Tuesday, 4 February 2014

The NHS needs to adapt to the lives of working people

Most proposed reforms carry with them the promise of a bundle of cash. If we throw X billion at Y problem, the public will see we’re doing something and said problem will be fixed. But the fact that Labour invested huge sums in education and health yet we still have an underperforming state school system, and a health service that often fails to get the basics right, shows the limitations of money.

It’s always been a source of frustration for me that aspects of the NHS don’t seem to cater for those in work, i.e. most of us. If you’re elderly, unemployed, self-employed or a student, you’re fine. You can afford the rigidity the service demands. But, if you work the standard 9-5, Monday to Friday shift, you’ll find a health service not always accommodating to your needs.

This is particularly the case when trying to see your GP, although I’ve never really had my own GP. I always laugh when the receptionist asks who my GP is. I never see the same person twice so your guess is as good as mine is the response I never but should give.
Recent experiences have left me frustrated, angry and bemused at how inflexible and unresponsive our system is. Often it leaves me with the impression that the needs of its staff come way above those of its patients. The NHS should adapt according to how we lead our lives and not bristle every time changes are suggested that attempt to do just that.   

Speak to any working person and I’ll have a small wager that most of them have had one of those ‘why is this so difficult?’ moments. I regularly have one of those moments.
Because people were getting fed up at not being able to phone their surgery and make an appointment to see their GP on that same day, the last Labour government stepped in to remedy that. In typical Labour fashion, they put something right by going to the other extreme. How to attract more GPs? Pay them a whopping salary, tie them in to long contracts, and allow them to opt out of evening and weekend work. Can’t see your GP on the same day? From 8.30am put your surgery number on redial and compete with every other poor sod also frantically trying to get one of the handful of available slots that day.

Now trying to book a GP appointment has become as much of a lottery as trying to get through to Ticketmaster to book concert tickets. Yes I know, most of the latter is now done online, but it’s much more fun dialling the same number over a hundred times in an hour on the off chance that the engaged tone will miraculously become the ringing tone.
If you plan to ring up at 8.30, you need to be organised. Where will you be at 8.30am? Not everyone gets to work at this time. Londoners tend to start later than everyone else. 8.30 is probably going to be too late to leave for work. You may be stuck on the tube at 8.30, or on a crowded bus, or even worse, in an open plan office. You can’t disappear from your desk for an hour with your mobile stuck on redial. But, the best thing about this system is that it doesn’t realise how barmy it actually is.

The last time I took part in this process left me grumpy all day. At work, at 8.30am, ready to start ringing. Incredibly, I got through within 10 minutes. Only about 20 redials needed. I asked if I could have the latest possible appointment. Was I able to come in at 9.30? Wow, that is late, I had no idea my surgery opened that late. Good for them. They didn’t. The receptionist meant in 40 minutes time. I explained that wasn’t possible as I was already at work and reliant on public transport. I would never have made it back in time. I meant later as in not early.
I was offered 11.30am. Again, not convenient. Unfortunately, my working day is longer than 8.30-11am. I was told all the late appointments had been taken. Already? Yes, they’d been booked up in advance. How advanced I enquired? A few weeks ago. If I wanted a late slot, the next available day would be in two weeks. Reluctantly and quietly fuming I asked for one of those. The receptionist told me patients have to ring after 11.30 to make future – non same day - appointments. It was at this moment I leapt aboard my high horse to begin the inevitable rant, but being the polite chap that I am, made sure I prefaced it with a courteous: “look, I know none of this is your fault. It’s the system.”

If for whatever reason you are home all day, you have the luxury of being able to see your GP at anytime. If you don’t, be prepared to say very rude things the next time you hear some Leftist devotee describe the NHS as ‘the envy of the world.’
I know this isn’t something that afflicts all people. Some surgeries offer late night appointments, although often reserved for one day a week. You are now able to book online if you’re lucky.

My new surgery has embraced the internet age and offers this service. However, in order to be eligible to use it, you first need to fill in a form, which can be emailed back. My surgery informed me last week that they currently have no working email address so the form has to be returned in person. Thus, if you want to use the online booking procedure, you need to fill in the form online, print it out, and then traipse to the surgery to hand it in, in person. That is when you have the time to go to your surgery. On a day you’re not working of course. I was also helpfully notified that only some appointments to see only certain doctors would be available online.
When I first joined this surgery I was told that my registration form couldn’t be filled in online but had to be brought back in person. I’d left any suitable ID at home so couldn’t hand it in there and then. Two trips to register were required.

It shouldn’t be this hard. I realise that many people, such as the elderly, don’t have access to the internet, or are uncomfortable at using it, but for those that do, having to revert back to a time where things need to be booked over the phone, and forms need to be handed in, is a right pain in the backside.
When politicians talk about reforming the NHS or any other area of the public sector, it’s the little things they need to get right. The things that shouldn’t cost a fortune.

The NHS is not flexible or internet-friendly enough. The backlash from GPs when the government proposed that all surgeries open weekends and evenings is evidence to me that they’ve had it their own way for far too long. For £103,000 a year (the average salary of a GP partner), the least they should be doing is opening for a few hours on the weekend and until at least 8pm during the week.
Our medical records should be available online. Patients should be able to email surgeries rather than rely on phoning. Steps are already in place to ensure that patients will soon be able to register to see a GP near where they work, or near their children’s school. Ideally, we’d have the option of registering at two practices: one near home and one near work.

It’s true that those of a working age are also the least likely to need a GP, but that doesn’t mean that when we do need one, the process should be tortuous. The hard-working-people-that-want-to-get-on would like to see their GP at a time of their convenience please.
This comment piece was first published on Speaker's Chair on Tuesday 4th February 2014

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