Appointment with Destiny

Does your life intersect with the NHS? No? Do you have dealings with the PCT and the inaptly named PALS. Then you're either below a certain age or you lead a healthy lifestyle. Personally, I don't and I'm over 55 - I gave up smoking way too late, but I still drink 3-4 glasses of wine of an evening and am entirely sedentary in my pursuits... a lifetime of reading, eating, drinking, cooking and playing games (both board and video) will eventually ensure that mere survival dictates that you make the increasing acquaintance of doctors, nurses and surgeries and hospitals.

The latest crop of unpleasantness stems from following the advice of a really good district nurse at my local doctor's surgery: come back at the first sign of a potential problem - they're much easier to deal with then. Well, I booked an appointment with the 'ulcer clinic' only to find out that the PCT in its wisdom had decided that district nurses would now only visit those who couldn't make it to the surgery. So the combined wisdom, experience and knowledge of these excellent people was at a stroke removed from the surgery (both doctor's and practice nurses referred and relied on them to deal with the specialised area of leg problems due to poor circulation). That was unbelievable enough.

I have complained bitterly about this, the surgery agrees with me, the practice manager getting involved, three separate doctors; three of the practice nurses - we're all in agreement. The PCT, refers my complaint to a PALS officer, who says they've passed my complaint on to someone who's on holiday. That's 5 weeks ago.

Consequently, no-one in the surgery was able to diagnose the venous eczema I had developed. And so after two weeks of increasing strength anti-biotics, the nurse admitting she was out of her depth, the doctors that they didn't have a clue, I was referred to the Dermatology clinic at the local hospital (a 3.5 hour hole in the working day). So, this money-saving wheeze of not having the district nurses have a practice based clinic resulted in palliative care and a delay of three weeks, plus a hospital appointment with a dermatology consultant with two nurses in attendance led to? Now, I was committed to eight weeks of going twice a week to the practice surgery to have my legs unbandaged, washed, treated and rebandaged, before the repeat hospital appointment to assess how far I'd got. There's a saving for you.

Bear in mind that I work from about 7.30 in the morning to 5.30 at night and each of these appointments is at least 2 hours out of the office... and then in the middle of this, I get a letter telling me that I have to go to yet another hospital. Also, that I have to go home, removed my own bandages, wash my legs and wrap them in clingfilm, put socks over this, drive for an hour, find somewhere to park, have tests undertaken, drive back for an hour and then have another appointment (which I was to make, knowing full well that the surgery can't and is turns out won't be able to fit me in) for about 30 minutes for the salves and bandages to be replaced at the doctor's surgery, because the hospital wouldn't do this. [At hearing this, well... common decency binds my typing fingers from the acid-soaked profanity that would otherwise eat it's way the screen.] So we can estimate that I would be missing from the office for 4.5 - 5 hours. And these tests can be done by any competent nurse. Every time I think about this I go incandescent with rage.

I really, really do feel like Victor Meldrew: I really, really don't believe it. The advice that I should get a friend (most of whom work and thus would have to take at least half a day's annual leave to help) or a member of my family (either dead or not talking) to drive me around, is so asinine...

All of the above, after the initial clinical problem, was mainly caused by managerial decisions being taken about clinical practice. What's worse is that it also exposes a level of internecine strife between the front-line staff at the surgery and the hospitals who seem to want to make things efficient by passing the shitty jobs back to the surgery and getting the patient to do the legwork in between. The surgery resist and simply say that they won't do it, which leaves me somewhere between the two with my legs wrapped in fucking clingfilm. Sigh. And the story is not finished yet.