Wednesday, 9 April 2014

Charging people to go to a doctor

or the emergency department of a hospital for a minor cut, bruise, the common cold, earache, a stubbed toe or a mosquito bite?
It is an idea being tossed around at present in an attempt to reduce the cost of public health care and make people a little more responsible for their own health.
On the surface it doesn't seem to be a bad idea. It might reduce the waiting time in A & E - accident and emergency. It might allow the real emergencies to be seen more quickly. It might give doctors more time to deal with the genuinely ill.
Yesterday I went to visit the friend with arthritis. She has just been moved from one hospital to another. The second hospital is the one where her pulmonary specialist works and he should see her today. The only ward where there was a spare bed however was the psychiatric ward. Patients in the psychiatric unit are not allowed to use their mobile phones. They are not permitted to have television in their rooms and the lights are deliberately too dim to allow them to read.
I assume the idea is that all this will make the patient get out of bed and watch television in the lounge area or read in the reading area and that any contact they make with the outside world can be monitored. I know nothing about the psychiatric guidelines for patients there, the ethics underlying them or the treatment being provided - although I do know that most of the patients are not there voluntarily.
And of course my friend is not there voluntarily either - for physical reasons. She is also being subjected to the same rules which is not helping her mild anxiety over not being able to breathe without assistance.  
The ward is locked. I had to press a buzzer in order to enter - and then state the name of the person I wished to see and the room number. They had actually moved her "to the quiet side" during the morning but the fact that I knew the old room number seemed to be sufficient.
So there she is, in bed unable to read or watch television - not that she is much interested in the latter - and unable to get down the corridor because of the oxygen and the fact that walking to the door is, at present, too much for her.
To complicate matters still further she is, despite the contra-indication of breathing difficulties, on a powerful narcotic called oxycodone. It is supposed to reduce the pain of her arthritis. There is a strict limit on how much she can have in a day. She knows that and asked me to keep her distracted before the next dose. She also has a small radio. I will take spare batteries when I go because she has it on almost constantly if very quietly. "I have to concentrate to listen."
Today I am going to phone the society which provides talking books to the blind and others who can no longer read. I am going to ask if they think she might be eligible. If they say yes - and I am hopeful they will - I am going to suggest it to her.
It will be something to distract her while she waits to see her doctors and they try to work out if there is anything else they can do to help.  It will distract her while they deal with the common cold and the stubbed toes and the mosquito bites in accident and emergency.
If anyone can suggest other distractions - please let know.

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