A maddening time. The penny dropped.
I’ve obviously been too busy elsewhere to be writing up here. Well, as some may know I’m writing a lot more stuff in other places and producing videos.
In the last 12 months I’ve been exposed to the worst kinds of human suffering. It’s in health services of course. If you were born this morning, you would believe the mantras about ‘No health without mental health.’
The reality is that mental health services are now far worse off than in the peak of the pandemic, from my observations. How?
- Staffing is worse.
- Communication, coordination, and organisation are worse off.
- There have been intermittent shortages of certain medications as well.
- The most vulnerable in our society are suffering worse neglect because of the above.
In the last few months, I came across unwritten information, that people have simply been thrown off clinic lists because they were either waiting too long or services could not provide appointments. Unwritten? Yes – done by word of mouth, so no record could exist! If it’s happened in one neck of the woods, I must infer that it may have happened elsewhere too.
It has been tough work. Why? GPs rule over specialist services. Some are unaware that GPs are the purchasers of specialist services. What does that mean? It means they have power to tell us specialists what they want and like. The penny dropped a few weeks ago, when I was in a telephone conversation with a GP. She made polite apology for not attending an important meeting I was inviting her too. She said, “I can’t attend – with a list of some 60 patients per day – I just cannot afford the time.”
What was this ‘penny’? Well, from around 2015, GPs have been under so much pressure that they don’t have time to think – or read much of the correspondence specialists send to them. By some sort of orchestration in the background, specialist letters have been reduced to a 30 to 60 second read. Basically – all the GP wants to know is about any medication changes or any important complications. You don’t expect them to admit to that. You might think, “Isn’t that enough?” You’d be forgiven as a lay person for asking that because most lay people don’t know what’s what and would go, “I’m not a doctor.”
Well sorry, even if you’re not a doctor you ought to know that the point of sending a patient to a specialist is to get some deeper insight into their condition, to make sense of it for the patient. Oooh… patient… what’s that? You may think ‘patient‘ is a person. You’d be wrong. The patient is a vehicle for the money!! Settle down. I’m not saying that ‘everybody’ is treated that way. I’m talking about what’s happening in the background. At the coalface, you’d be treated with love and care (if you’re lucky). But in the background, it’s the spreadsheets that are crunching the numbers away – and that’s what rules minds. Look – it’s this simple – what people say and what they do are often very different things! It’s just basic.
So, what did I do? I upset the apple carts obviously! I did full assessments, careful reading and summarising of case histories, the fullest mental state examinations, and wrote very careful treatment plans. In my letters GPs were told to read pages 1 to 3 where the most important parts were to be found – and that the rest of my letters were optional for context. See download my List of short links which I used every day.
People were given proper medication reviews.
I’m not short-changing anybody! No system is going to push me to do rubbish. End of!
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