What is the NHS for?
The NHS exists to look after the interests of the NHS. To be sure, this was not the original intention behind Aneurin Bevan’s vision, but it has become so as the titanic, monolithic, bureaucracy infection has metastasised within it.
NHS staff exist to look after the interests of NHS staff. Let me remind you of Tiktok nurses a year or so back, while hospital wards were empty and no treatment for life-threatening diseases was going on. Busy?
Undoubtedly there are still some misguided idealists within the NHS, who genuinely believe that they are working for the greater good of society or people’s health.
But look at the reality, in 2021. Is it possible to get a face-to-face appointment with an actual doctor? Only in a few isolated places where the afore-mentioned idealists hang on, fighting a losing battle.
As for seeing a doctor there are multiple lines of defence put up by GP practices to deter those pesky patients:
- the telephone system. This is structured to require a wait of several minutes, all the while being lectured on not bothering the practice at all during certain times of day/week;
- the receptionists. These (usually) ladies are highly trained individuals, able to perform complex diagnoses on the basis of only a few words from the caller (insisting on further detail if the complaint is particularly embarrassing) before denying the patient access to any medical intervention;
- the appointment system. This has zero appointments available to allocate, but is only able to function up to three weeks ahead. If the caller is persistent then they must be told to try again the next day when “further appointments are released” (see the beginning of this point, no further appointments will be added).
The upshot of this is that it is to be made as difficult as possible for a patient, even a stubborn and persistent one, to book an appointment – or if they manage to book one it will be for an inconvenient time of day at some distant point in the future, usually waiting up to six weeks for a “non-urgent” slot. And GPs complain about patients not turning up for appointments. Quelle. As they say. Surprise.
How are “urgent” and “non-urgent” defined? The answer is that they are not, the whole point being that most patients are too coy and embarrassed to insist that their complaint is “urgent”. This factor is relied upon by the practice and used to deter patients from booking.
So given the 6 weeks or longer delay for an appointment, if the patient is presenting with anything other than a simple malady which may be treated with some simple medication, the GP will opt out of taking anything approaching a treatment decision and refer the patient to a consultant/disease specialist. This starts the further fun and games of trying to get an appointment with said specialist.
Is it possible to get an appointment to see a disease specialist? Only by joining a “waiting list”. The waiting list system is designed to prevent patients from bothering a consultant, and to achieve one of the following three alternate outcomes:
- the patient is allocated an appointment so far into the future that they are likely to forget;
- the patient dies;
- the patient gets better without intervention.
Any of these possibilities is good for the consultant, as it reduces the workload, and the outcome can be reported back to the GP.
Let us assume that an appointment is granted. There will be further waiting periods designed to achieve one of the aforesaid three outcomes: then comes the actual appointment itself, which will be over in seconds and result in a report to the GP which will necessitate a further round of trying to see the GP to find out what the consultant could have told the patient at the time of the appointment.
More telephone calls, more waiting. Round and round we go, and where it will stop is… painfully obvious.
The NHS exists to look after the interests of the NHS, and especially NHS bureaucracy. Bugger the patients, they’re all too busy.
Time for another Tiktok video anybody?