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A bitter pill to swallow

By guest blogger BOB FERGUSON

I am, I’ll confess, a fully paid-up NHS groupie, my commitment rooted in family connections: a wife who nursed, and a brother and son both hospital doctors. However, the ties that bind do not blind; I am alive to its shortcomings. Lately, for example, I have concluded that trusting general practice to keep patients informed requires a leap of faith better suited to the gambling casino.

Consider the friend for whom Warfarin provides a life-line. One day he found his pharmacy package swollen by a number of unexpected, and unexplained, items. Had he consulted his crystal ball, he might have discovered they were the products of a prescription change which, in a crude reaction to overdoses caused by patients confusing 5mg tablets with 0.5mg ones, had replaced the former with a combination of lower strength.

Given Warfarin’s unsuitability for blister packs, my friend suggested to the surgery that people who can’t tell a large pink tablet from a smaller white one – with no guarantee they’d be able to count the additional replacements either – should have their medication intake supervised. It was met by a scarcely-suppressed snort of disbelief: “have you any idea how many patients we have on Warfarin?”

He later established that the intervention only applied to daily doses of less than 8mg, an unfathomable decision implying that higher dosage either confers competence in medication management or immunises against accidental overdoses. Crucially, he had mined all this information himself; there had been no communication from the surgery.

Then there was the mindless treatment of my written request for a repeat prescription to be brought forward to cover an absence abroad, during which the existing supply would run out. After an abortive trip to the pharmacy, some digging revealed that, in a triumph of bureaucracy over common sense, the prescription had been deliberately post-dated. To the day before I was due to fly out. No pressure, then. Not for the first time, there had been zero contact from the surgery.

Most astonishing of all, I recently discovered a diagnosis in my medical history of which I had no knowledge whatsoever. It had apparently been prompted by a single result from an unconnected blood test. According to the GP, it would not be unusual for this particular diagnosis not to be shared with the patient. Which leaves the “no decision about me, without me” mantra in tatters.

Missed targets may grab the headlines, but the reputation of the NHS rests on much more than numbers. My experience is of failure in the most rudimentary function of general practice, information giving; its need-to-know basis too often rates patients as needing to know very little indeed. Is this the first spark In a bonfire of cherished certainties? Has the NHS now been so corroded that being kept in the dark, either by design or by indifference, is a hazard patients must learn to negotiate?

  • The CT Blog is written in a personal capacity – comments and opinions expressed are not necessarily endorsed or supported by Caring Times.

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