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Where is the NHS?

by Ian Charles

At your dentist’s, you fill in a form saying you are a ‘NHS’ patient. This means you pay one of three charges (bands) and the rest of the cost is made up by the government out of taxation. Your dentist is a business.
When my Health Centre (a business housing GPs, nurses, Health Professionals, their practice manager, and some other staff, and which can be set up with ‘government help’) is closed for training, for the evening, weekends, bank holidays and so on, phone calls are fielded to a ‘Walk-In Centre’ which covers for them. This is ‘Nurse-Led’ and supervised by just one doctor, a Practice Manager, and administrated by receptionists.
I know about nurses, doesn’t everybody? The word is synonymous with Angels, Healers, Dogsbodies, Unsung Heroes and (usually) Heroines of the NHS. There are Practice Nurses (No! I want a Real One!) Mental Health Nurses, Health Visitors and District Nurses. There are Midwives and School Nurses, Children’s Nurses and Geriatric Nurses. Have I missed anyone out? There are also Healthcare Assistants who do things that Nurses are too busy to do, like routinely taking blood. But the tradition has been that Nurses make you better, listen to you, tell you off and tuck you in. They hold the spoon that tips the medicine down your throat. They twiddle the taps on the drip that carries the liquid medicines, the salty water, potions that flow directly into your veins through the cannula inserted for the delivery or removal of fluid. The correct response when being cannulated is to say, “Remarkable; could you give me John Smith’s intravenously, then?”
You will be told, “If Doctor prescribes it.”
And there we have the big difference between doctors and nurses: nurses treat you and doctors tell them how; by diagnosis and prescription, except at the Walk in Centre, where a nurse, whom you think is a doctor because they never say Who or What they are, rushes you in, hurries you out and sends you away with a ‘script’ because these people are authorised to ‘write them up’ for you.
My experience, and do tell me I’m wrong and then you can deal with the aftermath of these decisions for me, is that these specially trained nurses seem to have around three ‘Specialisms’ and start seeing all patients as sufferers of one of the limited conditions they’ve taken responsibility for. Thus my family have been sent away with diagnoses and medicines for: asthma, backache, depression, irritable bowel syndrome, and muscle strain.
These ‘Doctor-Nurses’ as the proud mother of one of them describes her have thus missed: bacterial sinusitis, perforated appendix, infection of the inner ear, osteoporosis, sepsis and thrombosis. Scared yet?
The comedian Michael McIntyre has a routine where his GP, baffled by any number of things, constantly ‘refers’ him to specialists: leg doctors, bum doctors, ear doctors, until one day he tells the doctor he has a headache.
“Ah,” replies the GP, “I know the answer to this one – Paracetamol!”
The reverse is true of “Doctor-Nurses” and now some GPs I’m coming across; they ‘know’ everything, and you aren’t referred anywhere if they can help it; a combination of arrogance, not listening, and penny pinching.
So you stagger-out of the Walk-in Centre and three days later are fighting for your life in the Intensive Care Unit of some big hospital, built and equipped with money totally ‘invented’ by a bank out of thin-air so they can extract a ‘money-flow’ from the NHS Trust for the next 25 years, and your life is saved by some kids from all over the planet, highly trained immigrants who will go home on the train and be abused by a drunk for being ‘over here’ and called a ‘parasite’ and you decide to complain to some Practice Manager about the crazily wrong ‘diagnosis’ you got initially. You receive a letter of apology ‘from the company’ explaining that your points are valid, that no proper examination was carried out, that data such as temperature, blood pressure, do not appear to have been stored on the system, that you weren’t advised to go to A&E should the symptoms persist, that training and oversight has been completely overhauled as a result of your letter, that it is completely unacceptable you’ve waited so long for a reply, and the complaint has been passed through many hands until it got to the GP, the solitary, totally responsible GP, acting for this Private Healthcare Company, ‘Nurse Led’ but managed by an accountant; the staff policy now is to greet patients with the phrase “Hello, my name is …” and explain what it is will be happening to you and why. So that’s OK now, then.
Half of all care under the NHS comes from ‘private providers’ – I understood this when I had my thyroid scanned by a friendly young woman in a unit on an industrial estate next to a warehouse storing phones and laptop computers. I didn’t expect that my GP, the Emergency Doctor, and the buildings and services of my cancer hospital would be owned by the sort of people who own my local football club, bank or car showroom. I just didn’t, is all.
When did all this happen, and why didn’t I see it before it happened?
Where is the NHS in all of this? 
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