By Phil Peverley
10 Mar 10

Phil offers three tales of NHS obstruction to the patient journey, ranging from irritating to tragic

Three vignettes from my surgery this week. They’re not rare or unusual. Just modern-day general practice patient journeys. You’ll know plenty of stories like these yourself.

Patient 1 came to see me a year ago after he’d crocked his knee playing football. I thought he’d damaged his anterior cruciate ligament and I referred him to an orthopaedic surgeon. I saw him again this week, and he was apologising for wasting my time. ‘I saw a physio nine months ago. She agreed with you I needed surgery, and she said she’d sort it out, but I haven’t heard anything. I phoned her but she’d left. I don’t know what to do.’ A call confirmed the physio had indeed high-tailed it out of the NHS, but had done nothing for my patient, other than discharge him.

Patient 2 has had bilateral tennis elbow for years. I referred her to our upper-limb surgeon, and after a few months I got a letter from a physio saying she was no better. My patient confirmed this; ‘I don’t know why I saw a physio. I thought I was supposed to see a surgeon. They poked a vibrating thing at me and it’s much worse.’

I wrote to the surgeon asking, in essence, ‘Why did this waste of time occur?’ and he wrote back answering, in essence: ‘I dunno. I never saw the letter.’

Patient 3 is undoubtedly more serious than the other two. This doughty, self-deprecating, highly-decorated World War Two hero started pissing blood late last year. He was due a diagnostic cystoscopy in November, but a nurse in the pre-op clinic managed to put a stop to that. ‘Your ECG looks funny,’ she told my patient.


Actually it didn’t. I’ve seen the ECG and it looks normal, but the ECG machine thinks it looks funny. But then every ECG machine ever made thinks every ECG ever taken looks funny. You just can’t trust the little plastic bastards. It’s best to rely on your own expertise. If you’re a doctor, that is.

Our pre-op nurse handed our noble but frail war vet a copy of the dodgy ECG (but no letter or any other communication) and told him to go to his GP to: ‘Get this fixed. Your GP will send you back when you can have your operation.’ Instead he went private, this man to whom we all owe so much, wasted fifteen hundred quid on unnecessary cardiac investigations, and was told there was nothing wrong with his ECG. He had his cystoscopy this month. His cancer is now inoperable. It might have been inoperable before. We’ll never know.

Stand up and be counted, you unqualified time-wasting shitehawks. Account for yourselves. Why are you standing between me and the consultant I wish to refer my patient to? Exactly how have you helped my patients get treatment? What are you FOR?

Okay, so you’re just nurses who have been overpromoted into the jobs doctors used to do. Maybe you don’t know you’re only there to save money. The real culprits are those cynical managers – the medical stooges who collude with this managerial idiocy and the bureaucratic bean-counting tyrants who have forgotten what the NHS is actually supposed to be there for.

Hang your heads in shame. If I could do to you what you’re doing to my patients, I wouldn’t hesitate for a second.

Dr Phil Peverley is a GP in Sunderland

(15/3/10)