Monday 29 November 2010

Which is the odd one out? National - Health - Service

I recently read an article about the Jeremy Kyle show, in which it was suggested that, for some, this is the only way they can access essential health- and other care like social and psychological support. It was even claimed that there was some sort of class-related disparity in the way the NHS provides care. An example was given of a woman who had become physically addicted to prescription painkillers after an accident. When she went to her GP for help, he allegedly stopped her prescription cold, without taking into account her physical dependency. This 'forced' her to buy tablets illegally in the street. When asked why she did not go to the doctor for help, she replied: "They don't have time for the likes of me." The journalist held this up as an example that people like her were alienated from and ignored by the medical profession.

I have to wonder though. If doctors don't care for her, who treated her after the accident? Who prescribed pain relief in the first place? Kirk takes potentially addictive prescription painkillers, but he is careful to stick to the recommended dose and monitors his intake to avoid developing a physical dependency, even if that means suffering pain instead. I very much suspect this woman did not follow her medication guidelines and allowed herself to get addicted. She then visited her GP for more prescriptions. No sign of reluctance to access health care yet! She had no interest in getting help to quit her addiction, she wanted it enabled. Quite rightly her GP refused. And that's when it suddenly becomes a class thing. He has no time for her because she's 'working class', not because she's an addict and a drug-seeker. Sure.

In the article people who were - I suppose - not 'like her' were described as 'middle-class' and 'yummy mummy'. Apparently, the latter are articulate, know their rights and demand appropriate care when they need it. And apparently, because they look after themselves, they are somehow depriving others of proper care. Don't we pay taxes? Isn't it 'national' health service? There should be enough provision to see all. Why are there such long waiting lists for everything? Why do we never get to see the consultant? Kirk has an endocrine problem that he practically diagnosed himself and he has had to fight every step of the way to get proper treatment for it. Meanwhile, in the same department he sees type II diabetics who refuse to stick to their diets and are unwilling to take their medication properly. Whether that's class related I don't really care. They're getting more and better 'service' because their own behaviour makes them ill. They risk fits and comas, they risk their limbs and their lives and they are continually seen and helped and treated for all these avoidable conditions they have brought upon themselves. Meanwhile Kirk who is not at fault for the microadenoma in his brain and who is careful to follow guidelines, avoids developing emergency conditions like fits and comas. Inadvertently, this also means he avoids getting seen at all. He's a low priority. He gets to go on the waiting list because he's not going to let himself acutely die in the meantime. So much for service.

If there is any truth in a class disparity in the NHS, I'd argue it is the middle classes missing out. We follow the guidelines so we don't end up in A&E with overdoses, addictions or missed doses. We take prescriptions and wouldn't dream of buying dodgy tablet illegally on the street, even if our prescription was stopped. We book appointments through the proper channels and wait months, rather than clog up the system with real or imagined emergencies. We suffer in silence. And suffering isn't good for our health.

So which is the odd one out? National - Health - or Service? None of them. They're all untrue.

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