Feathers - thank you - alerted me to this blog post, from 20 months ago, about the appalling way in which a patient was treated by our National Health Service. Today I append the entire post.
What's so special about this story?
Nothing, unfortunately.
There is nothing special about the story but, this time, the criticism comes from a GP (Dr John Crippen of NHS Blog Doctor - scroll down to 19th April) not a mere patient who can be demeaned and ignored. His comments shouldn't carry more weight than a patient's but they do and I thank him here for his honesty.
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"Thursday 19th April
A desperately frustrating morning trying to get some help for David and Mary, his long-suffering partner. David is a Welshman. He works, when he does work, as a bricklayer and thus can earn good money. He is a keen snooker player and, in a different life when he was in Wales, had ambitions to play professionally. It did not work out.
His marriage broke down. He moved to England several years ago and now lives with Mary, who is a hotel receptionist. They have no children, but David has a ten year old son in Wales, whom he sees occasionally.
David suffers from anxiety and depression. To allay the anxiety, he drinks. To bury the depression, he drinks. The drinking makes the anxiety and depression worse, so he drinks more. You can argue about the definition of “alcoholic”. David qualifies on any definition you care to advance. He drinks gargantuan amounts. Sober he is delightful. Drunk he is foul tempered and frightening. He has never hit anyone. He never gets violent. He does not smash things. But who knows what will happen tomorrow.
The psychiatric services are playing pass the parcel with him. He has been under the care of the CMHT for over a year. They tell him not to drink. He is under the care of the alcohol team and they tell him that he drinks so much it would be dangerous to stop abruptly. They have suggested he changes from vodka to beer. They have offered him group therapy, but he cannot manage that. He is too anxious to do “groups”. He was about to have a ten week out patient supervised “de-tox” course, but when he turned up for the first session, they breathalysed him. He had not had anything that day, but the previous day’s intake was still showing. You have to turn up to “de-tox” sober so they would not let him in. He had breached his contract.
David wants and needs in-patient de-tox. There is no NHS facility that provides that in my area. Because David always smells of booze, the medical doctors are not interested. The psychiatrists are not interested either. David has never seen a psychiatrist, even though he is has been under the care of the CMHT for a year or more.
Two weeks ago, he took another overdose. We are not talking the teenage girl’s three paracetamol and an Alcopop. We are talking forty to fifty 40mg Citalopram tablets and seventy 50mg Campral tablets, all washed down with two litres (yes, two litres) of vodka.
He was taken to hospital by Mary and a mutual friend. He was not seen by a consultant psychiatrist. He was not seen by any of the psychiatrists. He had a “risk assessment” done by a nurse.
Take a look at it. Apologies for the quality of the scanning
[CC Scanned images omitted here.]
[A partial extract only is transcribed : Colours: original letter; Dr Crippen's comments]
What can one say?
Mood : low. (really?)
Regrets his actions and believes he would not repeat od/self-harm. (Really? Why should he stop now? How many tablets does he have to take for someone to respond to his cry for help?)
PLAN
Discharge ( ? plan)
Refer to CMHT for early appointment. (He is already under the CMHT)
+++++++++
I have printed the letter in case you did not believe it.
The NHS is free at the point of entry. I heard that somewhere. Can’t remember where. Maybe I read it on the back of a match-box. David cannot find the door.
David needs psychiatric help and in-patient treatment and de-toxification. He needs help with his anxiety and depression. He is not going to get it unless he goes privately. He is not even going to see a psychiatrist unless he goes privately.
Make no mistake, David is a difficult patient. I spoke to someone about him today. They said, “Oh God, he is impossible; he will not co-operate; he won’t stop drinking”.
So, bog off David, you are a pain in the ass.
PLAN?
Nothing."
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I've heard similar stories where patients have been unable to access treatment but here we have a GP, not a patient, tearing his hair out at the system. I bet the medical establishment don't listen to him either because he is telling them what they don not want to hear.
Madness! The system is mad!
The system must be changed!
But only we can change it!
2 comments:
I know you will not want to hear this Calum but there are some patients whom the system, any medical system, is unable to help.
It is a great shame that David did not get into the detox program but maybe that would have been only a temporary stopgap.
We have a much better system than the NHS, although not perfect by any means, but I used to see the same thing over and over when a chronic alcoholic patient would be admitted to the hospital, treated for a while and discharged. But there has to be some cooperation on the part of the patient. When they were discharged they returned to their old ways and the cycle continued until ultimately they quit drinking or they died.
It is so frustrating for medical personnel in these situations. They put every effort into trying to help these people but they thwart all attempts to help until eventually, with the limited time and resources they have, they put their energies into other patients whom they might be able to help.
Dr Crippen has been railing against the NHS system for quite a long time. He is but one example of a caring medical person who is frustrated in trying to help his patients, not only David.
This is a heartbreaking story and I hope that someone was able to provide David with help get him off his cycle of self destructive behaviour.
Today saw a man who works in a centre....he is somewhat non conforming :) grew to like him as he talked and said how the mental health team did not like him.....:)
He has a tendency to be well known for his clients he helps (free) not NHS, who have alcohol and so forth problems due to anxiety and depression, abuse, he has worked with them for twenty years.....
He knew it all, spot on, immediately he stated five treatments they had never offered and are free.....he was angry they had not offered them. He wanted to know why....
He would be banging on their desks :) making them provide the treatment they are meant to do so, he stated how someone can have anxiety, depression, abuse, in their life's...overdose...they do not know how to fit you, which box to put you in...you could fit in depression, anxiety and so on ....but instead they do this, they think oh we know personality disorder :) and they shove you in the box.
he goes with people and states how they have to talk to them, he is very straight and abrupt, but very likable :) came away with the impression that this is the type of person who could get the job done. They also have to listen, do as he says, as he works within his field which is just bonus.....
he normally refers to others once he has seen someone but he has taken me on, because of how they have treated me....or rather lack off. Not personal to me at all, was very apparent to me this was the way they treated everyone, just how they work their system.
Even someone on the crisis line stated how many people phone.....that are so left with nothing, no help support, feel treated badly. He works on the line but is unconnected to them. It was very apparent from majority of people that no one really felt the system worked for them, regardless of the nature of their illness or they had a struggle to access the support they required.
CMHT......if you were not already in a crisis you will be once you met them.....some others think they secretly work for the tea bag people as when you phone suicidal....anxiety high depression they suggest a cup of tea.......:)as if there is some handbook somewhere.....
So hopefully this will adjust things slightly, it is just sad for people that it has to come to that.
Finding the right person to help you seems to be a major part of the battle. The Doctors work within the system and have come to the conclusion are limited, personally believe at times, probably feel just as frustrated at times as the patients do when they refer them on.
Feathers
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