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Thursday, February 06, 2014

Daily Mail's Scathing Indictment of NHS hospital trust for Watford General

"Managers of hospitals over the years have been increasingly recruited from outside the health service, and although their experience of running a supermarket chain might allow them to balance the books, it does not mean they have any insight into how a ward should be managed and patients best served. " ~Jo Brand, British comedian

   Yesterday's Daily Mail offers a scathing indictment of the NHS West Hertfordshire Trust which manages Watford General Hospital--one of three under its umbrella--the very hospital in which Les had his surgery. 800 cancer patients missed desperately needed appointments due to never being informed of them in the first place. Many thanks to fellow boater Mike Wall (NB Independence) for sending the link along via email.

   For Americans reading this, you need to know that over here the NHS appointment system functions as though we are all still living in the late 1800's when postal mail service was at its best as a thoroughly modern system of communication. British patients can call a surgery to get an appointment and the actual appointment information is often not arranged over the phone but sent in a letter through the mail, supposedly, as a follow up.
   When we were waiting for Les' appointments to come through last August for his scans and endoscopy, we received nothing from the NHS to tell us the appointments had been booked. No one called, either because over here no one really has to take any responsibility or culpability, or because someone assumes some other department has dealt with the appointment and the buck is endlessly passed on elsewhere. Les had to call all over hell's half acre to find out if the tests had been booked, where they were booked, and when. One letter did manage to find its way to our address--the afternoon of the day the appointment was scheduled!
   Last November after Les came home and was finally in full recovery mode he received a phone call from a woman who informed him he had an appointment for surgical pre-op booked for the following week. After a prolonged conversation in which Les explained he wasn't scheduled to have any surgery just yet, having just had surgery in October, the woman double checked Les' name, National Health Number and mailing address were the same as what she had in front of her, but basically shrugged her shoulders and said, "Oh well, I'll see what I can find out and hung up. Nothing ever came of that and Les was calling hell's half acre a second time to get to the bottom of the next NHS appointment debacle.
   Les explained to me that the young woman couldn't tell him anything about who booked the pre-op or anything else as she was just a clerk hired to make phone calls from a list!! A bloody telemarketer would have known more let me tell you! I was shocked by this.
   Why--WHY would a system which governs the life and death of patients have someone with absolutely zero connections to the referring physician or department make appointments for something as crucial as surgery scheduling or pre-op appointments? Perhaps because the actual receptionists for said doctors and departments are so bloody busy faffing about with printing out appointment letters that are overdue and seeing them off in the mail.
   I've never been treated so rudely in my life or dismissed so casually in the States as I have here by receptionists at my primary doctor's office, the Oncologists office, or the surgeon's office. Bad manners and an impatient attitude seem to be a per-requisite for being hired by the NHS as a medical receptionist--and I use the term "medical" loosely.
   Les did find out the Urology department supposedly scheduled this pre-op appointment. He called the Watford General Hospital Dept. of Urology and a bloke picked up the phone, commencing fifteen minutes of the strangest medical conversation. Les explained the crux of the issue which was that while he was informed he may need urology surgery for an enlarged prostate, he wasn't in the pipeline for surgery yet--he had an appointment for flow tests and other exams first to determine if surgery was indeed the best route AND he also explained he was recovering from rectal cancer surgery complicated by sepsis, and still had an abdominal catheter in place over a month after surgery which he wanted removed. 
   The bloke on the other end of the line told Les a urinary catheter should only be left in place for five days! Les asked the man if he was a urologist. 
   "No mate, I was waiting here to use the phone and it rang so I picked it up!" Really???? REALLY???!!!!! I kid you not; some days I feel like I've been sucked into the vortex of an alternate reality and come out the other end ass over teakettle landing on my head.
   Stateside one calls the doctor's office and asks for an appointment. The receptionist tells you which days/times are available. You choose one that works with your schedule. She pencils you in, and you are good to go. She will handle all the insurance forms, payment issues, etc.
  Some offices will send a reminder email or text. Some will call you the day before, but most assume you are a responsible adult with an urgent desire to see the doctor therefore you will turn up on time. If not, you will charged for the appointment anyway. ($75.00 for 15 minutes of a primary care physician's time--a whole lot more $$$ for a specialist's time).
   If your doctor determines tests are needed, referrals are required to specialists, or you need hospitalization, usually your primary care doctor's staff set these up for you with the next party in the chain and call you to let you know the appointment time and date. Otherwise you are given the pertinent contact information and asked to book those appointments directly.  Amazingly this system works successfully for millions of American patients.
   The amount of British taxpayer money paid to the mis-managers of the NHS is appalling. This article in the Daily Mail underscores our recent bad experiences and it makes me sad. British patients suffer terribly under the appalling lack of care and concern shown by the NHS and its minions. Good care and excellent customer service should not be the exception--it should be the norm.


K1 said...

Hummm... The new hospital CEO (Samantha Jones - fine sounding name) is the person I wrote to about your blog. No wonder they were on the case PDQ. She had probably already given them a rocket about the "broken" system she had inherited!

Anonymous said...

I totally understand your anger and frustration however please try and remember not all of the NHS is the same. My father was taken ill a few months ago with a terminal illness and he had fantastic care and not only did he have fantastic care my mother was looked after by the hospital as well. My mum was offered a private room to stay in at NO cost so that she could be by his side whenever she wanted or needed to. Mum had the room for 9 weeks during that time she was also on a daily basis given both breakfast and lunch along with endless cups of tea and coffee. The staff used to wait for either myself or another visitor to arrive before making sure she then went of an had a proper meal away from Dad just to give her some breathing space. She was updated daily on all of Dad's care as were the rest of the family and when she became ill after a nasty bite a doctor came and attended to her. So please please don' t assume every NHS experience is the same because it's not! When Dad passed away two members of the nursing team attened his funeral in thier own time, a very different experience I know but none the less true. Jane

Jaqueline Biggs said...
This comment has been removed by the author.
Jaqueline Biggs said...

Hi Jane,
I am happy to hear your family have been the recipients of good care however as you said, "please don't assume every NHS experience is the same because its not." That Jane is the crux of the issue really. Every individual's experience of care should be the very best this country can provide--not hit or miss; not fabulous in some places and total s*** in others. The boaters on NB Caxton are receiving excellent care at The Christie Centre according to their blog, but Keith and Jo Lodge on NB Hadar have suffered care more like Les has had. My frustration comes from having experienced another system of care and knowing that the NHS can and should be modernized. Its services are NOT free--none of them. Your parents and every working British citizen paid for health care long before most of them ever needed it. You are not charged at the point of service--you are charged years ahead of it and the British government and the NHS have an obligation to spend those funds responsibly and provide the best care for everyone from beginning to end.

Jaqueline Biggs said...

Yep K1,
I did wonder if the rattling of Watford Hospital cages back in October had any long standing effects. Perhaps so...and many thanks for your support during that awful time.

Anonymous said...

Jaq... the irish health system is the same. There is now 4 managers/secretarial/pen pushers for every 1 member of "working" staff. My mother who is 86 years old was pushed around and around until I threw a stiff legal/lawyer intervention into the mix. They have a system here in Ireland for evaluating the system..... its a quango of managers, so much so that 3 members of this quango were doing an inspection of our local community hospital... they were there for 4 days and at the end they presented an invoice for €82,000 for their time....YES €82K for 3 people for 4 days pen pushing ! ... yet the patients die because of the incompetence you describe... I really despair.
Anyway, both of you are more than a match for the NHS..... keep well Les and happy cruising both of you.

Dave Smith said...

Hi there, I am receiving treatment at Maidstone Oncology Dept, Kent. Personaly i cant praise them enough for their care and manner. I can only wish that all NHS hospitals were run with the same care and commitment.
Good luck Les and Jaq i've been enjoying the blog for past 2 years.

Jaqueline Biggs said...

Hi Dave,
While I glad to hear you are receiving good care, I am sad to know you need it at all. We wish you a strong and solid recovery mate.

I've added your blog to our blog roll and you and NB Bracken to our list of boats and boaters.
Take care and perhaps we will have the good fortune to meet up on the cut!
Jaq and LesX

NB Valerie & Steam Train by Les Biggs

NB Valerie & Steam Train by Les Biggs