Friday, June 22, 2012

Communication is the problem to the answer... *

The Blobshire General Hospital
London Road

Dear Dr Jest,

Your patient, Miss Archer attended our unit today.

Presenting complaint;                            Personal


Diagnosis;                                             29E: Gynaecological Conditions – other

Treatment:                                            511: Medication – oral


So ran the letter that wung (or is that winged, wang… er…) its way to my electronic in-tray yesterday. It seems all those hours spent on communication skills at the Big Hospital are not practised in the far flung frozen wastes of Blobshire, or at least not in their General Hospital.

You have to give them some credit I suppose. They’ve managed to compile a discharge note and forward it to the right GP at least, but sadly it’s of approximately no use. At least not as a clinical communication anyhow. What this is, in effect, is a glorified invoice. 

You see Blobshire is some distance from our own dearly beloved Ambridge, and our paymasters are unlikely to hold a contract with them for services of any kind, "personal" or otherwise. So if Miss A felt the need for medical attention whilst there on a visit, her treatment will have to be paid for, after the fact, by our own PCT sending a wad of fivers to the Blobshire Acute Trust. To do this our PCT will require evidence of treatment being carried out, which is where we came in.

Disappointingly even the codes are no help. Our 29E is “Pain- Sensation- other” and makes no mention of any gynae’ problem, all the codes before and after it having to do with various types of limp. And on our system 511 doesn’t even exist, so I’m really none the wiser. Sadly as it appears Miss A was not assessed at all, and had no outcome recorded, I can only imagine what happened to her a few nights back on the mean streets of Blobcester.

Still all is not lost, I missed off my absolute favourite bit of the letter. Without, so far as I can glean, the font being so devoid of expression as to make irony improbable, any hint of the same, the communiqué concludes thus:

“If you require any further details, please contact us on the above number.”

* You all know what's on offer by now. EVCHN to the first correct attribution.

Friday, June 01, 2012

Striking a pose.

In twenty days and for the first time in my career, it looks as though I may be called upon to take some kind of industrial action. Aunty says I’m going to be on strike, but that’s not quite right. If I’m doing anything “disobedient” I’ll be doing my level best to make sure it won’t inconvenience the good burghers of Ambridge, and a great many of my colleagues up and down the country will be doing likewise.

Also according to Aunty, this action is all about my pension. And on a technicality there they have it a little closer to the truth, but if they bothered to actually ask any pertinent questions, and then bothered to listen to the answers, they might appreciate there’s a whopping great iceberg of seething malcontent of which the pensions issue is the tiny bit you can see. Still why let the facts cloud a good argument eh? 

The whole pensions argument is a thorny one to be sure, and for anyone out there in the private sector sitting anywhere below top executive “Golden Parachute” grade must wear very thin indeed. Still at the risk of sounding like a seven year old in the playground, what Dave and his cronies are trying to pull is “just not fair”. They say that pension provision is unsustainable, and yet our pension contributions, you know the pay we have stopped to cover our future liability, pay into the treasury roughly £2bn MORE that the pensions take out every year. That’s money abstracted from the scheme by HMG for other purposes. Or put another way TAX (if you’re feeling charitable) or theft if you’re not. Robert Maxwell did something similar a while back but because he was a baddy it was bad. When it’s that nice Dave, and his pal George, somehow it’s o.k. (And yes Tone and Gordon were up to it to, this isn’t a party political point).

Anyhow, that’s the status quo ante, but now Dave and George want a bit more, and at the same time they want to hang on to all our contributions a bit longer too, since we’d only squander them on fripperies if we were allowed to retire too soon. This on its own rankles a tad. And yet, on its own, I very much doubt it would have prompted my colleagues to vote for industrial action in their thousands.

The thing is, as has been droned on about at some length, both here and other-where, our paymasters and rulers have rather lost the good will of the profession. Tone and Gordon playing fast and loose with the contract started the process, true.  Lansley’s back of a fag packet re-organization after we were PROMISED no top down re-structuring, and the appalling mess they’re making of its implementation (a mess so scary they’ve had to veto releasing the “risk register” for fear of frightening the horses) are way more important and way more worrying to those of us who wish to see a true National Health Service for our kids and theirs and so forth even unto the seventh generation and beyond.

The tiny problem with that is that you can’t hold a ballot for industrial action on an abstract concept, so we are left like disenfranchised barons attempting to force bad old King John to Runnymede on the issue of the unfair abstraction of our lands and chattels.

If you care about your surgeries, your hospitals, your lovely district nurses and midwives wobbling about on their sit-up-and-beg bikes and all the other paraphernalia of the only vaguely successful stab at socialized medicine in the known universe (excuse the hyperbole) I urge you to see past the whole “fat cat pensions” thing and think about why the B.M.A. for the first time in a generation has seen fit to hold a ballot at all. And if you’d then like to lend your weight to the campaign, why not email Dave*, George, Andrew , and your own MP to tell them so. 

If you’d like to do it weekly, even daily till they get the message then so much the better. And on 21st June I shall make a point of being on hand to see urgent cases whether they come bearing hob nobs or not. I’m just saying… ;-)

*seems you might have to write to Dave. 

House of Commons, London, SW1A 0AA
Tel: 020 7219 3475
And remember to sign off “LOL”
I'm told he likes it.