Don’t forget that nagging feeling
‘The proposal has prompted a vigorous response from family doctors on the Pulse website’
It would perhaps be reasonable to have expected more tangible improvements in our beloved health service than are readily apparent from the spectacular five-fold increase in funding in little more than 25 years – from £24 billion in 1989, to an impressive £120 billion today.
Still, at least referrals to see a hospital specialist have become a whole lot easier as there are now more of them, and quicker since the institution of the mandatory 18-week waiting-time limit.
Predictably, the demand for their services has escalated – hence the “leaked memo”, reported recently, on plans to cut back the number of referrals by (it is over-optimistically anticipated) a third.
This is to be achieved by requiring GPS in future to have weekly meetings in which they must justify to their colleagues their decision as to why Mrs X might require to see an orthopaedic surgeon with a view to having a knee replacement, or Mr Y might need to see a haematologist to investigate his unexplained anaemia.
The proposal has prompted a vigorous response from family doctors on the website of Pulse, the GP magazine: “a bats--- crazy idea,” wrote one; “[those dreamed it up] can go ---- themselves”, said another; “more time b-------- about, not seeing patients”; and, most pertinently: “I object to colleagues who know less than me telling me what to do.”
It is a tricky business. The decision to refer Mrs X and Mr Y might be sanctioned, but what about the common situation known as the “nagging feeling”, as in: “I am pretty sure there is nothing seriously wrong here, but I can’t be sure it’s not cancer”? Or the forceful patient with psoriasis who will not be denied referral to a skin specialist, even if it is not necessary?
Still, hospital referral is certainly not the best option in the notunusual situation where the GP just wants advice as to what is best to do in any particular situation. And now, thanks to a marvel of communication technology pioneered by the organisation Consultants Connect, he or she can simply call a number that puts them through to a local panel of, for example, cardiologists or gynaecologists, which then “loops through” to find one who is available to give appropriate advice – and all while the patient is sitting there in the consulting room. Brilliant!
In Essex, this system is claimed to have obviated the need for nearly 2,500 people to attend hospital – with the potential to save the health service substantial sums. Progress, indeed.
Ahoy, they’re pirates!
The Sussex woman afflicted, when sitting in her garden, by the bites of “a very tiny, black creature” of such intense itchiness as to prevent her sleeping, is most likely a victim of the minute pirate bug. “I can vouch for it, since I was bitten by one yesterday,” writes a reader.
Black, flat, oval and scarcely visible at one sixteenth of an inch long, these common flower bugs have, according to Dr Phil Nixon of the University of Illinois, a “needlelike beak with piercing mouth parts”, with which they penetrate their non-human prey (aphids and other garden pests) and suck out its juices. Insect repellents do not deter them, and apparently the only protection is to keep most of the body covered with longsleeved shirts and trousers.
A further possible culprit, suggested by several, is the harvest mite, active around this time of the year, whose larval stage is spent feeding on warm bloodied animals such as ourselves.
They have the habit of crawling around on the skin until their progress is impeded (by, for example, elasticated clothing), at which point they settle down to feed, injecting the digestive enzymes that cause the intense itchiness, before sucking up the residue. The several commended antidotes include Derbac-m (as used against head lice), tea tree oil, TCP and common household vinegar.