Wednesday 29 December 2010

Getting the best treatment

Let me start by saying that I love the NHS. I'm going to be a long term customer and I doubt that I could afford long term treatment for psoriatic arthritis without it. Unfortunately, what I've seen is that it is constantly in danger of letting down the most vulnerable.
The first port of call is the GP. They still practice the same 3 p rule as always: paracetamol, penicillin, piss off. You are not even investigated unless your illness is so obvious they would be negligent to miss it. In my case I was given 2 months worth of Naproxen and told pretty unequivocally that I had tendinitis as a result of repetitive strain. This was exactly the same as a year ago.


At this point my hands got significantly worse. Thankfully, and on the advice of friends, I was able to seek private care. The private practitioner was frankly a bit worried about the state of my hands and started immediate treatment to get the swelling down.


By the time I went back to my GP it was obvious to the hand therapist that there was something that needed to be looked into. Here again is where the NHS struggled. I had taken charge of my own healthcare and sought a number of opinions. The GP was unwilling to take on board the recommendations without me really fighting for it.


The NHS introduced Choose and Book in order to create patient choice. In some situations I'm sure it helps but the choice it offered me was not in any way useful. I could either wait 6 weeks to see a specialist at a hospital I believed to be good or gamble and see somebody within 2 weeks at a hospital I doubted the quality of. The fact is that within rheumatology there is no published rating of the different hospitals. As I had been out of work for 6 weeks at that point and I don't get any sick pay I had little choice other than to get the earliest appointment.


As I suspected the consultant did not inspire confidence and I left the hospital still at least 6 weeks away from a diagnosis. I saw a private rheumatologist two days later who diagnosed me in one session and gave me steroid injections that could potentially get me back to work within a couple of weeks. If I waited for the NHS I suspect it would be more months before I could get back to work.


Subsequently I have seen one of the top rheumatologists in the world and received a diagnosis that makes profound sense. The GP tells me it's wrong.

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