The UK’s National Health Service – 75 years old and senility has now set in…

Britain’s NHS was 75 years old yesterday. That is even older than I am. And dementia has now arrived…

…for the NHS.

I am only slightly behind, I fear…

In September last year, I received a letter from the NHS which arranged that I would have a video consultation with a kidney specialist at 1245 on 9th March this year.

In February this year, I got a follow-up letter from the NHS saying my appointment had been moved to 13th July at 0915.

Last month (June) I got a phone call saying the appointment had been moved to 0915 on Thursday 6th July (today).

On Monday this week, I got a text from a verified NHS number confirming my video appointment was on Thursday 6th July at 0915 and to ignore any text messages or phone calls telling me my appointment was on 13th July.

I went online today, as instructed, about 15 minutes before the allotted time, signed in and got through to a video Receptionist who said I had no appointment today but I did have an appointment on 10th and 13th July. She told me to phone the booking number to sort it out.

In fact, on 10th July, I do have a face-to-face appointment with a totally different kidney specialist (I have two).

But I phoned the booking number, as the video receptionist suggested, to sort it out. It was an answerphone, so I left a message about the non-existent appointment on 13th and the actual failed appointment today. I didn’t mention the 10th; I didn’t want to confuse things further.

As I was phoning the bookings answerphone, I got a text message at 0915 reminding me that I had a video appointment at 0915 on 13th July.

At 0944, I got a phone call from the consultant I had been booked to have a video appointment with today, who was wondering why I had not kept the 0915 appointment today. I explained.

We had a medical chat.

At the end, he told me that, if I was told by anyone I had a video appointment with him on 13th July, to totally ignore it.

Then I phoned back the bookings answerphone to tell it about the consultant’s call and advice.

I have a feeling I may be getting a complaint from the NHS on 14th July complaining that I didn’t keep the non-existent but noted appointment on the 13th.

I am now looking forward to my face-to-face appointment with my other kidney consultant on 10th July.

Once, back in the mists of maybe it was Autumn 2020, I had an appointment with the same consultant (who is very efficient). When I arrived, the receptionist had no record of my appointment on her computer. But he saw me anyway, because he did have me on his appointments list.

My experience is that the doctors, nurses and consultants working in the NHS are mostly very efficient. But all large centralised bureaucracies are incompetent.

Back in the 1970s, my grandmother was taken into an NHS hospital with diabetes. They cut her leg off. 

Fair enough.

Then she got gangrene. That’s the thing they got in the trenches in World War One. It’s caused by unhygenic conditions.

Her other leg got infected. They cut it off. She died. 

All large, centralised bureaucracies are, by their nature – and human nature – incompetent.

Nineteen Eighty-Four was a rather over-glamourised version of the efficiency of a centralised state. Terry Gilliam’s movie Brazil was far more realistic.

As an addendum…

Just as I was about to post this blog, at 10.56, I got another message from the NHS. 

It told me – by electronic letter – that I have a video appointment on Thursday 1st February 2024 and added: “We hope you find this appointment much more convenient.”

(YOU MAY ALSO BE INTERESTED TO READ MY SEVEN BLOGS ABOUT MY SEVEN DAYS IN AN NHS HOSPITAL IN JULY 2021… THE SURREALISM BUILDS UP AS IT PROGRESSES…)

The UK Government’s madly illogical bureaucracy for old age pensioners…

(Image by Sandro Gonzalez via UnSplash)

A chum of mine is an Old Age Pensioner. 

Or a Senior Citizen, if you are American or Woke.

Every year in April, UK pensions rise and you are told the amount of your new weekly payment in a letter which arrives in late February or early March.

That happened this year to my chum. The increase in the pension happens on 11th April this year. Every year, in February or March, she receives the letter informing her what she will get from April onwards.

But my chum has somehow managed to lose the letter she received from the Department for Works & Pensions in February, telling her the new pension rates which she will get from April. The one she gets, updated appropriately, every year. And she can’t remember the new amount, which is made up by adding four separate smaller amounts together.

So she phoned up the Pensions Service to ask if it was possible to send her a duplicate of the lost letter.

However…

Franz Kafka

She was told it is not possible to send her a duplicate of that letter because they are not allowed under government rules to send out the letter until after the new pension rates come into force on 11th April.

She said, not unreasonably:

“But you already sent the letter to me – at the end of February…”

Yes, she was told, but they are not allowed to post the letter to her until after the new rates come in.

“You are not allowed to send me until April a letter you already sent to me in February?”

“Yes. We cannot send you that letter until April. You could phone up after 11th April to ask for the letter to be sent.”

“…The letter which tells me what I am going to be paid from 11th April?”

“Yes.”

“But I can’t get a duplicate of the letter I received in February telling me how much I will receive in April until I have already received the money in April.”

“Yes. We are not allowed to send you the letter until April.”

“The one you sent in February.”

“Yes.”

The search continues for the letter always sent every year in February or March which cannot be sent until April…

The surreal UK Covid-19 self-isolation advice: Franz Kafka meets Catch-22..

(Image by TheDigitalArtist via Pixabay)

On the morning of Christmas Day, I tested positive twice for Covid on a lateral flow test, although I had no symptoms. That same day, I was able to walk in to a PCR test area and get that more definite test. Two days later, that test, too, came back positive. 

I had taken two lateral flow tests (morning and evening) on Christmas Eve which had been negative.

Current UK government guidelines for England said I should isolate for up to ten days from my first positive test. ie until Tuesday 4th January. But, if I took a lateral flow test which was negative on Day 6 and, 24 hours later, on Day 7, the rules said I could stop self-isolating.

On the evening of Christmas Day – the day I first tested positive – I had some internal flu-like shivers overnight; and the next night some lesser internal shivers. And, for the first four or five days of self-isolation, I had a new and persistent hard-edged hacking cough. 

But, by Day 6, I was back to having no real symptoms. 

However, on Days 6 and 7, I still tested positive for Covid.

Positive, too, on Days 8 and 9.

On Day 9 – that’s today – I phoned the government’s 119 Covid advice line because my attention had been drawn to the government’s own online advice, updated on 30th December.

The online advice said (and says):

“You should not take any more LFD tests (ie lateral flow tests) after the 10th day of your isolation period and you may stop self-isolating after this day.”

But presumably only if you test negative?… No. It doesn’t say that.

It continues:

“This is because you are unlikely to be infectious after the 10th day of your self-isolation period and should not take any more LFD tests after this date.”

The italics are mine. And there is no time period mentioned.

What is said – and still clearly says – is that you should stop self-isolating after 10 days come what may and, in theory at least, you should never again under any circumstances at any point take any other lateral flow test.

Obviously that cannot be the intended advice – that you should never again take a lateral flow test. 

But the advice is clearly that, whether you test negative or positive on Days 9 and 10, you should stop self-isolating and re-join society.

This sounds mad and, I thought, cannot be the actual advice so, like I said, I phoned the 119 Covid advice line set up by the government.

Their on-the-phone advice was that, as a person triple-jabbed with vaccine, if I test positive on Day 10, I should self-isolate for 10 days although I could un-isolate if I test negative on Days 6 and 7.

“But,” I said, “the government website says I should not take a lateral flow test after Day 10, so I won’t be able to know if I test positive or negative on Day 6 and 7 of the new self-isolation period without taking a lateral flow test which, the advice says, I should not do.”

“That’s right,” I was told. “You should not take a lateral flow test after Day 10.”

“But, if I have to self-isolate after testing positive on Day 10, tomorrow, how can I know on Day 6 or 7 of isolating if I am positive or negative?”

“If you are negative you can stop isolating, otherwise you have to keep isolating until Day 10, at which point you can stop taking the lateral flow tests.”

“But I would not know if I were positive or negative without taking a lateral flow test and the government says, after Day 10, I should not take a lateral flow test.”

“If you do test positive, you have to isolate for another 6 days or until you have done 10 days in isolation and then you can stop isolating and do not have to do the lateral flow tests.”

They say Frank Kafka died on 3rd June 1924. I am not sure. 

I have always been attracted to surreality but there are limits.

I am going to return to daily life after Day 10 while keeping a healthy, well-masked distance from people and will wantonly keep taking daily lateral flow tests even though I have no symptoms. If I have two consecutive days where the tests have negative results, I will feel less wary… though not of bureaucracy.

Now the UK National Health Service wants me to attend a nuclear facility…

My last blog was about the reliability of the NHS – You can always rely on their organisational arrangements to be in total chaos.

Basically, I was told that a Renal hospital appointment I never had was being moved to a date which doesn’t exist. I was told that the new appointment was on Tuesday 20th November – but 20th November is actually a Saturday. 

The same message also said I should attend the “Kidney & Urology Dept on Wednesday”… with no time nor date mentioned.

Neither the previous non-existent appointment nor the previous non-existent new date were on a Wednesday.

None of the above has been sorted out yet.

So imagine my lack of surprise when I got home around 8.00pm last night to find I had received a letter about a totally different new hospital appointment unrelated to the other two (or it might be three) previously confused appointments.

I have ongoing calcium level and kidney function problems which put me in hospital last May and this July. 

The previous confused communication had been about the hospital Renal (ie Kidney) Dept and the Kidney & Urology Dept.

This new missive was about a forthcoming appointment with the Nuclear Medicine Dept at the same hospital with which, on Monday 29th November, I now have an appointment to have a Spine and Hip Bone Density scan or, as the letter says, “Bone densitometry DXA”.

This scan has never been mentioned before at any of my chats with my Kidney Man and my Calcium Man – and neither have my spine nor hip been a source of interest – but I’m prepared to believe it’s a legitimate part of the search for what’s wrong with me. I had a PETscan at the same Nuclear Medicine Dept in August this year. A PETscan is the one where they inject radioactive material into you and then (as I understand it) look at it circulating in the body.

I have been told by two separate consultants that I am a “man of mystery” because no-one has any idea what on earth the cause or causes of my calcium/kidney problem is/are.

This means, among other things, of course, that I cannot be treated because they have no idea what they should be treating. They know the result of my problem but they have no idea of its cause.

The actual doctors seem efficient and thorough.

But the NHS bureaucracy – like all large bureaucracies – is a catastrophe of incompetence.

More UK National Health Service chaos: my life is in their incompetent hands…

In hospital in, erm… who knows when?

As long-suffering readers of this blog will know, I was in hospital for seven days in May last year and again for seven days in July this year with a very high calcium level and (as a result) dangerously low kidney function.

No-one has been able to find out the cause. So I keep seeing consultants, mostly kidney and calcium men.

My kidney/calcium levels are pretty-much but not-quite back to normal now. But, still, no-one has any idea why they twice went dangerously haywire.

I wrote a blog in August this year when I simultaneously got three completely self-contradictory and chaotic letters about NHS hospital appointments.

Doctors, of course, like to use posh names, so ‘kidney’ staff are usually called Nephrology or Renal staff… and ‘calcium’ staff are usually called Endocrinology staff. In what follows, I have anonymised the hospital names as Hospital A and Hospital B.

In September, I was told my next appointment with the Nephrology team (my Kidney Man) would be on Monday 13th December at Hospital A.

Then, this afternoon, I got a text from Hospital B, which is part of the same group as Hospital A: 

Renal means Kidney.

The message concluded:

“Please attend Hospital B, Kidney & Urology Dept on Wednesday. TO RESPOND please follow this link…”

I did and responded:

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I’m confused. Can you clarify?

I have an appointment to see Nephrology at Hospital A on 13th December at 10.30. (See attached letter.)

I had no appointment to see the Renal Dept at Hospital B on 16th November. 

And the ‘new’ date you give – Tuesday 20th November – does not exist (20th November is a Saturday).

You also seem to ‘confirm’ I should attend a Kidney & Urology appointment at Hospital B “on Wednesday” (no time given but presumably either Wednesday 10th November this week or an unknown Wednesday in December).

Could you tell me if the ‘new’ Renal appointment on Tuesday 20th November (a date which doesn’t exist) is the same as the Kidney & Urology appointment I have never previously heard about at an unknown time this Wednesday 10th November?

If I do have to attend Hospital B this Wednesday, could you give me a time for the appointment?

John Fleming

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I await a reply with open-mouthed interest but little hope of efficiency or factual accuracy… It is always a tad worrying when your life and death is in the hands of large impersonal bureaucracies… All large bureaucracies are inherently incompetent…

A slow UK handclap for the continuing bureaucratic incompetence of the NHS

A standardised NHS container designed for taking the piss

As regular readers of this blog – particularly some recent blogs – will know, I have a very high opinion of the medical staff working in Britain’s NHS.

Equally, I have a very low opinion of all large bureaucratic organisations, of which the NHS is one.

This year I have written several blogs about the NHS’ wild incompetence.

I currently have high calcium level and low kidney function problems which have been going on for over a year – since at least May last year. And the doctors have still got no idea what the cause of the problems is.

That is fine. They are trying.

But it means I have to have dealings with the bureaucratic side of the NHS.

Yesterday I received three letters in two envelopes from the NHS, all dated four days before.

I have had a longstanding appointment to see a kidney specialist in my local hospital at 1030 on Monday 20th September.

The first of the three letters was from my local hospital and cancelled that appointment.

The second letter (contained in the same envelope as the first) was from the NHS Trust/Group to which my local hospital belongs. It said I should ignore that first letter cancelling the appointment. The appointment, it said, was not actually cancelled. I had been put on a waiting list and the appointment would be rescheduled.

The third letter, also from my local hospital and dated on the same day as the previous two, said I now had a confirmed appointment at 1030 on Monday 20th September.

The eagle-eyed may have noticed that is the same time and day as the original appointment which had been cancelled. Sorry! Not cancelled but to  be rescheduled.

I am not 100% certain if the first and second letters are referring to the third letter and the appointment no longer exists.

Or if the third letter refers to the first and second letters and it is rescheduling the appointment, which is now confirmed to be once again on Monday 20th September 2021 at 10.30.

I live on the outskirts of London. All three of the above letters from my local NHS hospitals were posted to me from the NHS in Bristol. 

I have no idea why and, I suspect, neither does the NHS.

The many-headed Hydra of mythology (The Farman Collection, 1987, via Wikipedia Commons)

 

Has the UK’s National Health Service any idea about what it is actually doing?

I have blogged about the chaos in the UK’s National Health Service before. The larger a bureaucracy, the larger the potential chaos.

I was in hospital for a week in May last year – with abnormally high calcium levels and dangerously low kidney function. This was reversed by a week’s worth of intravenous bisphosphonates – a drip to you and me.

But I have not had a full night’s sleep since June last year (ie exactly 12 months ago). No-one knows why I had the calcium/kidney problems and no-one knows why now, when I eventually go to sleep at night, I wake up at least once every hour every night with my mouth as dry as the Sahara Desert, forcing me to drink water.

As no-one has been able to diagnose the cause, there is no treatment. 

Currently, I have appointments with a Calcium Man in July, a Respiratory Man in August and a Kidney man in October.

One of the 6 pages of my Blood Test results

Yesterday morning, I got a 6-page print-out of my latest blood tests. I also got a call from another man at my local hospital to arrange a ‘Water Deprivation’ test two days before I see the Calcium Man. 

The Water Man was arranged by the Calcium Man.

The Calcium Man told me that it would be an early-morning urine test and I would not be able to drink liquids for several hours before the test.

Yesterday, the Water Man (who was a tad dithery) told me I would have to do “a 12-hour fast” before the test so I would not be able to eat or drink anything after 6.30pm the previous night. He had not told me what time the test would be.

“Oh,” I said, slightly surprised, “is my appointment at 6.30 in the morning?”

“9.30 in the morning,” he replied.

A slight pause.

“Oh,” I said, with a sinking heart. “So really a 15-hour fast.”

A slight pause at the other end of the line and then some linguistic confusion along the lines of “Umm… Err” followed by some audible recalculation.

“7.00pm,” the Water Man said, having recalculated the 12 hour gap before 9.30am. “So you can’t eat or drink anything after 7.00pm the previous night.”

I know when there is no point asking any more questions.

We left it at that.

But this does not increase my confidence in the efficiency of the UK’s National Health Service. I guess each generation thinks its doctors are experts and know what they are doing. Frankly, I do wonder if giving up on the application of leeches to the body was a good idea.

“The lies, and truths, and pain?… oh! yet… Stands the Church clock at ten to three?
And is there honey still for tea?” (Photograph by Ivan Mani via UnSplash)

 

ECCENTRIVIA – Mis-gendering, Tit-Bits, Potato Heads and Janey Godley

In yesterday’s blog, I mentioned the NHS wasting time and money sending out three letters when only one was required. That referred to a local hospital appointment I am (still) having on 11th May with the Respiratory Department.

Today I received a text on my mobile from the same hospital about a telephone appointment I have with their Physiotherapy Department on 4th March. The text tells me that my telephone appointment has been changed to a telephone appointment.

Apart from the surrealism of my telephone appointment being changed to a telephone appointment, there is the quirkiness of the fact that they could have saved money yesterday by sending me one text rather than three physical letters. The technology seems to be not unknown to them.

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The NHS is an organisation that just keeps on giving. After reading yesterday’s blog, a care worker I know sent me a message she received from the NHS’s ‘Health Education England’ – presumably sent to all NHS workers in England who interact with members of the public – advising her what to do if she should “misgender someone by accidentally using the wrong pronoun”.

Her reaction to me was: “FFS, I think I’ll stay in lockdown”.

********

In other gender-bending news, Hasbro’s Twitter account announced that, from Autumn this year, its iconic Mr & Mrs Potato Head toys will be getting “a 21st-century rebrand” as ‘Potato Head’ so that the toy could “break away from traditional gender norms” and, when the new brand is unveiled, “kids will have a blank slate to create same-sex families or single-parent families”.

This would mean the toys would not “impose a fixed notion of gender identity or expression”, freeing kids to do whatever feels most natural to them. A girl potato might wear trousers and a boy potato might wear earrings. Hasbro would also sell “boxed sets that don’t present a normative family structure”. This approach would allow kids to project their own ideas about gender, sexuality and family onto their Potato Head toys, without necessarily offending parents who might have more conservative notions about family.

After some surprised reaction on social media, Hasbro then re-Tweeted yesterday that, although the toys would indeed be re-branded as Potato Heads, they would also still be identified as ‘Mr’ and ‘Mrs’ on the packaging.

So Mr Potato Head will now be called Potato Head to avoid gendering the toy, but the toys will be identified on the packaging as Mr Potato Head or Mrs Potato Head.

I am undecided whether this is good publicity – lots of coverage of the brand – or bad publicity – too much ducking, dodging, diving and weaving in the PR.

Collins Dictionary currently defines ‘Potato-head’ as “[slang] a dumb or stupid person”.

********

Meanwhile, on Facebook, Man-of-All-Arts Peter Stanford has spotted a piece in a 1884 edition of Tit-Bits magazine.

Peter’s reaction was: “I so want some reputable magazine to offer this service. I would write my own, and send it off with my subscription, just in case.”

********

All publications are desperate for readers and ever have been.

In yesterday’s Daily Record (basically Scotland’s national equivalent to England’s Daily Mirror), there was a prominent article on comedian and author Janey Godley ‘dividing the internet’ by posting a picture of her dinner: a plate of toast, mince, peas and onions.

According to the Daily Record, “many were outraged by her choice of dish”.

You know you have really succeeded in the fame game when a national paper starts reporting your dinner (with pictures) for the sole reason that, if they publish your name, people will want to read the article. All the more jaw-dropping because this week Janey started writing a weekly column for the Daily Record‘s competitor, The Herald.

 

 

Reaction to the incompetence of the UK’s National Health Service…

Yesterday’s blog was me bitching about the inefficient, mindless bureaucracy of the NHS. In particular, about how they sent me three self-contradictory letters about changing my meeting with a Consultant in June (in four months’ time) from an in-the-flesh meeting to a telephone call (because of the infection risk during the current COVID outbreak).

Inevitably, about ten minutes after posting that blog, I got a phone call from the NHS about changing from flesh-to-telephone a different appointment I have tomorrow with a different Consultant at the same hospital.

Something of a pity that I am not seeing him in the flesh because last week I had a recurrance of the vertigo I suddenly had without warning three weeks ago… and the neck/shoulder/arm pain which has recently got worse since it started back in November… and, of course, the fact I have not had a proper night’s sleep since I was in hospital in May last year – I wake up at least once every hour during the night, dehydrated, with my throat and mouth parched and having to drink water.

This means – because of the water – having to go to the toilet a lot during the night, which is not helped by falling-over vertigo or a painful and restrictive neck/shoulder/arm problem which is easier to describe visually rather than over the phone.

It also means I will not be given a blood test to see how my calcium level/kidney function is progressing or not. Those were involved in my problem last May, the cause of which is still a “mystery” (technical term).

Anyway, I got a fair number of comments about yesterday’s blog. These are a few…

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Andy’s response was:

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You should raise this with The Minister at The Department of Administrative Affairs. The response will be that to change a standard NHS letter issued by a single key stroke that generates three different but essential standard letters to the same person whilst informing several departments of the change is essential in effective running of the appointments system. 

Whilst admitting that this does appear to be wasteful and confusing, particularly if the three letters received by the patient are opened in the wrong order, to alter the system requires the employment of a number of consultants and support staff over a period. It’s estimated, that may extend over several years because there is no central office for administration within the NHS. 

You’ll recall the failure of the government proposed computer system to link all the the NHS computer systems into one seamless system. It’s considered that to fix this issue, which is considered mostly harmless, would take in the area of £736,000,000 and is therefore not worth doing.

In addition, all of the Ministers’ friends are all currently overstretched in other government projects they’ve been awarded so won’t be able to start work in this until at least 2037.

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‘King1394’ observed:

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Yes it is the efficient work of computerised automation. Once there would have been a thinking clerical worker managing your appointments. But computers are cheap to employ even if they produce three contradictory letters where one would suffice.

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Alan commented:

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This is the same bureaucracy that, when medics were crying out for Personal Protective Equipment, refused to deal with many suppliers who had stockpiles of exactly the right equipment, in date, authorised for medical use… They refused to purchase it because that particular supplier couldn’t be added to the procurement system due to a lack of past dealings.

Every once in a while there’s a cry-out for everyone in the NHS to receive a pay rise or bonus due to the hard work they’ve done in fighting the pandemic.

While I wholeheartedly agree that every single person in the NHS who has been right there in the hospital, facing danger, risking their own health as well as that of their families should get something, I’m still very reticent to make it a blanket award as I don’t want to reward those who made it more difficult or who simply did their job from home at no additional risk to themselves or others.

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…and Sandra said:

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The NHS? I have been lucky in my treatment from them in the main.

Apart from the time when I was sent for physio, when in fact my hip was on the point of fracturing.

Plus one other doctor whom everyone avoided.

As it turned out, he mis-diagnosed my condition, complained about the price of the meds he was about to prescribe, then ran after me begging forgiveness because he had given me the wrong prescription. Bastard. 

And I told him so, leaving out the word bastard…

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Obviously, I realise my alleged problems are only relatively minor inconveniences, but – hey! – look – it’s my blog. It needs writing and where else can I selfishly whinge up my own arse if not in my blog?

The mindless administrative mess that is the UK’s National Health Service…

(Photo by Bofu Shaw via UnSplash)

This week, on one single morning, I got three NHS letters in two envelopes from the same London hospital, all posted from Bristol and all written on the same day, five days earlier.

The first told me (in paragraph 2) that my appointment to see a doctor at 10.30am on Friday 18th June had been cancelled “as part of our response to the COVID-19 outbreak”. 

In paragraph 3, the letter explained that, although the second paragraph “states your appointment has been ‘cancelled’, this is not the case. You have been placed on a waiting list.”

Attached to this letter was a second letter saying: “We’re sorry but we have had to cancel your appointment” at 10.30am on Friday 18th June.

Both these letters were in the same envelope.

In a second envelope which arrived at the same time on the same day was a third letter dated on exactly the same day as the first two letters.

It said: “This letter is to confirm that a telephone appointment has been made for you at 10.30am on Friday 18th June. When you have a telephone appointment you are not required to attend the hospital.”

So basically, entirely reasonably, to avoid people attending the hospital in person during the COVID-19 outbreak, my in-the-flesh appointment at 1030 on Friday 18th June (over four months away) had been changed to a telephone appointment at exactly the same time.

To do this, I was sent a letter saying my appointment was cancelled but not cancelled… an attached letter saying my appointment was cancelled… and a third, separate letter saying my appointment had been changed from physical to telephone.

All that I needed to receive was one letter saying my appointment had been changed from physical to telephone, not three letters, all sent from the source on the same day.

Have I mentioned before how much I hate mindless bureaucracy in general and what an administrative mess the NHS is?

… CONTINUED HERE …