Times are hard and wearisome 

 It's been some time since the planets came into alignment and I have been granted the ability to see the time to write here...

 By god it's strange to get the time and the will to actually do something and write this down.

The trouble with medicine, especially in A&E is that the sheer coal-face nature of it all.  Sometimes you just can't be bothered to express how the situation goes.

A&E has no 'off' time.  You are either there or not.  'IT' rolls on, never stopping, never drawing breath.  In they teem, gone are the days of appreciation and now people expect perfect results in 10 minutes with our legendary 'wonder-drugs'.  People have a free ride into medical care nowadays, which is fine - perfect even.  But they then expect a free ride after that too.  Like if they're not sick, a free ride home is what they want, which is ironic seeing as they want a free handout after we've spent probably at least £200 on them.  If only to rule out some crazy disease that they may have (which of course we have to do as they've attended.  Amazing how many 20 year old girls think they are having a heart attack when in fact they've had a cough for a month and strained a muscle.  BUT we have to be sure because some people do have this problem).  I feel aggrieved by people like this, cos they are the ones who get annoyed when they have to wait when someone gets knocked over by some nutter in a rush...  

People in this country are now used to getting what they want when they want it, not what they need when it's actually possible.  As such, it puts an almighty strain on services.  Very few people go to their GP first nowadays, which is a great shame as it would quite often sort out their minor ailment without having to resort to waiting 4 hours for a junior doctor (as opposed to the consultant level GP) to agree with the GP and send them off home.  Some even more sensible characters come the day after treatment is started by the GP, expecting immediate results.  Patience - whatever happened to it?  Turned into patients that's what.

I think that the NHS 'WunderPlan' as worked-out by Sir Ara Darzi (a Consultant in a tertiary referral hospital who's speciality is advanced tele-surgery) for Primary Care and Hospital Services is woefully inadequate and optimistic.  Although entertainingly it is along the principle of the old 'Cottage Hospital' which the government (this one, the last one, who cares) has shut down.

Essentially, he seems to think that in a growing and ageing population, reducing acute hospital beds is a good idea, and that most problems can be sorted out in 'new' Poly-Clinics.  Which will obviously be able to keep Mrs Miggins in overnight until her Social Care Package can be arranged.  Oh sorry, that's right not a chance.  But you'll always be able to see your own doctor.  Oh sorry, once again no chance.  Hey it's ok, Pharmacists can do the job of a GP.  Let's just wait and see the mortality rates shall we?  How many young girls need to die due to the OCP for that one to be revoked?

Maybe I'm just cynical.  Maybe I realise what reducing the size of a hospital to save money in a growing area does to the community.  Maybe I know that people want to see 'their' doctor at their 'local' hospital if at all possible.

Just bear in mind that actually most problems associated with getting old need acute care at some point - people don't take their pills at home, and then expect to be fixed...

Posted: Wednesday - December 12, 2007 at 05:55 PM           |