Sunday, January 6, 2013

Cynical Cacophony...


Social media is an interesting experience..to say the least. I spend time on twitter in the hope of learning and listening to patients and perhaps also to pick up pearls of wisdom from the great and the good. Examples of the former...numerous, a shining example of the latter? Sir Muir Grey..absolutely inspirational, someone who looks forward, eager to help us, the generation today, make the changes needed etc...but unfortunately they stand out as small oasis's in a sea of cynicism of anything new, mixed with excuses for any shortcomings of the healthcare system that have been highlighted.

Let's take some examples. Recently the DH launched the FFT or Friends and Family Test..in short, would YOU recommend the hospital, department or GP to your friend and family? Flaws? Of course...but as s starting point, why not indeed? I will give you a personal example..a few years ago, after a trip from Goa, I fell severely ill..and I had the most exemplary care ever possible from my GP. He didn't know my background but went out on a limb to help..simply..a patient. He reckoned I needed to be admitted, tried the local hospital and got...refused. I saw my GPs frustration...the medical registrars haughty tone to a senior colleague still rings in my ears...so I picked my phone up, phoned a colleague who was a Consultant in the hospital and he kindly arranged admission. diagnosis? Paratyphoid fever with liver dysfunction needing Intravenous antibiotics etc etc. Does my GP get my vote? Without a second thought. Would I want my family to be subject to the arrogance and ineptitude of the medical Registrar on call? No. I had to use my position to get admitted...why on earth is that right? Once admitted, again care was excellent...but that "refusal" jarred. So today when I see something like this, it sounds like a good thing...but oh no, the cynics are out in force...how it's not scientifically validated, how it's a tick box exercise...maybe so..but at least it's a start isn't it? What exactly are we afraid of..someone actually saying.."No, the care provided wasn't good enough?"..are we that arrogant that we cannot possibly be wrong?

Lets look at the NHS Bill...issues not quite right with it? Plenty. The fear and bane of privatisation, the perhaps unnecessary complete overhaul...but for gods sake, don't patronise me by saying all was well before. We have the Mid Staffs sitting in front of our eyes...where care has been shown to be appalling. I always hear the cry of staff shortage and time issues...I have also, during my training period, seen staff plonk down a porridge bowl on front of a frail elderly patient...just out of her reach.. Requests to correct that has been met with a glare, a lecture about junior doctors and their "place" and even a caustic.."do it yourself". Kindness does not need excuses...there is no defence against what has happened...but hey go to social media and look at the reasons why it could happen. I am always told about the numerous examples of "kindness" and "good care" which overwhelms such blips...but the naive side of me thinks those 2 traits are why we chose to do this in the first place? So doing that should be the norm, isn't it? And those who don't should be held to account...or is that too simplistic a view?

Let's look at "leaders" of healthcare professionals.Their job, at least in my book, is to guide their membership to make patient care better. If however that time is spent in defending the members, then the distinction between them and their trade union blurs. I see leaders rise in indignation when any GP is challenged..evidently there is little to correct..all that is needed is more money.To quote my teenaged patients.."Whatever". 
Here's an example in my own speciality ...data is pouring out that diabetes care could be better, we do worse than other countries...but I haven't seen any national diabetes body or leader come out and say "Sorry folks, we have failed you...our penchant to protect our own bastions ergo primary and specialists care has compromised care..and we will get it right this time around". Oh no...it was someone else's fault..if not, it was the patients fault...those pesky type 1 patients deliberately not taking their insulin and not attending clinics ( how dare they?!) or the type 2 patients who just needed to "run more and eat less".... Who needs accountability when you have the twin towers of cynicism and excuses?

Thankfully on twitter there's a button called "Unfollow"....so you can stop listening to the constant cacophony...but what do you do in real life? My personal philosophy has been to simply...try. If each individual kept faith to their belief of kindness, then the sum total will and must add up. 

Naive? Maybe. But don't patronise me by saying I haven't seen enough. I have..and so far, the debate about public funded or privatisation is a moot one if the personnel involved can't find the time to get that porridge bowl closer to that patient. As the meerkat cheerfully says..."Simples".

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