My Doctor has a clean and tidy practice.
They have a myriad of rules which disempower the patient. Rule number one seem to be : “You will be seen when it suits us and not before!”
You want results? “We don’t phone you -you need to phone us!”
Have you tried speaking to the GP of your choice? Forget it.
It is much less painful banging your head off a brick wall than trying to get sense out of the reception staff.
I have an elderly friend, a retired doctor, who despairs of the loopholes he has to go through to speak to his GP.
I must admit, I find it uncomfortable as a patient, but nobody asks that question – possibly because of lack of interest in the answer.
Compared with other countries we are far behind – but we don’t know that.
The NHS was best described to me by Swiss architect, who said, in deep distress at the care her elderly mother was receiving: “I know you don’t pay much for your Health Service, but it shows.”
I know of no-one who has left this country who wants to return to the NHS. I know people who are paying to avoid it. I know people who have the choice and say “No Thank You”. It may be free, but it is not comfortable. On holiday, I met a British couple, who had moved to France and enthused about their improved relationship with their GP. There is no receptionist. in that country: no-one to come between the patient and the doctor. no-one to tell you when you would be seen.
The patient/doctor relationship is sacrosanct there, and when patients phoned up they spoke to THE DOCTOR. Of all the benefits of living in France, this was amongst the most important.
The doctor knew the individual, a time would be agreed that was suitable for both. There was no-one to broadcast details of your illness all over the surgery. There was a small fee to deter time-wasters, but the fee (£10) was far preferable to our system, they maintained. Should further treatment be required, it was freely available from the following day. There was no need to wait unless the PATIENT chose to do so. I was told it was absolute bliss, and it certainly sounded better conceived than what we have stapled together.
In the Surgery, behind the scenes secretaries typed up notes, and collated information, but they were never seen by the patient: the comment that these ex-pats made on the NHS, having lived in France for seven years?
“I don’t know how we put up with it for so long…”
My best patient experience was also in France, and there is nothing and nobody to compare in this country – the systems simply are not in place.
Dickinson and Ham make this point in their 2008 paper:
“integrated multi-professional care is only possible to the extent that professional and directorate barriers are broken down, and a culture of shared clinical governance is cultivated in which staff are empowered to accept responsibility and accountability at all levels of the hierarchy”
(Engaging Doctors in Leadership: Review of the Literature. NHS Institute for Innovation and Improvement)
So my Gps surgery, I contend, is unexceptional – it conforms to what the Government wants. No barriers are being breached: nobody is putting their head above the parapet. and the patient is minimally involved.
In other words, it’s as good as we are prepared to make it in Scotland. Or as they say in Glasgow:
And if there is one phrase I despise, that is it.
We need to do something about it, though!