Wednesday, 1 October 2014

"Keep your mitts off my NHS"

Last week there was a speech at the Labour Party conference which, in my opinion, knocked the spots off any I've ever heard from a politician of any colour. I know politicians usually enter politics out of conviction, but they nearly all seem to get sucked into the slimy world of focus groups and spin. Power,  or the love of power, does corrupt. It was beautifully constructed and delivered by 91-year old war veteran, Harry Smith. He described his childhood in depressed Barnsley and the death of his sister of TB, as the family couldn't afford treatment for her. "My childhood was not an episode from Downton Abbey." Watch it here: Harry Smith on the NHS

I was reminded of this when I went to our local surgery on Monday. I wanted to ask my GP some things, and I needed a regular blood test. First it was to the phlebotomist (the nurse who specialises in blood tests). Not only did she take it to test my drug level and liver function, but "Why not do these others while we're at it?" she said. I lost count of them. Then she said to Jane and me, "Have you had your flu injections yet?" The answer was no, although Jane had had her letter. "Would you like me to do them now - get them out of the way?" And so she did.  And saved us an expedition.

Then we sat in the waiting room for a bit, until the doctor came and summoned me. The major question I wanted to discuss was about the pneumococcal vaccine. As I'd written to my friends who have slow forms of MND, "I've received a letter from my local surgery, headed 'Pneumococcal Vaccination'. It says, 'Our records show that in the last month you had your 65th birthday, congratulations!' Then it goes on to explain it's usually a one-off jab to protect against a number of infections including pneumonia. 'We would like you to be vaccinated now....' In the old days, pneumonia used to be called 'the old man's friend'. (As Net Doctor puts it, 'pneumonia is called the old man's friend because, left untreated, the sufferer often lapses into a state of reduced consciousness, slipping peacefully away in their sleep, giving a dignified end to a period of often considerable suffering.') I'm not sure whether I want immunity from pneumonia. I wouldn't mind dying sometime. I'm inclined to say yes to the yearly flu jabs, but no to a lifetime pneumonia one. I wonder what others think about this." My GP listened and heard exactly what I was saying. I don't imagine she had ever had a patient with MND raising that dilemma before. She didn't hurry to reply. In the end her answer reassured me. The vaccine doesn't give complete immunity and by the time I'm ready to pop my clogs it will probably be even less effective. In the course of our conversation we talked about whether I would want treatment and resuscitation at the moment, were I to get an infection - to which the answer was Yes. Life may be limited and frustrating, but it's definitely good, and I'd like to enjoy this gift while I may. There will no doubt come a time when I say, "Don't interfere anymore, thank you," - which, you will appreciate, is entirely different from, "Please have me put down."

I also had three others things to ask her, including about respite care. At no point did I feel she was clock-watching. She was focused on me. We concluded at the end that I would have the pneumonia jab, and Jane had the good idea that I might have it then as well. So we asked the receptionist if there was a chance. And there was. She fitted me in with a nurse. Thus I left, after about an hour, having had blood tests, flu and pneumococcal jabs and a consultation with my GP. Now that's what I call service. And at the point of delivery, it cost me nothing. Of course I and my employers have contributed over the years. But it's worth it. That's the National Health Service. The practice, by the way, is Newbury Street Wantage.

I gather that one of tabloids had a leader comment today which started: "With dreary predictability, GPs’ leaders have raised objections to David Cameron’s hugely welcome plan to restore that most basic mark of a civilised society – the right to see a family doctor at any time, morning to evening, seven days a week...." Besides being transparently part of a policy of squeezing small practices out of existence - surely The Daily Mail looks back further than ten years to the golden days when one- and two-man practices were the norm? - , I reflected my elderly in-laws' experience over the past fortnight. Their sizeable GP practice lists 111 as its out-of-hours number. My mother-in-law has had resort to it three times in the past fortnight, and according to her the service has been excellent. It sounds as though it was in every way - keeping her informed, the doctors visiting, the follow-up and the quick coordinating with their GP. I recall receiving a visit from a lovely emergency doctor a few years back on Christmas Day. The system works now. I can see no way in which Mr Cameron's plan will not soak up any new money he offers - and more. Thus we shall end up with fewer resources spread more thinly, and worn-out doctors with even less time to spend with each patient.

As veteran Harry Smith ended, "Mr Cameron, keep your mitts off my NHS!" And that applies to all of you meddling politicians. Keep your mitts off our health service - and our education service.

PS I'm told I should have mentioned how nice our practice nurses are. They are very good. My second jab was quite pain free.


  1. My husband has the flu jab as there are reasons which make it advisable. The ONLY year I had a flu jab,10 years ago, I was extremely ill. I havn't had it since and seem to be a fairly tough old bird!
    Our surgery has a 'walk in' surgery every day, but you need to be there by 8.30am You will ALWAYS see a Doctor, but not necessarily your own or preferred GP which seems fair enough to me. Home visits can be requested too if really necessary.
    This year the Practice Nurse is coming here to do a flu jab clinic in the Communal Dining Room for anyone who would like to take advantage of the opportunity. She will also go to the housebound.
    I've done the co-ordinating for this. 26 people including 6 housebound so it won't be a wasted visit ( except for me!)
    Our surgery provides a really good service. Wish I could say the same for the next door pharmacy! Mistakes are their speciality. We have just changed to another pharmacy where they are really helpful, kind and professional.
    I feel our GP's have pretty tiring, stressful days as it is and definitely don't want to see them burdened any further.
    Perhaps you could organise a petition Michael?
    Having said all that about our GP's, one cannot say the same for Consultants in hospitals. It appears quite the norm for my husband to have a 2.00pm appointment and STILL be waiting at 4.00 pm. without anyone even coming out to apologise. This is a regular occurrence.
    That's where the NHS gets itself a bad reputation.

    1. It sounds as though your consultants' clinics could do with learning normal polite communication. I'm sure you taught your pupils better manners! Despite its human imperfections I still think our NHS is pretty marvellous.

  2. Regarding education, "bring back Michael Gove". He was perceptive, astute, intelligent, and really committed to improving standards.
    Mr Cameron made a HUGE error there, in my ( not so humble) opinion.

  3. Only a pity he wasn't better at human relations, to equally opinionated me!

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    Just thought someone may find this interesting. What an honest and courageous Pope we have!

    1. Thanks for that, Ann. He is wonderful man.

  6. Hello Michael,
    We got back from a workshop/conference in Glasgow last week in connection with epilepsy which focussed on the theme of "conversational analysis". I was there as a service user and Christine as my carer. We threw in a few comments, and we found the conversation with nurses, psychiatrists and neurologists that followed most interesting - they seemed to be genuinely interested in us as people.
    The whole thing was the brain child of my consultant neurologist who lists amongst his interests "communication between doctors and patients". I first saw him quite a while ago having been referred by my G.P. for a second opinion.
    His predecessor had nearly killed me as a result of indifference and poor attention to communication. In some ways it is all too easy to criticise the NHS but those of us who have complex medical conditions, know what a difficult task doctors have in a system that is strewn with accountability, targets, paperwork and funding. Generally they achieve a great deal of success so I agree Mr. Cameron and others: "Hands off our NHS". What a wonderful speech.
    My mother would have been the same age had she lived beyond 50, hard to believe how many years she was robbed of.

    1. Your consultant reminds me of the marvellous Dr Kate Granger, who lives up your way, Rob, and has done so much to improve the care of terminally ill patients while dying of cancer herself. Among other simple things, she started a scheme to encourage health professionals to introduce themselves by name. I think it's called, "Hello, my name is....". But as you imply doctors are as human and fallible as the rest of us.