I love the NHS (National Health Service for you non-Brits). Free at point of delivery healthcare. Zero bankruptcies from medical debt. But, and it’s a big but, it does have its problems. Many of these stem from 12+ years of chronic under-funding from successive Tory governments – may their bodily hair be infested with the flees of a thousand camels.
This has resulted in a number of very serious issues. For example, GP (Primary Care Physician US) appointments were often available same-day not so many years ago. Certainly within a couple of days. Heck, GPs made house calls in more serious cases! My GP surgery – a typical one – now has routine appointments available three weeks from now. For anything that is not an emergency you can got to Urgent Care at the hospital. Or there is the gatekeeping NHS helpline on 111. That number can be useful, but often takes a while to answer.
Waiting lists to see specialists or for surgery are now very long. Months, sometimes more than a year. More than that for elective non-urgent surgery – this unfairly affects trans folk seeking gender-reassignment surgery (apologies if I’m using incorrect terminology).
The above (and other issues) have resulted in a great deal of gatekeeping. This has the effect of making you feel like you’re in the system, while no real progress is actually being made.
Let me give you a personal example:
A couple of months ago my migraines started getting worse and more frequent, so I wanted to see the specialist. This needs a referral from my GP. They triage you online. My answers must have triggered the “Oh fuck, what if he has a tumour/stroke/brain rot?” part of the algorithm *the other easy to trigger errr, trigger, is possible heart attack.
This caused a fast response and a call offering me a same-day appointment. Accessibility became a problem at our surgery last year*. But I did get face-to-face with a new GP who impressed me with her thoroughness, questions, tests and listening skills and she made an immediate referral to the migraine specialist.
48 hours later I get a text message telling me I need to call the specialist’s office to make an appointment. Fair enough. Doing this will trigger their system to mark me as being in process because they have spoken with me (for target reporting purposes). The call itself was utterly pointless – a complete waste of my time. They confirmed they had my referral and would get back to me “in due course” with an actual appointment.The appointment itself – a telephone consult because the specialist has seen me before – is just before Christmas.
Did I just perfectly illustrate gatekeeping in the NHS, or was it a random blather?
* The GP surgery is on two floors. The lift terminally failed some 18 months ago. They’re still arguing with the landlord of the building (it’s their responsibility) about getting it replaced. The Nurse Consultants and Healthcare assistants are typically upstairs – as was my doctor this day. You have to tell the receptionist dragon that you can’t get upstairs and then sometimes have to wait for a downstairs room to become available for your professional to see you.
Addendum: My wife has just been offered a long-awaited physiotherapy appointment. On the first floor (2nd floor to Norff ‘Murricans). Up a full flight of stairs. There is no lift. She’s a wheelchair users, although many other folks needing PT would also find stairs difficult or impossible. FFS!
Header photo by Travis Saylor via Pexels.
