3 ms·

> The whole “4 hour” thing is mad - you should be seen in a reasonable time frame for the ailment you have. Severed hand? Go right ahead. it's already like thi

> The whole “4 hour” thing is mad - you should be seen in a reasonable time frame for the ailment you have. Severed hand? Go right ahead. it's already like this, A&E is run on triage, "4 hours" is a target not an instruction and if you go to A&E with something like a cold you'll be given a stern talking to and sent home

oldcynic 9y ago
Here's some background on the pros and cons of clinical targets. They can distort priorities https://www.kingsfund.org.uk/projects/general-election-2010/performance-targets https://www.kingsfund.org.uk/projects/general-election-2010/...
chrisseaton 9y ago
> you'll be given a stern talking to and sent home Yes and then sometimes that person dies as the recent case in the news about the girl with asthma who was told off for being late and sent home to die. The NHS’s matronly they-know-better is a real problem of an effective state monopoly on healthcare. You can’t complain or take your business elsewhere. If they tell you to go home that’s it and there’s no other option.
- cjrp 9y ago
  > If they tell you to go home that’s it and there’s no other option. Not even remotely true, if you don't mind paying. You can see a GP privately, there are already lots of apps which let you book appointments. A colleague had an ear problem, couldn't get an appointment with his local GP and so used one of these app-based services and got a same-day appointment with a doctor near the office.
  - chrisseaton 9y ago
    I think there’s only one private A&E in the UK. Most people wouldn’t be able to get to it. If you go private and something happens during treatment they have to put you in an ambulance and take you to an NHS A&E. For most ordinary people if the NHS tells you to go home that’s it you have to accept it. And people die because of this!
    - pjc50 9y ago
      Sure, and if the private system in the US tells you to home because you're not covered, you're just as stuffed. e.g. https://www.snopes.com/shane-patrick-boyle-died-after-starting-a-gofundme-campaign-for-insulin/ https://www.snopes.com/shane-patrick-boyle-died-after-starti... This is not to say that the NHS could not be better, but its problems would generally be made worse not better by introducing market or pseudo-market mechanisms. Unless universality can be guaranteed.
  - cjrp 9y ago
    Sorry, I was replying in relation to your example of the girl with asthma. She was turned away from her GP, not from an A&E.
- pjc50 9y ago
  It's not true that there's no other option, there's a decent number of private hospitals and most major cities will have a private GP practice in too. Just like the American system, this is only useful for people who can pay for it.
- dazc 9y ago
  That was a at a local GP, not a hospital though, IIRC. It was also the doctor who'd made the decision not to see the girl. https://news.sky.com/story/girl-5-died-after-doctor-turned-her-away-for-being-10-minutes-late-11269249 https://news.sky.com/story/girl-5-died-after-doctor-turned-h...
- jjoonathan 9y ago
  The ER is appointment only and you get turned away for being late? If true, that would be horrible, but I suspect it isn't.
  - laumars 9y ago
    I don't know the story but A&E (I guess our equivalent of ER) is not appointment only. "Surgery" in the UK often refers to the office where the GP (general practitioner - ie a non-specialist doctor you'd visit first and foremost for non-emergency cases) presides. So perhaps the story was about a patient visiting a GP but the context got lost in translation.
- deleted 9y ago
  [deleted]

oldcynic 9y ago

Here's some background on the pros and cons of clinical targets. They can distort priorities https://www.kingsfund.org.uk/projects/general-election-2010/performance-targets https://www.kingsfund.org.uk/projects/general-election-2010/...

chrisseaton 9y ago

> you'll be given a stern talking to and sent home Yes and then sometimes that person dies as the recent case in the news about the girl with asthma who was told off for being late and sent home to die. The NHS’s matronly they-know-better is a real problem of an effective state monopoly on healthcare. You can’t complain or take your business elsewhere. If they tell you to go home that’s it and there’s no other option.

cjrp 9y ago
> If they tell you to go home that’s it and there’s no other option. Not even remotely true, if you don't mind paying. You can see a GP privately, there are already lots of apps which let you book appointments. A colleague had an ear problem, couldn't get an appointment with his local GP and so used one of these app-based services and got a same-day appointment with a doctor near the office.
- chrisseaton 9y ago
  I think there’s only one private A&E in the UK. Most people wouldn’t be able to get to it. If you go private and something happens during treatment they have to put you in an ambulance and take you to an NHS A&E. For most ordinary people if the NHS tells you to go home that’s it you have to accept it. And people die because of this!
  - pjc50 9y ago
    Sure, and if the private system in the US tells you to home because you're not covered, you're just as stuffed. e.g. https://www.snopes.com/shane-patrick-boyle-died-after-starting-a-gofundme-campaign-for-insulin/ https://www.snopes.com/shane-patrick-boyle-died-after-starti... This is not to say that the NHS could not be better, but its problems would generally be made worse not better by introducing market or pseudo-market mechanisms. Unless universality can be guaranteed.
- cjrp 9y ago
  Sorry, I was replying in relation to your example of the girl with asthma. She was turned away from her GP, not from an A&E.
pjc50 9y ago
It's not true that there's no other option, there's a decent number of private hospitals and most major cities will have a private GP practice in too. Just like the American system, this is only useful for people who can pay for it.
dazc 9y ago
That was a at a local GP, not a hospital though, IIRC. It was also the doctor who'd made the decision not to see the girl. https://news.sky.com/story/girl-5-died-after-doctor-turned-her-away-for-being-10-minutes-late-11269249 https://news.sky.com/story/girl-5-died-after-doctor-turned-h...
jjoonathan 9y ago
The ER is appointment only and you get turned away for being late? If true, that would be horrible, but I suspect it isn't.
- laumars 9y ago
  I don't know the story but A&E (I guess our equivalent of ER) is not appointment only. "Surgery" in the UK often refers to the office where the GP (general practitioner - ie a non-specialist doctor you'd visit first and foremost for non-emergency cases) presides. So perhaps the story was about a patient visiting a GP but the context got lost in translation.
deleted 9y ago
[deleted]