Saul Goodman
It's all good, man
I feel let down by a GP who hasn't got a single prescription right in 8 years.
Anyone else feel like the NHS almost doesn't exist for them any more?
- Thread starter nightowl
- Start date
Last post before I do as sojourner tells me…
I’m angry at people blaming a systemic failure on GPs and their poor fucking receptionists. Maybe Red Cat is right and fear makes people blame a face rather than a system. I just think it’s dumb.
We need strong leadership to redefine what healthcare we will and won’t pay for, and how we will pay for it as the NHS is fundamentally broken and more money alone will not fix it.
But I support healthcare paid for by taxation. I think it’s essential for it to be free at the point of delivery. For the sake of people who cannot afford private healthcare, for children, for society, and because it creates better medicine. I care about that to the extent I will stand next to a frigging Marxist in a hat and hold a placard.
I’m angry at people blaming a systemic failure on GPs and their poor fucking receptionists. Maybe Red Cat is right and fear makes people blame a face rather than a system. I just think it’s dumb.
We need strong leadership to redefine what healthcare we will and won’t pay for, and how we will pay for it as the NHS is fundamentally broken and more money alone will not fix it.
But I support healthcare paid for by taxation. I think it’s essential for it to be free at the point of delivery. For the sake of people who cannot afford private healthcare, for children, for society, and because it creates better medicine. I care about that to the extent I will stand next to a frigging Marxist in a hat and hold a placard.
ouirdeaux
Caring, Understanding, Non-judgemental Type
Can you not change your GP?
UnderOpenSky
baseline neural therapy
Must say my views soften about the admin staff after doing six months of IT work in GP surgeries and watching them work. It's a tough job.
Saul Goodman
It's all good, man
That's been on the cards since I moved house 3 years ago. But I'm pretty sure it'll involve stress that I don't want or need, so it's been put on the back burner.
Look, I think a lot of what people do and think is stupid too. Of course when I'm at home I rant about stupid people or people who don't give a fuck about others. I'm not sitting there analysing stupid or antisocial behaviour in my normal everyday life, well I do because that's how I'm made, but that's alongside ordinary reactions to situations and people I don''t like or who have pissed me off or I feel treated badly by.
But in work, part of my job is to try to understand the motivations behind blaming and scapegoating states of mind, and sometimes its not fear, sometimes it's enjoyment of putting the boot in, but either way, that's no different to me than a political discussion, politics to me means trying to understand why people and systems behave the way they do so we can all live better.
brogdale
Coming to terms with late onset Anarchism
Not wishing to draw you back in to the thread, having said you'll withdraw, but really, what on earth does this mean?
Why would "we" want "strong leadership" to tell us what healthcare capital deems necessary for their continued accumulation?
Silas Loom
Advanced. Forthright. Signifficant.
What’s the problem with them, then? And what do you think “functional” means?
scifisam
feck! arse! girls! drink!
I don't know about anyone else, but when I complain about the difficulties I have with accessing healthcare, I'm not blaming the individual medical practitioners (with one exception).
It is the failing system I'm angry and sad about - there's no need for anyone to take it personally.
It is the failing system I'm angry and sad about - there's no need for anyone to take it personally.
Puddy_Tat
naturally fluffy
it's worth questioning whether the system is failing, or if the system is being failed.
there are those whose political and / or financial interests want us to think the system is failing and that the only answer is privatisation
(see the railways, the royal mail for how much better it would all get...)
there are those whose political and / or financial interests want us to think the system is failing and that the only answer is privatisation
(see the railways, the royal mail for how much better it would all get...)
I think we'll find increasingly that a lot of these patients are autistic, often but not always undiagnosed women. The inclusion of sensory differences in the diagnostic criteria allows the research to make these kinds of links in a way that it didn't when autistic people were reporting these experiences as painful and impairing but they remained excluded from the criteria. Also, the rise in women gaining diagnoses and turning their attention to exploring these issues clinically and in research will see some change too.
When health workers don't understand, the person is described as complex.
Health was the great untapped market, it's not a series of unfortunate accidents that we are where we are.
Silas Loom
Advanced. Forthright. Signifficant.
When health workers don’t understand, the person is described, completely inappropriately, as having a “functional” disorder, spurious correlations with neurodiversity are posited as facts, and then suddenly psychologists get to weigh in. They should stay in their lanes.
People with autism are likely overrepresented among people who are chronically ill with conditions lacking biomarkers or treatments, but who don’t have the interpersonal nous to realise that sceptical, psychosomaticising GPs are the last people you should discuss your condition with if you want responsive care on unrelated matters.
They use functional and they also use complex.
I don't think they are spurious actually, my observations of young people in inpatient with 'functional' disorders 20 years ago is that they were very likely autistic girls, and also most of the yp referred to CAMHS with pain. Autistic people describing burnout is very much the kind of presentation that gets described as functional by medics. I haven't suggested they are facts though there is some research that links them though (not I said links, not cause).
If you mean specifically your own diagnosis, if you have one, then I don't know about that, I was speaking more generally, fibro, diagnoses that are given to women.
I am not a psychologist but my experience is they're not so very interested in physiological or biological causes, it's much more in their training, and that of psychotherapists, to take a psychological pov i.e. functional.
Whose lane is the lane for what you're describing then?
Silas Loom
Advanced. Forthright. Signifficant.
It’s still primary care, but staying on topic, all the NHS needs to do is show empathy, believe patients, don’t skimp on pain relief, and don’t waste public money on referrals to clinicians who want to treat “deconditioning” or “pain beliefs” or “sensitisation”.
If you want more of a discussion about this, it’s a K&S one. But I’ve found your advice on autism in young women very helpful in the past, would like to stay on friendly terms, and I don’t think we have a good chance of agreement on this particular topic.
I don't know what you think I'm arguing but I haven't said anything about psychological care being the answer here at all. In fact, my argument was literally about believing patients and it being far more likely that there's something else going on, whether that is linked to autism which was an example, or some other cause, than the description functional implies.
You do know I'm autistic myself don't you?
Anyway, lets leave it there then, I don't want to fall out either.
You do know I'm autistic myself don't you?
Anyway, lets leave it there then, I don't want to fall out either.
InArduisFouette
Well-Known Member
thanks to the unique way General practice was funded in 1948 becasue the NHS wasn;t going t o be able ot buy out the properties of GP practices , where the hospitals were all ready often state owned all ready, owned by charitable foundations or have been created out of thin air during WW2 ( a number of sites were using 'EMS huts' a type of prefab well into the 2000s ( e.g. Pinderfields Lettered wards before the move to the new hospital in 2010)...
even when the nHS built new health centres the GP practices became tenants of the nHS but the practice was still 'owned' by the GPs who were the GMS contract holders - hence the reason you often find Health centres with a mirrored but seperate GP surgery areas, as although they brought two practices onto the site they were still two distinct Practices for contractural reasons as well as any NHS community services and a community pharmacy as a tenant
InArduisFouette
Well-Known Member
Deconditioning is a major cause of morbidity and mortality
NHS England » 70 days to end pyjama paralysis
it's clear that mistakes were made with the over reliance on graded exercise in someof the chronic fatigue / post viral syndromes but outside this subset of patients deconditioning KILLS
there is a psychological aspect to pain management and a reluctance to acknolwedge that in favour of piling in more and more highly addictive pharmacological agents is a problem
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Silas Loom
Advanced. Forthright. Signifficant.
Deconditioning is a major cause of morbidity and mortality
NHS England » 70 days to end pyjama paralysis
www.england.nhs.uk
it's clear that mistakes were made with the over reliance on graded exercise in someof the chronic fatigue / post viral syndromes but outside this subset of patients deconditioning KILLS
there is a psychological aspect to pain management and a reluctance to acknolwedge that in favour iof piling in more and more highly addictive pharmacologicla agents is a problem
I would put fibromyalgia and EDS patients in this subset.
InArduisFouette
Well-Known Member
potentially it's evangenital Dogwhistle , basically cut Reproductive health, GUM , HIV/AIDS and Gender Affirming care away from the system if not outlaw it as we are seeing in the MAGAt states
InArduisFouette
Well-Known Member
Very hard to NOT agree some to many fibromyalgia patients fit into that 'chronic fatigue ' category where pacing managing an energy budget has to come ahead of preventing deconditioning - but this is much the same as some of the arguments elsewhere about overtraining for elite sport / dance and the dmanaging effct seen in young people from this in the not that distant past
I have a feeling that EDS may end up being split into a number of differnet conditions at some point , equally early identification of EDS and EDS-type syndromes might help prevent some of the people who become as disabled by it as they are from reaching the point where they are unable to cope
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ska invita
back on the other side
Dont worry everyone, New New Labour will save us....
Oh.
Oh.
Plumdaff
joy in people
There are probably some difficult and challenging conversations to be had, and some of those need to be with the public, but often they need to be with different parts of the state which currently have conflicting interests and create larger problems.
For example - we have a unspoken public health emergency in this country around neurodiversity. In most cases, in order to access even the most basic adjustments at work or in education, or even the most low level intervention or support from social care/ NHS/ Third sector you usually require a diagnosis. MH services currently cannot and do not have the capacity to offer a timely diagnosis to the amount of people asking for one (round my way about in some areas 70% of referrals into MH services are for ADHD assessment). One sensible way around this would be to just offer most adjustments and support to people who seem like they need it and sod the diagnosis but that's an anathema to how our means testing/ hoop jumping / gate keeping institutional culture works.
Similarly (and I am not talking about everyone - many people do require specialist treatment) if we had a society in which most people had a secure home, enough money to meet their basic needs, felt integrated into a community, and had access to leisure and exercise, far fewer people would be mental health services for what we'd badge as mild-moderate support (often started by very reasonable distress at their cicrumstances) and we could target our support to people with acute and moderate - severe need more effectively.
I'm not saying MH services aren't failing. But badging societal pain, for want of a better phrase, as MH and then sending everything that way will never work, but looking more broadly at how we solve things is much harder, and arguably neoliberal governments don't want to do that thinking. Far easier to blame those nurses promoted beyond their ability trying to manage this mess (this is intended to be lighthearted, given what I do for a living, and not intended to continue any interpersonal beef on the thread).
For example - we have a unspoken public health emergency in this country around neurodiversity. In most cases, in order to access even the most basic adjustments at work or in education, or even the most low level intervention or support from social care/ NHS/ Third sector you usually require a diagnosis. MH services currently cannot and do not have the capacity to offer a timely diagnosis to the amount of people asking for one (round my way about in some areas 70% of referrals into MH services are for ADHD assessment). One sensible way around this would be to just offer most adjustments and support to people who seem like they need it and sod the diagnosis but that's an anathema to how our means testing/ hoop jumping / gate keeping institutional culture works.
Similarly (and I am not talking about everyone - many people do require specialist treatment) if we had a society in which most people had a secure home, enough money to meet their basic needs, felt integrated into a community, and had access to leisure and exercise, far fewer people would be mental health services for what we'd badge as mild-moderate support (often started by very reasonable distress at their cicrumstances) and we could target our support to people with acute and moderate - severe need more effectively.
I'm not saying MH services aren't failing. But badging societal pain, for want of a better phrase, as MH and then sending everything that way will never work, but looking more broadly at how we solve things is much harder, and arguably neoliberal governments don't want to do that thinking. Far easier to blame those nurses promoted beyond their ability trying to manage this mess (this is intended to be lighthearted, given what I do for a living, and not intended to continue any interpersonal beef on the thread).
Orang Utan
Psychick Worrier Ov Geyoor
Why does this need redefining? It should be the same as it was in 1948: we should provide healthcare to anyone who needs it.
The current CAMHS crisis is undoubtedly autistic and ADHD young people not coping with the massive pressures in education and on families and society generally. This was happening before Covid but I also think there's a lack of recognition that Covid was traumatic to our more sensitive youth, it turned their word upside down and afterwards schools piled on the pressure so they couldn't process and recover. They need smaller and more flexible and gentle schools and there would be less need for CAMHS.
The whole thing around MDT assessment and the ADOS administered to anyone over 10, such a waste of time and money, informants from family as though autistic people have no insight, it's disgusting really, and very expensive. Its not sustainable.
Puddy_Tat
naturally fluffy
HeAthen
Nadgers.
More great experience with the NHS for me. Was referred to Ophthalmology by my optician for 'narrow angles' with a glaucoma link. Saw the consultant within a week and a half and was then referred for laser surgery to burn a hole in the iris of both eyes to relieve pressure. Told it would probably take 4 months but have the appointment through and it's in just over a month. Really can't complain and in my case it's similar to other service I've had from the NHS. It really does seem to be a lottery going by others peoples experiences and that needs to stop.
PTK
Paul Kegan
Yes, that seems to be the case with the surgery local to me, although it is a continuation of what was happening before, with telephone appointments rather than in-person appointments.
PTK
Paul Kegan
Yes, thank you.
InArduisFouette
Well-Known Member
education in particular when you have the likes of Birbalsingh and the other paraphilic fetishists around uniform , quiet corridors and the like ...
funny how those those scream 'let kids be kids' are the ones turning them into corporate drones and/or evangenital zealots
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