Den, I was sorry to hear in your last missive you were hospitalised. I know you’re getting better though just by reading this!!!!
As usual, you hit the nail on the head. When Dad was in the BRI I was apoplectic with rage about the same. Bits of paper with hastily scribbled on notes, staff stood for hours at terminals on portable trolleys inputting vast amounts of data. Yet no one appeared to be able to tell me anything about Dad’s treatment or condition (Dad had a total laryngectomy in 2009 so we had to be his voice in there). Suffice to say, and sadly, I can’t concur on your view of the level of care in my Dad’s case for so many reasons - in my view, ineptitude, non-communication, lack of consistent process and yes - good data. All underpinned by a significant and regular lack of required staff for each ward/shift.
Get home soon Den and don’t stop poking the bear!!!
Thx Liz - I can be hyper critical of my own care but then I’d lose perspective. Even so, I’m not prepared to throw my hands up and say ‘it can’t be fixed’ because therein lies the path to both defeat and more waste. I was initially fearful coming here as I remember it a few years ago when Jude had to come in for heart issues. It was a shit show but then it was at the height of the pandemic.
Things HAVE got better but it’s more to do with the (mostly immigrant and cheerful) staff I see than the crumbling infrastructure that’s glossed over with a bit of fresh paint here and there.
It does need fixing!! An interesting perspective to consider. I had breast cancer 10 years ago. It was picked up in a routine mammogram - I say routine, I was in a trial around extending the screening window from 47 (was 50) to 73 (was 70). I had my first almost at 48, and then a second at almost 51. I am CONVINCED that my cancer was detected through the diligence of the mammography and radiology staff in picking the breast cancer up (the tumours were small, early, starburst...) and in particular because I had NO SYMPTOMS. The prognosis at first was optimistic but down the line the cancer itself was aggressive and I scored 8/9 on the Nottingham Score, indicating high grade.....I digress.
At my diagnosis appointment the experience went like this:
Appointment at 4:30, I check in at reception at 4:15 and sat down for 30 minutes in the main reception and then was taken by someone with my file to another holding area - a corridor where I (and my husband) waited for 3 hours to be seen. There were not enough chairs in the corridor and a sign indicated that only patients could have a seat.
There were 3 rooms - 2 doctors each in a room, and a third room. Women were either shown to the third room after their consultation or sent on their way down the corridor.
I know what was in the 3rd room - 3 chairs, a small coffee table and a box of tissues - go figure. Before I go to the room - my consultation was as follows:
Enter room, 1 chair at the side of the doctors desk, a further chair at the other side of the room. Before my bottom had hot the chair this was the consultation:
You've got breast cancer
You need to have a mastectomy
You have an appointment with a plastic surgeon on Tuesday.
No wonder there were tissues in the 3rd room, since after those 3 sucker punches I heard nothing more the doctor was saying, in total shock and disbelief. Fortunately my husband was sat (at the back of the room) and heard the most of the rest.
I decided after a few days - after the shock was less - that there was NO WAY, that I was going to be treated by the team at the NHS hospital. I am lucky - I have employment related private health cover.
I researched breast surgeons and reconstructive plastic surgeons, I called around. I had an appointment privately (with the same Consultant Breast Surgeon who worked in the NHS in the NHS hospital I had attended but had not met) on the following Tuesday. He spent 2 hours understanding my particular cancer and treatment options (throw the kitchen sink at it after the surgery)....
Fast forward - My billing for the whole of my treatment which included:
Mastectomy
Reconstruction (several operations over a period of time)
Chemotherapy x 8 sessions - and all the associated drugs to manage side-effects
Hercpetin and associated diagnostics such as echocardiography
DEXA scanning for bone density
Hospitalisation and treatment after a serious infection including a renal specialist
Tamoxifen x 5 years
Hospital overnight stays ( around 12 days in total)
was circa £140,000.00
Based on your assessment on costs - I reckon it could have been at least 1/3rd more in the NHS system. And I suspect that the private hospital made some profit on the £140k too.
yes, and eternally grateful for being so. NHS Mammography done very well, empathetic, considerate, surroundings were calm and peaceful. After that it went downhill, felt I was in a cattle market at that diagnosis consolation, also forgot to add - too many people trailing around in uniforms seemingly aimlessly with bits of paper and not actually doing any clinical/caring work.
I hate to be scathing of the NHS but my own experience and that with my Dad has left a very negative perception. I know it's not the people per se, it's the system. My fear that there has been agenda's for change for 20 years or so, maybe there has been change but from a "service user" perspective, service is far worse now IMHO.
Just to add - I know I am very lucky to have health care insurance, but my point is that the staff that work in the private sector also work in the NHS and the levels of care appear to be totally different. Same staff, different processes, cost management etc.
Glad you are improving. i think the central issue is that when the NHS was founded in 148 the UK population was 50,033,200, there was little immigration and people lived very basic lifestyles:
Today the population is 68,898,267 (plus we have to assume a large number of illegal immigrants/slaves) and the medical world is unbelievably sophisticated. The old adage that in the late 40's the NHS only had one iron lung and somebody is already in it still applies to a degree today albeit on a much larger scale.
The hippocratic oath and HIPAA compliance means everyone has to be treated in the USA regardless of ability to pay, which plays havoc with commercial medical businesses and basically means what's left of the middle class gets hammered with medical bills.
It's an extremely tricky conundrum, especially with big pharma looking to get everyone and their brother on lucrative 'for the rest of your life' meds and a lamentable shortage of holistic care.
The NHS is clearly at breaking point (someone in my family just became a GP and earns less than someone at burger king). It will take enormous political will and skill to sort out and sadly I see zero politicians capable of doing anything but their masters bidding...
Den, I was sorry to hear in your last missive you were hospitalised. I know you’re getting better though just by reading this!!!!
As usual, you hit the nail on the head. When Dad was in the BRI I was apoplectic with rage about the same. Bits of paper with hastily scribbled on notes, staff stood for hours at terminals on portable trolleys inputting vast amounts of data. Yet no one appeared to be able to tell me anything about Dad’s treatment or condition (Dad had a total laryngectomy in 2009 so we had to be his voice in there). Suffice to say, and sadly, I can’t concur on your view of the level of care in my Dad’s case for so many reasons - in my view, ineptitude, non-communication, lack of consistent process and yes - good data. All underpinned by a significant and regular lack of required staff for each ward/shift.
Get home soon Den and don’t stop poking the bear!!!
Thx Liz - I can be hyper critical of my own care but then I’d lose perspective. Even so, I’m not prepared to throw my hands up and say ‘it can’t be fixed’ because therein lies the path to both defeat and more waste. I was initially fearful coming here as I remember it a few years ago when Jude had to come in for heart issues. It was a shit show but then it was at the height of the pandemic.
Things HAVE got better but it’s more to do with the (mostly immigrant and cheerful) staff I see than the crumbling infrastructure that’s glossed over with a bit of fresh paint here and there.
It does need fixing!! An interesting perspective to consider. I had breast cancer 10 years ago. It was picked up in a routine mammogram - I say routine, I was in a trial around extending the screening window from 47 (was 50) to 73 (was 70). I had my first almost at 48, and then a second at almost 51. I am CONVINCED that my cancer was detected through the diligence of the mammography and radiology staff in picking the breast cancer up (the tumours were small, early, starburst...) and in particular because I had NO SYMPTOMS. The prognosis at first was optimistic but down the line the cancer itself was aggressive and I scored 8/9 on the Nottingham Score, indicating high grade.....I digress.
At my diagnosis appointment the experience went like this:
Appointment at 4:30, I check in at reception at 4:15 and sat down for 30 minutes in the main reception and then was taken by someone with my file to another holding area - a corridor where I (and my husband) waited for 3 hours to be seen. There were not enough chairs in the corridor and a sign indicated that only patients could have a seat.
There were 3 rooms - 2 doctors each in a room, and a third room. Women were either shown to the third room after their consultation or sent on their way down the corridor.
I know what was in the 3rd room - 3 chairs, a small coffee table and a box of tissues - go figure. Before I go to the room - my consultation was as follows:
Enter room, 1 chair at the side of the doctors desk, a further chair at the other side of the room. Before my bottom had hot the chair this was the consultation:
You've got breast cancer
You need to have a mastectomy
You have an appointment with a plastic surgeon on Tuesday.
No wonder there were tissues in the 3rd room, since after those 3 sucker punches I heard nothing more the doctor was saying, in total shock and disbelief. Fortunately my husband was sat (at the back of the room) and heard the most of the rest.
I decided after a few days - after the shock was less - that there was NO WAY, that I was going to be treated by the team at the NHS hospital. I am lucky - I have employment related private health cover.
I researched breast surgeons and reconstructive plastic surgeons, I called around. I had an appointment privately (with the same Consultant Breast Surgeon who worked in the NHS in the NHS hospital I had attended but had not met) on the following Tuesday. He spent 2 hours understanding my particular cancer and treatment options (throw the kitchen sink at it after the surgery)....
Fast forward - My billing for the whole of my treatment which included:
Mastectomy
Reconstruction (several operations over a period of time)
Chemotherapy x 8 sessions - and all the associated drugs to manage side-effects
Hercpetin and associated diagnostics such as echocardiography
DEXA scanning for bone density
Hospitalisation and treatment after a serious infection including a renal specialist
Tamoxifen x 5 years
Hospital overnight stays ( around 12 days in total)
was circa £140,000.00
Based on your assessment on costs - I reckon it could have been at least 1/3rd more in the NHS system. And I suspect that the private hospital made some profit on the £140k too.
Insured?
yes, and eternally grateful for being so. NHS Mammography done very well, empathetic, considerate, surroundings were calm and peaceful. After that it went downhill, felt I was in a cattle market at that diagnosis consolation, also forgot to add - too many people trailing around in uniforms seemingly aimlessly with bits of paper and not actually doing any clinical/caring work.
I hate to be scathing of the NHS but my own experience and that with my Dad has left a very negative perception. I know it's not the people per se, it's the system. My fear that there has been agenda's for change for 20 years or so, maybe there has been change but from a "service user" perspective, service is far worse now IMHO.
Just to add - I know I am very lucky to have health care insurance, but my point is that the staff that work in the private sector also work in the NHS and the levels of care appear to be totally different. Same staff, different processes, cost management etc.
Glad you are improving. i think the central issue is that when the NHS was founded in 148 the UK population was 50,033,200, there was little immigration and people lived very basic lifestyles:
http://www.primaryhomeworkhelp.co.uk/war/changessince.htm#1948.
Today the population is 68,898,267 (plus we have to assume a large number of illegal immigrants/slaves) and the medical world is unbelievably sophisticated. The old adage that in the late 40's the NHS only had one iron lung and somebody is already in it still applies to a degree today albeit on a much larger scale.
The hippocratic oath and HIPAA compliance means everyone has to be treated in the USA regardless of ability to pay, which plays havoc with commercial medical businesses and basically means what's left of the middle class gets hammered with medical bills.
It's an extremely tricky conundrum, especially with big pharma looking to get everyone and their brother on lucrative 'for the rest of your life' meds and a lamentable shortage of holistic care.
The NHS is clearly at breaking point (someone in my family just became a GP and earns less than someone at burger king). It will take enormous political will and skill to sort out and sadly I see zero politicians capable of doing anything but their masters bidding...