Saturday, 3 January 2015

If you need an NHS appointment, my wife will sort it out for you

Bit of background: an endoscopy is a procedure during which they stick a length of wire with a camera at the end of it down your throat and have a look at your innards. The unpleasant thing about it is that it makes you gag when they first insert the wire (judging by the recent experience of comedienne Joan Rivers, it can also kill you). It’s more than 20 years since I last had one. Last June, a consultant at Charing Cross Hospital decided it was probably time for another gander at what’s left of my pancreas.

The good doctor wrote to the hospital’s endoscopy unit requesting an appointment on my behalf (this should have been done via my GP, according to exciting new rules, but, astonishingly, I and the consultant had already discovered that the introduction of two extra and totally unnecessary steps in what had formerly been a fairly straightforward process before some idiot administrator got involved shrank the chances of actually getting an appointment to near zero – so my consultant naughtily broke the rules.

Fat lot of good it did, because when, after realising I hadn’t received a letter confirming a date for my illegally requested endoscopy examination, I made a series of phone calls to the hospital, and was eventually told that the endoscopy unit had never heard of me. I mentioned this at my next chat with another gastroenterologist in October and he clacked away at his computer and assured me I would be endoscoped before my next appointment with him in January (i.e. this month). Just before Christmas, I once again realised I hadn’t yet had a letter about the examination, so I rang the endoscopy unit. There was no reply. I phoned various other departments, but they just kept transferring me to the non-answering number.
Yesterday, after about a dozen more unsuccessful attempts to get through, my wife decided to cut to the chase and drove to the hospital (which is fairly close), and located the endoscopy unit, only to discover a nasty little hand-witten message written in pencil on a torn scrap of paper sellotaped to the relevant window informing the world what the world already knew – i.e. that there was no one there. Nevertheless, my wife decided to wait (she is infinitely more patient than I am). Eventually a woman in a hijab arrived, removed the note – and scuttled off before she could be questioned. But my wife’s patience was eventually rewarded when a bloke appeared in the corridor. She grabbed him and explained what she wanted. Amazingly, he admitted to being a member of the unit and went off to check the records to see if I had an appointment. He returned to reveal that he had found the request(s) from my consultant(s) asking for a booking – but that that no such booking had been made. Would my wife like him to book an appointment for me there and then. Well, dur!

So I’m due to have a camera inserted down my gullet the week after next. I’m not looking forward to it – but I’ll be delighted to get it out of the way. But the whole seven-month saga (assuming the examination isn’t cancelled) does leave me wondering exactly what the hell is happening with the administration of the NHS. This from The King’s Fund website:
While the total number of NHS staff increased by around 35 per cent between 1999 and 2009, the number of managers increased by 82 per cent over the same period, from 23,378 to 42,509)... As a proportion of NHS staff, the number of managers rose from 2.7 per cent in 1999 to 3.6 per cent in 2009. 
In which case, why does it require my wife to turn up and hang around a hospital corridor and grab the first vaguely medical-looking non-veiled person she sees in order for me to get an appointment which had been requested by two separate doctors in the same hospital as the relevant unit on two separate occasions? And why – as my request was in the system and all the appointments for January hadn’t been filled – were those requests not acted on? And why does the departmental phone number which all patients are directed to use (there is no other way of contacting the blighters) not automatically provide a pre-recorded message when no one is there to pick it up (a seemingly permanent state of affairs)? It’s just so dreadfully haphazard and Third World – it’s like an incident in a novel about Soviet-era Russia, or present-day Africa. What do all those extra administrators piled on during the Blair and Brown terrors actually do for a living? What is NHS management actually for?

One slightly scary thing about all this is that London is supposed to be a lot better than most of the rest of the country (I’ve recently heard horror stories from a relative about the NHS in Essex, and the Welsh version has become a byword for incompetence and cruelty). The other worrying aspect of my relatively minor annoyances with the system is that while I’m not that unwell – I drove to Brighton and back yesterday with no ill effects - and I have a healthy partner who cares sufficiently about me to go and sort things out on my behalf, many of the people trying to fight their way through this sort of Kafkaesque lunacy are having to do so while feeling either extremely ill or terrified or both.

The envy of the world? Yeah, sure.

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