There is a disturbing scheme that is being rolled out by the British government across GP surgeries in the north east of England, but anyone and everyone who uses the NHS in the United Kingdom should be worried.
In a previous post, I mentioned the troubling practice of GPs being incentivised to reduce the number of specialist referrals: discovering that the Clinical Commissioning Group (CCG) in the county where I live in was one those named explained so much regarding the difficulty I had in getting an initial referral to a rheumatologist.
Now it seems that the government wants to add yet another obstacle to accessing specialist care by placing ‘assessors’ between the GPs and the Specialists. Essentially this means that every referral letter (except for those relating to Oncology) will be intercepted and checked for relevance: if the assessor deems the request to be pertinent then the letter will be sent on to the relevant department – if, however, it is considered superfluous it will be returned to the issuing doctor with ‘recommendations’ for alternative treatment.
“Those deciding will not have access to patient notes, they will get a letter, check it against guidelines and either send it on as requested or send it back – that will cause a delay in the referral and a delay for the patient.
If they had access to notes, this would be a lot easier and safer as they could go in and see exactly why we referred in the first place.” – Professor Ahmet Fuat, GP
Think about that for a moment.
Access to specialist care will be based on the referral letter alone, and not on a patient’s medical history or current needs. In addition, much like the Department for Work and Pensions’ ‘disability assessors’, there is no guarantee that the person making the final decision will a consultant or expert in the field.
“The system will focus on referrals in ophthalmology, gynaecology, cardiology, rheumatology, ears, nose and throat, dermatology, gastroenterology, and urology.”
I really don’t want to make this a ‘women’s issue’ but with seven years being the average length of time for an Endometriosis diagnosis, and signs of cardiac arrest being ignored because women’s bodies don’t follow the male pattern, I don’t see how having someone dismissing symptoms as ‘bad cramps’ or ‘Anxiety’ is going to be of any benefit. At a time when people are finding so difficult to be believed by their GPs in the first instance, this may prove to be one roadblock too many.
The government may claim that this arrangement is necessary in order to bring down the costs of running the NHS, but what is glaringly obvious is that lack of care in the earlier stages of an illness will evidently lead to the need for acute care later on – essentially shifting the strain from the CCG to the emergency room then back to the consultant from whom initial treatment was originally sought.
However, for me the truly alarming thing about this clearly ideological decision is that many of the areas considered for secondary checking are ones where the patient will need long-term care; and because of the way disability is characterised by government officials and the media, people have a tendency to think of it in terms of a ‘life-changing event’ (i.e. car crash, work injury) rather than something that will happen to pretty much all of us if we live long enough. What separates many Spoonies from the general population is often not their actual illnesses but their age at the onset of symptoms. If I was eighty-five years old a great number of my issues would be of little surprise, but in someone in their forties, they are actually a concern.
What this all boils down to is that people with complex or rare chronic conditions will find it increasingly difficult to gain ingress to the targeted treatment they require, while those that have the temerity to live to a ripe old age will have their advanced years used as an excuse to deny treatment. The money will be saved because the patients will die before they can be cared for.
Earlier this year, the comedian and activist Adam Hills made a very important point about the current government’s attitude to disabled people, and when you hear what he had to say you’ll realise that a lot of these ‘money saving measures’ are merely a thinly veiled attempt to ration people’s access to healthcare and other national safety nets – the very definition of a ‘Dereliction of Duty’.
Link to the source article: here
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