemes, leaving them very little access to medical treatment.

I think my tax bill is very high. But, every month when I took at my payslip and see how much has been taken off by the government before I even get to see it, I take some comfort in the fact that it is going to help those less fortunate than me, I mean that’s the point of having a social welfare state right? But incidents like this make you question, how many people are slipping through the gaps?

A quick google around tells me that you can pick up a homeopathic remedy for anxiety for as little as £13.17 plus shipping.

But here is the thing. It’s just water.

Suddenly seems rather expensive for 15ml when Tesco are doing 2,000ml for a rather more reasonable £0.17.

It really makes you wonder however why the NHS are spending millions of pounds of our money on homeopathic remedies. And as such I’m starting a new campaign to promote greater understanding of homeopathic medicine because, much like religion, the thing that will do the most damage is if people actually learn what it’s about.

You can learn more about the bullshit the NHS is spending money on at the campaign’s website, It’s Only Water.