Friday, 12 December 2008

The patient patient and other stories

We already have monuments to the Unknown Soldier. Somewhere in England we need a statue to the Unresponsive General Practitioner. It would show a seated figure, man or woman, with pens in a top pocket, an air of abstraction and a hand hiding a barely stifled yawn.

It would be dedicated to those selfless individuals who make sure that healthcare expenditure in England is kept within sensible limits. For a price. A high price, since the new GP contract of a few years ago, but who can grudge them their salaries when we think of the service they provide in controlling access to care?

Like most companies, mine offers death or invalidity in service insurance. To qualify, you need to complete a health declaration and the insurance company needs a questionnaire filled in by a GP. I duly completed the declaration and registered with a surgery. I even went to see the GP, since I have a minor chronic complaint and need a prescription to get the medication.

So far so good.

Three months later the insurance company wrote to say that the questionnaire hadn’t been returned by my GP. Despite two reminders. So I e-mailed the practice. I had a response immediately, even though it was a weekend, from a manager who passed on my e-mail to an assistant. Who wrote on the Monday morning to say she was tracking things down. And again on the Wednesday to say she’d found the questionnaire and would ask the GP to complete it. And again on the Friday to say that he’d been ‘poorly’ (who gets poorly these days? Only GPs, I assume. The rest of us just get sick). He was going to deal with it on Monday. On Monday she wrote to say that he hadn’t had a chance to complete it but would look at it when he was next in on Wednesday. And again on Wednesday to say that he had promised to deal with it on Thursday. And finally on Thursday to say the questionnaire was complete and would soon be in the post.

The practice had seen me just once. Otherwise they had nothing on me, unless they’d received my old records from when I was last in the UK, 13 years ago. British authorities seem to be pretty good at losing people’s records in the post or in railway carriages, but I have little confidence in their being able to get them from one GP’s surgery to another over a decade later. More likely that my old records are somewhere in a landfill site by now.

So how much work did my GP have to do? Under ‘known conditions’, he could list the complaint for which I'd been to see them. Under anything else – well, he could give my name and address and pretty well nothing else. He didn’t even have to put the thing in the post – someone else was going to do that. What are we talking about? Five minutes work? And in nearly four months culminating in two weeks with a reminder every couple of days, he couldn’t find five minutes?

Cynics might suggest that he was slow because this isn’t one of the myriad services for which a GP can charge an additional fee. But I have faith in my doctors. I know these are altruistic people motivated by the desire to serve. And they know that the NHS can only survive if access to its services is rationed. They selflessly hold up, delay, obstruct.

It preserves the financial equilibrium of the service. And it teaches us patients patience.

And a postscript without relevance to the above

The news is full of strange stories these days. I don’t mean about recession. That’s just run of the mill. I remember the oil crunch in the 70s, Black Wednesday in the 80s, the John Major recession in the 90s. Every time we get howls of ‘catastrophe’ and reminders of how much better things were three years ago. Just like now. You remember the golden age of 2005? When nobody complained about the economy and everyone was happy? And loved the government?

No, I’m talking about the interesting news. Like the fact that the prestigious Max Planck Institute in Germany has just published an issue of its journal dedicated to China. On the cover they printed a few lines of Chinese characters which a resident scholar told them were inoffensive. It turns out that they refer to job opportunities for young women in a branch of industry that I won’t mention in this family-oriented blog.

And then there was the tale of the Austrian actor in a play that ends with his committing suicide by slashing his throat. It was fine until unfortunately he found himself playing the part with a real, sharp knife rather than the blunt one he was expecting. And found himself lying on the stage in a pool of his own, completely authentic blood, being applauded by the audience for his realism.

Fortunately, he’d missed his carotid artery – though not by much according to the doctors who treated him – and he’s back in the play, acting with a bandage around his throat.

The police are investigating just who gave him the knife.

1 comment:

Mark Reynolds said...

Good thing there weren't any British GPs in the theatre at the time ("Is there a doctor in the house?" "Yes - please ring my secretary for an appointment, and we should be able to fit you in before the matinée showing next weekend. By the way - Bravo!")