Tuesday, January 09, 2007

Prevention Better Than Cure? Not in Today's NHS...

This came in from one of my blog correspondents this morning, so I thought I'd share it with you...

I'm diabetic, and every year I get my eyes tested for various things that diabetics are prone to. This time, I went to the optician as usual, to be told that one of the tests (the one where they give you eye drops that dilate the pupils so that the optician can have a good look inside and study the retina for damage) could NOT be given as the local HCT had decided that from Jan 2007 this test should be carried out at hospital. I balked at this. Hospital appointments=lots of wasted time + car parking charges + dodging the rubbish hanging around in the waiting rooms. "Bollocks" I thought, I'll just go without. But then the optician says words to the effect that he was perfectly happy to do the test privately, it would cost just £12.50, which of course I did. So I am £12.50 out of pocket, and Gormless Gordon is better off by a similar amount (the fee to the optician for doing the test having gone down). And I don't have to waste three hours hanging around in the hospital. I know, it's only £12.50, and a lot of people would consider me a wealthy man. I can certainly afford it. It sticks in my craw though, here is the NHS having money fire-hosed at it in prodigious quantities and yet they feel the need to pick on patients like me, and reduce the services in a manner that I suspect the 'target' statistics will not pick up. I could get quite cross about it really.

Now in theory, you could say that this was a good thing - people who can afford it paying a small price for a service. But of course the real issue is the number of people who just won't bother to go down to their hospital and have the test done, thereby storing up more problems for later. I wonder how many more types of tests this applies to. One for the NHSBlogDoctor perhaps?

12 comments:

  1. A couple who I am friendy with moved to the UK from Australia about a year of so ago. She is a GP in a London practice having being there around 6 months. Over drinks at Christmas she told me that she was staggered at how much GPs were earning in London (and the UK generally) and the pay for a "sharp and commercial" GP is at least 5 times the level in Australia.
    Even taking into account the different national pay scales and relative costs of living she thinks that GPs here earn at least 2-3 times the going rate in Sydney.
    PS even more controversially she is surprised at how lazy and incompetent some GPs are!

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  2. The answer is lots - it's another tick in the box - diabetic man seen tick - gone!And what the statistics will show is that this man was " treated" as they don't analyse any further than that. Puke.

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  3. My wife was faced with the same dilemma recently, and reached the same conclusion as your correspondent. She also chose to pay her optician to undertake the procedure privately.

    Up here, in not so sunny Cumbria, the hospital visit would have entailed a 45 mile return journey, at least half a day off work, coupled with hospital car parking fees etc. Moreover, because the patient is unable to drive for some time after the test has been carried out, I would probably have needed to take time off work myself to convey my wife to and from the hospital.

    It also appears to be the case that had she elected to visit the hospital, the procedure would have been carried out by a non-specialist who would simply photograph the back of her eyes in order that the resulting picture could be inspected by a specialist at some later date.

    The government will no doubt describe this as efficiency, although it is anything but efficient for the hapless patient.

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  4. Always thought that that Iain Dale was a socialist deepdown!

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  5. Bah, that's nothing - didn't you know there's money in them there diabetics.

    The Government set a target a couple of years ago about blood sugar levels. If I understand the fraud/scam/wheeze correctly the GP's got money for helping sugar levels to fall. So what they do is one year test everybody before lunch (when levels are low) then the next year test everybody after lunch. Hey presto sugar levels normalise and the GPs are quids in for each patient. Easy money.

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  6. Not so easy javelin. The annual blood tests are Hba1 tests that are fasting blood tests, but they measure the average level of glucose in the blood.

    (Actually in the case of diabetics, the GP is trying to get the blood sugar level down not up. Excess blood sugar (which causes a lot of problems) arises because either because the pancreas does not produce enough insulin (type1) or because the body does not react to the insulin (type2).)

    I find the original story quite bizarre. The annual eye test for diabetics is a standard eye test. The pupil dilation bit is quite quick (albeit that there is a 15 minute wait for the eye drops to take effect), so I don't see why the NHS begrudges the extra cost. Diabetes qualifies sufferers for an exemption from NHS prescription charges and the annual cost of drugs for diabetics running into hundreds of pounds, it would make sense to check whether they are working.

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  7. Does this change of policy only apply in England? It's unlikely the Welsh Assembly or Scottish Parliament would tolerate it!

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  8. OTOH, there will not be a single woman who wants IVF turned away.

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  9. Another favorite trick of specialists is to give you an appointment for in 3 month time when you're in total agony. I payed the same specialist I was to see 'on the NHS' in 3 month £150 to see me 2 days later in an NHS building privately, basically it is set up so that you either suffer or pay the bribe to get what you already have payed for.

    A voucher system is badly needed -- I payed twice for what was due to me, and whilst I'm 'ok', I also know that many people would just have to suffer the blackmail wait.

    (think about it, if the same guy can see you within 2 days, what does this tell you about the waiting list? Do you really believe the waiting list exists because it has to, or because the consultant can make £150 in a 10 minutes? *cough*)

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  10. Now in theory, you could say that this was a good thing - people who can afford it paying a small price for a service.

    "... a good thing..." my arse!

    He's already likely paid a large price in taxes. Why pay twice?

    If we go down the "if people can afford it" route, we'll eventually be bleeding everybody dry, despite already having paid upfront already. The Government already plans to do so with waste disposal and road pricing. But then, we can "afford" that, right?

    I'm surprised you even said that- "in theory" or not!

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  11. I am a type 2 diabetic and have just had my annual eye test at my opthalmic optician's half a mile from home at no charge.
    Is this something that changes health trust by health trust?

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  12. If yout think that's a problem, then consider my experience: I am diabetic, but am routinely refused prescriptions for insulin and Blood Glucose testing strips (which are VITAL for maintaining Diabetes management on a day-to-day basis) because the NHS can't afford it. So I now don't bother even attempting to, since I would need more than 50 times the amount that I actually get prescriptions for.
    Since it is known, that the number of diabetics in the UK will be double its current level - within the next five years - it certainly says to me, that we don't want diabetics - the only way the NHS will be able to cope with that increase is by trebling EVERYBODY's tax level - as a bare minimum!!! I don't see any political party in the UK offering that - which is desperately needed.
    Plus, many GPs offer "so-called" Diabetic services but NOT a single one of them has the remotest idea about diabetics - and I have met many hundreds of them. They have absolutely no idea, - just pretend that they know what they are doing.
    Lastly, as far as vision is concerned, Mrs Thatcher, in her infinite wisdom (!!) has caused all the experienced opticians in the UK to leave the profession - I qualified as one a number of years ago, but since NOBODY ever checks to see that an optician is properly qualified and registered, over 95% now never use a properly qualified and registered optician any more - because it is more profitable for them to use unqualified people. Even so, most optical practices do not really make much money (and MANY are seriously struggling!!) since people in virtually ALL other developed nations spend vastly more on eyecare than UK citizens do. I have access to some independent statistics that support that view.
    Most of the job applicants in other countries are coming from UK qualified opticians who can't work in this country any more - they are almost ALL leaving the profession or the country within 10 years of qualifying - so there will be nobody left with any useful experience in 20 or 30 years' time. Like the Post Office used to say about their small local post offices, "Use it or lose it" but the UK don't want opticians who know what they are doing any more, or certainly aren't going to pay for it, so you are all losing it.

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