Monday, 7 January 2008

Oh Doctors, We're In Trouble


So. The Government now thinks it would be a good idea to instigate a screening programme for life-threatening diseases before they become a problem. On paper, that is indeed a great idea. Hopefully they realise it can only be a good thing if done properly and with a clear plan of how to deal with the inevitable knock-on effects, because without such a plan and a commitment to spend huge additional amounts of money, a screening programme will be useless. A bit like a one-legged man in an arse-kicking contest, it just won't stand up.

Admirable though the notion is, the idea that we can introduce universal screening without a guaranteed corresponding improvement in treatment availability means that this is unlikely to be successful in the long term. What "waiting list initiative" will be able to cope with the additional thousands of people who will no doubt swell the queues for specialist treatments because of their early diagnoses? Would it be better for them to fret about a potential deadly disease which may be progressing unchecked whilst anxiously waiting for months to be seen, or less worrying to live in blissful ignorance? Who can say? But perhaps the NHS should only ask the questions when it is committed to doing something with the answers. It's no good revealing a hidden problem early if there's no early treatment available for it, surely?

Forgive me for being cynical, but what concerns me is how on earth all of this is going to be paid for when, apparently, even now the NHS cannot afford the drugs which can prolong the lives of breast cancer sufferers and other patients are routinely switched from "too costly" drugs which treat their symptoms efficiently and are tolerated well, to something cheaper which fails to do the job and leaves the patient feeling ill. Psychiatric facilities are a shambles, geriatric services a disgrace, filthy hospitals are a breeding ground for bugs which are resistant to everything except good old fashioned cleaning, also deemed to be too expensive. So now we have to rely on bottles of gel instead of washing our hands, on antibiotics to make people better after we've made them sick, all for the lack of decent hospital cleaners and a bucket of hot bleach and a clean mop. Yet instead of fixing existing problems within the NHS, and goodness knows there are enough of them to go at, the Government is thinking of yet another way to put an additional strain on already hideously overstretched resources. And no mention of how it's all going to be funded. Brilliant.

Prevention certainly is better than cure, but it all takes money and unless this is definitely going to be made available (and not at the expense of some other deprived area of the NHS) just what is the point anyway? Hasn't anyone thought of the consequences and the requirements of a scheme such as this? If you ask me, it's a bit of a tease.

Or just another sick joke?


Norman said...

I'm afraid "Uncle Gordon" is no better than "ex-President Tone." All hot air and no substance. All I would say to our Scottish PM is, "Wisht thee blethering and hie thee havering. Just dee summat for a change!"
Isn't there a Brummie/Black Country similar saying about trouserless mouths?
All this health screening is all very well but is the wherewithall in place to follow it up? I don't think so.

CalumCarr said...

I think you found the flaw in 1. Without a fundamental restructuring the NHS cannot cope with the increased demand.

May I suggest you change your blog name to "Sometimes SwearingMother". I had to read the post a few times before I realised there was no swearing. What a disappointment. You swear so well.

Swearing Mother said...

Norman, if you weren't the gentleman that thou art, I'd say this plan was as much use as a one legged man in an arse-kicking contest, i.e., no good at all.

Or of course, there's the all time Brummie favourite, "all mouth and no trousers".

Either would do!

Swearing Mother said...

Hi Calum, I was too cross to swear, which seems incredible.

Be back to my usual foul mouthed self ASAP, or I may go back and add a little something later.

Was thinking about you and yours a bit when I wrote this.

Bretwalda Edwin-Higham said...

Forgive me for being cynical, but what concerns me is how on earth all of this is going to be paid for when, apparently, even now the NHS cannot afford the drugs ...

The thought crossed my mind too.

Winchester whisperer said...

I agree with you - what a crazy policy!

Winchester whisperer said...

Forgot to say, "Maybe GB needs a check up?"

DogLover said...

Don't you, swearing mother and your commentators, realise that Mr Brown has discussed his proposals with the top people in the NHS and been assured that they will be able to cope?

Or am I wrong and he hasn't? Surely that can't be the case! Tony wouldn't have bothered to consult the people who mattered, either! And Gordon has been too consumed with jealousy to have learned from Tony's mistakes.

I often wonder about politicians - most of them have no training in other fields before they become MPs. Imagine announcing an initiative like this in any form of business or commerce and not doing your homework first - you'd get your P60 immediately.


DogLover said...

"So now we have to rely on bottles of gel instead of washing our hands, on antibiotics to make people better after we've made them sick".

Spoke to my doctor the other day because Carol my secretary from long ago is in hospital with c.diff (clostridium difficile) and seriously ill. He says that many of us have the c.diff bug in our intestines, but the good bacteria keep it under control.

However anti-biotics can kill off the good bugs and c.diff then goes on the rampage.

So people can "get c.diff" in hospital through anti-biotics as well as through infection from the dirty state of the premises and bad practices.

Just thought you'd like to know!


Mid-lifer said...

All I can say is *sigh* - it's completely nuts - upside-down politics.

Cannot beleive you didn't swear either.

The Grocer said...

Not sure I entirely agree with your arguments, surely there is a case for some treatment costs to be lower through earlier detection, i.e in the case of secondary cancers or reduction in heart attacks as a result of heart disease? This reduction in treatment costs can then be ploughed back in to where it's needed.
That said i still question the motives of all of our paid politicians.
Good post by the way and ~I bet you can't go a whole year without Swearing.

Swearing Mother said...

Hi James, having worked in the NHS since the late 60's (oh dear, that's a bit of a giveaway), I've seen it all before, so that's probably why I am such a cynic..... the NHS has long been used as a tool for political point-scoring and I haven't seen anything recently which makes me change my mind about that.

What a pity.

Hello WW: GB certainly looks as if he needs a checkup, a haircut, a new suit and a charisma transplant, but I won't hold any of that against him ;o).

Hi Doglover, nice to read you again. That was the point I was trying to make about the overuse of antibiotics. Instead of trying to control bugs by sensible means (i.e., proper cleaning, better custom and practice, common sense measures and strictly adhered to hygiene policies) over the years we have instead chosen to rely far too much on medication to treat hospital acquired illnesses, and the bugs have become cleverer than we are so now it's a vicious circle. Human beings not only carry clostridium difficile in their gut, they carry all manner of bugs up their noses too not to mention on clothing, shoes, bags etc. The most bug infested thing on the wards is a doctor's pen (I never lend them one, or if I do I don't want it back). Hence the need for proper cleaning and hygiene measures rather than reliance on popping pills when an already sick patient catches an additional illness from the hospital.

I've worked for the NHS in large teaching hospitals for nearly 40 years now, and I really believe that this is just another pie in the sky idea that we won't be able to pay for unless we take the money away from other services. It sounds good, and would indeed be good, but the foundations of the NHS need to be shored up before we attempt any more additional load.

Midlifer, it was close. I only put "arse" in to please Calumcarr. What is the matter with me?

Hi Grocer, you are completely right when you say that early detection would be more cost efficient in the long run than treating advanced health problems. I absolutely agree with you on that. What I worry about is that we're about to embark on an ill-planned initiative before we've really got to grips with the existing problems, and that may make everything worse for everybody.

It is a really brilliant idea to offer universal health screening, but only if discovered problems can be treated immediately, otherwise it's just useless exercise. I just don't believe the NHS is in the position to do that at the moment, judging by the most recent financial cuts to services.

And no, I don't think I'll take your bet re not swearing for a whole year, it would be too bloody hard.

Bretwalda Edwin-Higham said...


Anonymous said...

The country's going to pot. Or has it already got there?

Crystal xx

Manic Mother Of Five said...

Interesting point and as ever, well made....... I can claim no particular expertise in health matters so am happy to listen to your (coughs politely!!) YEARS of experience. It does seem at the moment that our PM will jump on any particular bandwagon he feels may score him some desperately needed points.......

As for C Diff, just don't get me started - my lovely (younger) husband went into our brand new purpose built hospital in 2004 for a routine overnight procedure and came home after a month, having been on the high dependency ward having contracted undiagnosed and subsequently mistreated C Diff. He spiked the highest temperature they ever recorded on the ward - what a claim to fame!

Tina said...

I'll be honest, I think I'd rather not know. If I've got the potential to get something, but its not causing me any problems, and I might not be able to get any treatment for it for ages if ever, I'd rather live in blissful ignorance.

This writing business - will they give you a column in The Lancet? No?

Glad you posted yesterday, was coming back this evening to give you kick up arse, as you requested...

Swearing Mother said...

You're welcome James.

Crystal, if we haven't gone to pot yet, I think we're teetering on the brink.

MMOF, Hi! That's terrible, going in for a minor op and coming out with more than you bargained for. I feel a bit sorry for our PM, he just doesn't deliver bullshit quite so convincingly as Tone did, and everyone's having a go at him. Ah bless.

Hiya Tina! Yes, the Lancet should really employ me when I consider the number of "papers" I must have prepared for them over the years, unfortunately none of the written by me, just typed. There ain't no justice in this world.

Norman said...

I was just listening to our glorious leader blethering on about hospital"deep cleans" and other infection control methods as if they were something brand new.
When I was a very junior nurse, Matron ruled and woe betide any interfering "management" idiot still wet behind the ears who had the misguided temerity to interfere.
Deep cleaning as now described by these so-called "experts" was routine in those days as were a number of basic hygeine procedures which seem to have fallen by the wayside.
What the hell's going on? Its been downhill all the way since "cutbacks" and "private tender" became buzzwords.
Gaw'blimey, SM, you got me going now....

wakeupandsmellthecoffee said...

Excellent post. Very thought-provoking. I always defend the NHS, having come from the US and its insurance-led health care. But you are so right.

By the way, I've tagged you. See my blog for details.

Swearing Mother said...

Norman, you and I are singing from the same hymn sheet. Back in the days when clean meant spotless, Matron would have strung up anyone found sitting on beds, leaving any rubbish anywhere, not wearing a white coat, etc. Now wearing white coats is frowned upon, nurses wear their uniforms in ASDA, and people in theatre greens eat their lunch next to "civilians" in the canteen. The loos smell like a zoo, we're knee deep in fag ends at every entrance, and you can wear what yu like to work and wash it at 30 degrees C with your children's school uniforms because it's too expensive for the hospital to have a laundry. And this is called progress.

Come back Florence Nightingale, all is definitely forgiven.

Wakeup HI! It must seem like ingratitude to criticise a "free" health service, especially when I work in it, but so much money is wasted on stupid initiatives when the real point of it all is getting missed. Anyway, am trying to think calming thoughts now, so will be over to your blog ASAP.

@themill said...

Bring back Hattie Jacques to the wards, say I!

She's like the wind said...

I agree, but then politicians infuriate me, I watched the news and it showed a clip of GB speaking at parliament, he made a comment and was heckled by grown men and women, to which he responded with a personal dig at one of the other members, anytime I see clips this seems to be general way they carry on. I am not knowledgeable in the area of politics but we trust this man to run the county and they go on like school children!!!! aarrrggghhhh.

As for your New Year goals, you go girl, I can give you not tips but every post you write has me in laughter and that's a good thing.

Please note my change of name.

selfemployedmum x

Swearing Mother said...

@themill, you are quite right, what we need to hear are more cries of "ooh Matron" - she'd sort of things out.

Thanks for visiting.

Hello She's Like The Wind: nice new name btw! I often wonder what our politicians would like to be when they grow up, and how they justify their salaries. Can imagine them saying to the wife "hard day at the office dear, had to stick my tongue out at Gordon Brown because he kept biting his nails and annoying me."

Come to think of it.........