January  2012

Since this blog was first started, my family circumstances have changed a lot and with that the blog itself is changing. It no longer has hidden information relating to my own continuing personal development as a doctor.  Rather, it seems to be becoming a resource of reliable information for my own children, none of whom are medically qualified.

I am rather uneasy about the way the NHS in the UK is going. It is becoming increasingly reliant on protocols guiding members of staff who are no more qualified than my own children to make a medical diagnosis.  Furthermore, many “pathways’ are being developed. Some of these seem sensible, but others appear to be a deliberate obstruction between  GP and consultant i.e. the GP is, in certain circumstances, not permitted to refer a patient to the consultant of his/her choice, or indeed to any consultant. Instead patients are being diverted to other health care workers who have never been trained in diagnostic skills, and worse still, they don’t recognise they do not have these skills. Indeed a close family member recently was “fobbed off” by the system because it was “necessary” to enter one of these pathways that obstructed direct access from either GP to a consultant or from GP to the appropriate investigation. The Health Care Workers involved (there were several) made a wrong diagnosis. The patient was an outlier whose symptoms did not fit the tick boxes provided. These members of staff did not have the knowledge to interpret these symptoms and signs outwith the protocols they had been given. They should never have been given the responsibility of triaging patients by making their protocol driven diagnosis.   The patient suffered several months of severe pain before a final diagnosis was made – out of necessity – in the private sector.

The diagnosis that was missed was a serious one.

Cancer.

I could tell of other similar stories but won’t because they do not involve my family directly.

If this patient from a doctor’s family fell through the system, how do patients fare who do not have a doctor in the family, and perhaps cannot afford £1000 to see a consultant who organised the appropriate investigations in order to make an accurate diagnosis?

This cannot be allowed to go on.

I want  this blog to help my own children understand these deficiencies in the NHS and how to recognise them, work their way round them and challenge them if they ever need to.

I want them to understand the great care that the NHS can give too, and hope that care does not slip away with repeated reorganisations as the patient becomes regarded more and more as a commodity that can be bought and sold.

So, from now on, a new icon, a golden egg will be introduced from time to time.  This will indicate a conversation with my children to help guide them through a healthcare system that has already failed some of them and other members of the family in various ways on several occasions.

However, I still believe with a few adjustments and much common sense, the NHS could become the best healthcare system in the world.

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