Thoughts on politics and life from a liberal perspective

Friday, 19 February 2010


I had a notable experience this morning. I was trying to book an appointment for my wife to be able to go and see her doctor. She was told by NHS Direct yesterday that she should call her surgery first thing (8am) to make an appointment. I called on her behalf at 7:58 (message saying surgery closed) 8:00 (same message) 8:01 (waiting on hold for about 3 minutes) and when I finally got through to someone I was told that all the appointments for today were gone and the earliest that she could see our doctor would be 8th March, i.e. nearly two and a half weeks away. After some discussion the only suitable alternative doctor was available on 1st March but that's still well over a week away. In the end the compromise was that a doctor would call my wife at some point today but that's not really a substitute for a proper consultation.

If we had been willing to classify the problem as an emergency then I expect my wife could have been seen earlier but I thought that the government had a target of all patients being seen within 48 hours if that is what they want. Perhaps I have misunderstood what this target actually means in practise?

The situation reminds me of what happened in the run up to the 2005 general election. Tony Blair was being grilled by a BBC Question Time audience and one of them raised the topic of doctor's appointments. The lady said that she could only get appointments within the next 48 hours so for example if she wanted to book one for the following week she had to wait until 48 hours before and then ring them. Blair initially seemed confused about this and suggested it could be a one off but then lots people in the audience made it clear this was a widespread problem. He promised he would sort it out.

Now what I have experienced today is a bit different to that. It is actually more like the kind of problem that Labour pledged to sort out back in 1997.

Maybe I am being unreasonable. I can imagine that trying to get appointments booked is a very difficult juggling act and the only way I can think of guaranteeing this sort of thing is to have lots of slack in the system which would then garner accusations of people being paid to do nothing! However the problem is that we were promised things a decade ago that are still not being delivered.


Denny said...

The reason they won't make an appointment until the last minute (48 hours is generous - most surgeries are 'phone at 8am for morning appointments, phone at 1pm for afternoon appointments' - not very useful if you have a regular job) is so that they can have a high chance of hitting their target for number of appointments _kept_. People who only made the appointment 2 hours ago are quite likely to attend.

So, partly blame target culture, and partly blame idiots X years ago who didn't phone in when they weren't going to keep their appointment.

Unknown said...

If NHS Direct had said that she should be seen by her GP the next day, then that, in my view, is what should have happened. I would probably have stood my ground.

I've had the same experience with my GP surgery on several occasions and most of the time I've been reluctant to take an emergency appointment in case it stopped some desperately sick child being seen. To me, emergency means life or death so not being able to see properly didn't really count for that from my point of view, but apparently it did from my GP's.

The difficulty is with my surgery if they can't give you an appointment on the day, you have to ring up the next day and the next until they can fit you in. And they have an 0845 number. It's expensive enough for us - in one month a couple of years ago when my husband was seriously ill, we spent £15 just on ringing the surgery to make appointments (don't get me started on how you can wait for 15 mins and then be cut off as you get to the head of the queue) as well as prescriptions.

We can take that sort of hit, but people without a landline would have to pay more.

Dingdongalistic said...

I seem to recall that you used to be able to book appointments on a first come first served basis, and that Labour ditched this in '97 -- I can see why, though the present situation isn't perfect, it's preferable to having one where hypochondriacs take an appointment space that's far more desperately needed by someone with an urgent illness.

In other words, the NHS can't cover people perfectly. Tbh, there'll never be a universal healthcare option where people are seen as quickly as they like, because there just isn't the funds, or the quality of management to go into that one option.

Of course, ask someone like Sarah Palin, and they'll say something like "what do you expect from socialised medicine"? I prefer my answer, however.

Dingdongalistic said...

@Denny"So, partly blame target culture, and partly blame idiots X years ago who didn't phone in when they weren't going to keep their appointment."

I think the NHS branch in Herefordshire has the policy you refer to. It has been suggested that the NHS be able to find people for missing appointments without notifying -- always wondered whether there was something in that.

But I think you're also missing the other side of the coin, which is unless an appointment is an emergency one, the NHS can justify a small delay. Otherwise there would be lots of far worse stories in the news about people needing quick treatment being delayed endlessly due to delays in booking a GP appointment.