Postal Lottery
I have been living in London for a very long time.
My voluntary work in my local community gives me an extra insight into the lives of my neighbours... Our organisation provides some support services in the community, so we get the chance to form an opinion of certain local NHS services delivered locally.
I also attend the local NHS authority meetings where a bewildering number of statistics is shown - and this amply demonstrates the huge variety of indicators - from Emergency & life saving to the routine out patients clinics and after care services they have to deliver.
I live in London W1. My local hospital is new- less than 10 years- UCLH. Within our area we have 4 large GP practices [I ignore the GPs who operate on their own].
I can see my GP on the day- they have a system of 'walk in clinics' for emergency appointment, and a system for routine treatment. It works pretty well. Maybe I am fortunate enough to have a good clinic?? [and my impression is shared by many other 'clients'!]
Postal Lottery seen in education [hence why parents are anxious to live within the catchment area of good schools] , health, local authorities , private medical care etc.
Let me give you some examples of the experience of some close friends:
Liver transplant: my friend had a life saving operation, which gave her a new lease of life. Ever since, we have been in touch with the unit at Royal Free. We are impressed with the quality of care, the -still rising- success and the after care services.
NHS at it's finest.
Prostate cancer: amongst men, the most common cancer. Northwick Park Hospital/Central Middx Hospital.
The medical experts my friend encountered are world class [at the age of google you can easily find out!] . You can either see them on NHS, or privately, but they would be the same people.
Another issue is 'technical': Like so much in medicine, technological advancement offers new and less intrusive way of treatments.
You have to see your GP before you see a specialist. There is a waiting list for a specialist.
Question: what do you do? do you wait ,or go to see the specialist privately= jump the queue?
Well, this is up to you: it is not easy to tell how widespread the cancer is, the only way you can tell is by a blood count- i.e. indirectly.
Now you see the specialist: what sort of treatment? again, you have the NHS treatment or the private treatment.
In my friend's case, there was a substantive choice: There was a new laser treatment which was not tried and tested yet, so not offered yet by the NHS [it is now offered by the NHS]. This new laser treatment was less intrusive, but there was a catch:
You can only do it once. And it did not have 100% success rate. in case of failure- a operation was necessary.
The only successful way to treat is to remove the prostate completely- via operation- provided that the cancer did not spread.
What was recommended to him by the specialist was either the new private treatment or the standard radiation NHS treatment, or operation to remove.
What do you do?
my friend elected to go the NHS radiation way. He is still alive today, and he did not have the prostate removed.
His treatment was good, he was a assigned a coordinator who saw to it that the process [over a period of a few months] went smoothly.
Did he make the right choices all along? he is alive today...
another friend living in Burgess Hill- West Sussex health authority. heart problems. They are bad. do not live in their catchment area. they do not offer physio on NHS for instance.
Pregnancies: I have not heard many complaints from expecting mothers- i.e. there was no common thread to the issues that were raised by them. I am sure that this is due to different expectations!
I agree that preventative care facilities are not good. There is the GP, and there is the hospital, and not much in between.
Your local GP practice can make a bit of a difference too- we have a good dietitian for instance, but it is not enough.
I found it a bit difficult to persuade my GP to undergo an general health check.
regards
עשיתי כמה קורסים על הנושא). עם זאת, אני חושבת שחשוב להסתכל גם על התמונה הכללית ולראות יתרונות וחסרונות של שתי האופציות. נכון ש"רפואת יתר" היא רעה חולה שמוציאה את השליטה מידיו של הפציינט כמעט לחלוטין (אני אגב יותר חושבת על זה בהקשר של רפואה מתגוננת- רופאים שמנסים להמנע מתביעות ולכן עושים אבחון יתר), אבל במניעה ואבחון של מחלות שיכולות להפתר בקלות יחסית (בהשוואה להשלכות החמורות שיהיו להן בעתיד אם הן לא ייפתרו כשהן עוד "קטנות")- לענד זה מחיר ששווה לשלם.
