Of all the animals of prey, man is the only sociable one.
Every one of us preys upon his neighbour, and yet we herd together.
The Beggar's Opera: John Gay

Monday, 15 July 2013

The No Hope System (1)

Since the spotlight is currently on the shortcomings of the NHS,  I am resurrecting this post from the archives which first appeared in 2010 under the title '10 Ways the NHS is Killing People'.

What Subrosa has to say today on the Scottish NHS and the delays in treating cancer patients suggests that very little has changed in the intervening years. While I'm sure there are plenty of meetings going on among management staff, I wonder how much has been done to find out from patients exactly what is going on.


Over the past few years, several close relatives of mine have been seriously ill in various parts of the UK. In each case, the chances of survival were seriously impaired by a catalogue of mismanagement and inefficiency. In particular, the delays in diagnosis and treatment, if other patients have had the same experiences, could be significant in the UK’s shameful cancer survival statistics.

'No shows' at consultant appointments cost the NHS many thousands every year. To the best of my knowledge, nobody has ever fully researched why patients miss appointments; they could start by asking members of my family, who, despite their assiduous efforts to attend every appointment, have experienced the following administrative errors:
1. A consultant’s hospital appointment letter sent to an empty house – the ‘client’ being a long-term in-patient in the same hospital at the time. 
2. Several urgent appointment notifications received some days after the appointment date because, according to the staff on the appointment desk, ‘the hospital post-room only operates one day a week to save money’.
3. A vital letter which the consultant never saw – as is standard practice, it was opened by a secretary and placed straight in the filing cabinet.
4. An urgent explanatory letter from a consultant which did not reach the patient in time because his secretary took two weeks to type it up. 
5. The receptionist who failed to mark the patient as having arrived for an appointment so the consultant went home without seeing her. 
6. The receptionist who gave a cancer patient an appointment (requiring an 80-mile round-trip by taxi) on what turned out to be the consultant’s day off.
Of course, you have to get a referral to the consultant in the first place, which is not easy when you are faced with:
7. The GP who, for nearly 3 years, failed to diagnose a life-threatening medical condition because the non-smoking, non-drinking 7-stone patient ‘didn’t fit the profile’. 
8. The GP who dismissed advanced cancer symptoms as side-effects of HRT, saying ‘if people bothered about side-effects, nobody would ever take anything’. 
9. The GP who refused for 5 months to carry out a PSA test (an indicator of prostate cancer) because, he said, the problems were 'just normal statin side effects'– when the test was finally done, the cancer it clearly indicated was too far advanced for treatment.
And then again, there’s the careless lack of attention to detail:
10. The consultant who, we assume, gave a diagnosis of cancer to the wrong person.  The actual patient arrived at the hospital to be told that her name had been ticked off the list earlier and she had already received her test results.
All of the events described here have happened to members of my family and have contributed to at least one premature death. I’m not going to say any more on the personal side here, but I have promised them that I will use any means in my power to publicise what has gone wrong while safeguarding their anonymity.


  1. The GP who failed for years to diagnose a serious medical condition because the non-smoking, non-drinking 7-stone patient ‘didn’t fit the profile’.

    Evidence Based Medicine again.

  2. Quite, JH, this time aided and abetted by a computerised diagnosis which simply left the disease off the list.

    The GP later justified the omission; 97% of people with this cancer are obese, so the probability of you having it was only 3%.