Dear NHS
We believe in the basic principle of the National Health Service, namely free health care for all at the point of delivery. The small amount of treatment Sue and I have received from the NHS during our lives has mostly been of the highest quality. We have great admiration for NHS staff, the work they do and their dedication. However, our new lifestyle has cast a new, harsh spotlight on our NHS. Let me explain.
After working since the age of 18 and paying our taxes, including National Insurance, we took early retirement last year, sold up and moved onto a narrowboat. We pain stakingly worked through all aspects of our lives that would be affected by this major change, or so we thought. We did not take into account the bureaucratic behemoth that is the NHS. When we left Malvern, our last 'normal' home our GP practice manager told us we could no longer remain registered with them because we would no longer fall within their catchment. Now fully into our peripatetic lifestyle we are frequently encountering problems with gaining access to a doctor (and dentist, come to that).
Currently, we are registered with a practice at Great Haywood because they were happy to deal with boaters and accepted the post restante address in the village. Wintering here at Mercia Marina, Willington our initial contact with the local surgery has been rather disappointing. Having innocently let slip we plan to be here for four months I was told by the receptionist I had to register as a permanent patient not a temporary resident. Apparently the time limit for a temporary resident is three months. This rule can only be about the practice's funding from the Primary Care Trust. Clearly, as a temporary resident the practice would not get as much funding for our 'custom' as they would should we be registered full time.
OK, so apart from filling in all the forms, what would be wrong about registering as a full patient? Well, we know from experience (we are an ex-RAF family with plenty of moves under our belt) it takes months for our medical records to catch up with us so they would most likely arrive here just as we were about to move onto our next destination. And so on and so on. So what's to be done?
Sue requires repeat prescriptions for medication so she must have proper, regular access to a doctor. Neither of us is getting younger so our need to have access to a doctor is likely to increase as the years pass. However, if we have to register at each practice nearest to our location then there is every chance our medical records will never catch up with us, or even get lost at some point. It seems to us we shall have to register with a GP somewhere we have a connection. That means register with our daughter's GP as she very kindly agreed to our using her address as an accommodation address for important matters. That way we at least know we have a regular doctor. The downside? For anything important we would have to travel to Bristol from where ever we are located. Luckily, we could afford the cost that would incur but our question is, "Why should we?".
So, dear NHS our question is this, what is so difficult about delivering health care free at the point of delivery to we boaters? We have NHS numbers, we pay our taxes, we are British borne and bred. Why can we not just pitch up at a GP's surgery, present our credentials and receive treatment? If I can find someone in the NHS to address this question to I shall, otherwise I guess this is an entirely rhetorical question.
As a Practice Manager I believe I'm qualified to respond.
ReplyDeleteIts not the fact that you are boaters that causes problems its because you move locations and as the NHS is presently structured (managerially and financially), like all travelers, it introduces a whole set of operational problems that do not exist with a permanent residence.
The first issue you answered yourself - your medical records. For reasons of confidentiality (first and major consideration for YOUR protection), medical records cannot be simply posted or transferred by conventional means. One (and they're not many) advantages of the huge failure that was the NHS IT spine was to enable secure access to your records anywhere in the UK but unfortunately (and thank GOD) its failed.
Second issue as you correctly identified is funding. It has nothing to do with how much the Practice receives (its the same) but it has everything to do with how funds are allocated to each PCT area. When you register, a packet of money is given to your practice from the PCT fund holder but when you then move, that packet is then withdrawn and transferred to your new practice. When you cross PCT area borders, it causes a huge amount of paperwork and administration time. Hopefully, this will be less of a problem when the Practices become (just like the old days) fund holders in their own right.
Thirdly, the differentiation between temporary and permanent is simply based on time. To be blunt, if your not staying put for a given length of time, its simply not worth the administration time and money in trying to keep up with you.
To address your question concerning who can you shout at, its not the Practices or the PCT's. They only conform to the policies and procedures that flow out in ever increasing volumes from Central Government and you can only show your displeasure at voting time.
From my own personal perspective, until the NHS is run by professionals and not politicians, the situation wont improve.
Our doctors were in Wales & we used to winter moor in Stourport. Like your wife both myself & my husband take medication on a daily basis.We went to the local doctors & registered on a temporary basis this was for 3months, at the end of the 3mths you just re register, whilst we were there I needed back surgery & the doctor sent me to see a specialist at the Royal Orthopaedic Birmingham. All around the country seeing a doctor for repeat prescriptions has been no problem
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