NHS in Meltdown: 31 Week Waiting List To See a Cardiologist 130

I am afraid this is a personal medical story, but I think it makes a very damning point about the state of the NHS. There is no sensible way to tell it without giving an uncomfortable (I suspect for both of us) level of medical detail about myself.

I had two collapses very early in the New Year, one with loss of consciousness of over ten minutes. On the second occasion we called 999, and the response was superb – a paramedic in less than five minutes and and ambulance in less than ten.

In A & E, I had an ECG and x-ray and was told there was an indication of minor heart failure. I then collapsed again and had entered major atrial fibrillation. I was rushed up to the critical conditions unit, where the condition responded to injections. I was kept in for the next six days. The diagnosis was paroxysmic atrial fibrillation. I was discharged on a dose of 1.25mg of Bisoprolol a day, 2 x 50mg of Flecanide and 2 x 150 mg of Pradaxa. The bisoprolol, even at that low dose, puts me into bradycardia at about 50 beats per minute, but the fibrillation immediately returns without it – that was the conclusion of the six days admission.

All these drugs were new to me.

I was slightly concerned that in six days in hospital, my total face time with a cardiologist was about three minutes – one sighting of two minutes and two of about thirty seconds. In virtually none of that three minutes did the cardiologist address me, but rather the junior doctors and nurses. There was no echocardiogram done.

On discharge the cardilogist told his team that he needed to see me again in six weeks to assess my progress on the medicines. I was discharged on 10 January and therefore was surprised to receive an appointment for 7 May. I telephoned to query this, and the cardiologist’s secretary told me that she knew six weeks was requested, but that 7 May was the first available appointment. I asked if she realised that was 17 weeks not 6, and she replied that was within the allotted NHS target time.

Unfortunately I have been feeling constantly ill since starting on these medicines. Dizzy, faint and nauseous, with severe palpitations. I get very tired very quickly, and fall asleep instantly on putting my head down at any time of day or night.

On discharge from hospital the consultant also ordered a 24 hour ECG (3 week waiting list) and contrast echocardioram (8 week waiting list). Having now had these investigations, I have no idea what the results were and apparently will not be told until I see the cardiologist.

I have twice been to see the G.P. to explain how ill I am feeling. The G.P. said he would write to the cardiologist to see if the 7 May appointment could be brought forward.

Then yesterday I received a letter giving a change of cardiologist appointment – to 17 July! That is a 32 week wating list. It is exactly 26 weeks – half a year – after the date at which the cardiologist said I should be seen again!

In the meantime, I have no idea whether I feel so ill because of the drugs, or because of progressive heart failure. I have no idea what were the results of my tests. I have no idea of the prognosis. I have no idea as to the cause of the paroxysmal atrial fibrillation in the first place.

I have to say that my experience of the NHS in London was entirely different to this. When I had heart problems in 2004, all apponitments and tests and an eventual procedure were carried out extremely promptly – within days – and I at no stage felt left in the dark.

Is this an extreme example of a postcode lottery, or has the NHS declined so drastically in the last few years (or both)? My strong suspicion is that NHS resources are more freely available in more affluent areas, and that being treated out of the QEQM hospital in Margate is probably as bad as the NHS gets (I know those outside S.E. England may find this hard to believe, but Margate is a centre of serious poverty and social deprivation).

Please print this article out and keep it. In the event my heart packs in before I see that cardiologist, please douse it in petrol and stack it against the door of No. 10.

130 thoughts on “NHS in Meltdown: 31 Week Waiting List To See a Cardiologist

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  • Amir

    This is purely unacceptable from medical standpoint, if I may add as a physician. At least where I work, it is by law forbidden to discharge a patient unless he agrees to do so. You might end up needing both a pacemaker and higher dose of atrial fibrillation blocking agents. I would go to the ER and refuse to leave until the problem is definitively answered. This is not a good use of resources but I am looking at it from an individual standpoint, not from a public policy point of view. The latter, I leave to Blain and co.

  • crab

    Craig, your work and play routine seems quite risky for dealing with serious health problem, so you can at least put a super diet to work on it, and do some quiet-mind-body meditation, nothing psychedelic just give your subconscious some me-time to work on straightening things out. Clear headed posture and breathing experiments. It makes a difference. I hope the rest comes together soon.

    Is there no one to report such health service failure, to have it corrected? Not even a Physician finding it unacceptable can do anything other than recommend a protest at A&E.

  • nevermind

    Crab, do you mean emptying your mind and telling your body to heal itself?

    the capacity of our body’s to self heal is never much talked about, something regretfully ignored by a pressurised health community with very little time for anything else than a patented NISA kosh.

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  • Mary - for Truth and Justice


    NHS still threatened by privatisation

    The Guardian, Monday 11 March 2013 21.00 GMT

    It is premature and ridiculous for Labour to claim that Jeremy Hunt’s decision to rewrite some paragraphs of the draft regulations made under secton 75 of the Health and Social Care Act is a U-turn. Your report (6 March) makes it clear that the revised draft will permit clinical commissioning groups to decide only how and when, but not whether, services should be opened to competition; and that while they will not have to put all services out to tender, it will be only in exceptional circumstances they will be allowed not to. As for the insistence that competition must not be at the expense of integration and co-operation, writing conflicting requirements into regulations serves only to make an ass of the law.
    Keith Bilton

    • I hope the government is preparing to deal with a clinical shambles of its own creation. From next month, the contracts for England’s least complicated and most remunerative medical work (and money) will be snapped up by (“commissioned from”) the predatory private medical companies. The remaining mass of complex, expensive and demanding patients, the training, the teaching and the research (and the private sector clinical failures) will be generously left to the NHS, with its depleted taxpayer funding and loyal, unpoached medical and nursing staff.
    Professor Harry Keen
    President, NHS Support Federation

    • Thank you, Keith Farman, After all the negativity about our irreplaceable NHS, your letter (The NHS saved my life, 7 March) was a sublime breath of fresh air.
    Elizabeth Poland


    The NHS has just saved my life

    The Guardian, Wednesday 6 March 2013 21.00 GMT

    The NHS just saved my life. With no prior symptoms, On 18 December I suffered a minor heart attack. Three hospitals, three ambulance transfers, upwards of 50 dedicated professionals and nine days later I had a world-class triple bypass to remedy a previously undetected life-threatening condition. I was kept informed throughout of what was happening and why, with clarity and sensitivity. At all times I was treated with unfailing care and concern – as a patient and a person. When I thanked one of the surgeons, he smiled and said it was a team effort, and that the contribution of nursing and support staff was an equally important part of the process. I witnessed a level of teamwork, personal commitment, discipline and professionalism by staff at all levels that I never encountered in 20 years in industry.

    In most countries I would be dead, bankrupt or dangerously risking a major heart-damaging second attack while I waited for surgery. Nightmares like Mid Staffs (Editorial, 6 March) are not caused by anything arising from within the value-structure of medicine or the NHS. They are caused by the simplistic misapplication of long-discredited business techniques by politicians and civil servants who have never run anything except a doubtful argument. The corporate vultures are circling the NHS, scenting red-blooded profit. Our naive politicians are easy prey for the snake-oil salesmen. Hospitals are not businesses. Patients are not customers. But my albeit anecdotal, experience shows that the NHS already has a level of disciplined, rigorous, empathic delivery of a life and death service that would be the envy of any private enterprise. Politicians should listen to the professionals who have dedicated their lives to the values of the NHS. Then shut up and find the money to save it.
    Keith Farman
    St Albans, Hertfordshire


  • Mary - for Truth and Justice

    Enough said.

    13 March 2013

    London NHS spends £13m on public relations
    BBC News, London

    Millions of pounds have been spent on the NHS press officers and PR projects
    The NHS in London spent almost £13m on public relations in the last three years, a BBC London investigation has found – enough to recruit 600 nurses.

    Some £9.7m went on press officers’ salaries at hospitals and primary care trusts (PCTs) and private PR companies were paid a further £3m.

    Critics called for “medical doctors not spin doctors”, pointing to longer waiting times and cancelled operations.

    Some trusts said PR spending was needed to educate the public on health issues.

    The BBC sent Freedom of Information requests to all 33 London hospitals, in addition to the capital’s primary care trusts and NHS London.

    The research revealed some 82 press officers on the public payroll, with an average salary of £37,278.



  • crab

    “Crab, do you mean emptying your mind and telling your body to heal itself? ”

    Yes Nevermind 🙂 It sounds twee but I came to experience it myself for some health problems. There is something absurd about dealing with ill health with business as usual and a few extra worries and discomforts, and also some drugs and directions from an excessively busy doctor.

    You just allocate some timeslots to a quiet frame of mind where you attend and experiment with your bodies posture, breathing, internal sensations. Attending to the body consciously, the subconscious joins in after a while (like it does with other things with demands beyond our conscious capacity; like playing chess etc.) The subconscious is known without doubt to have all sorts of control of physiology.

    From personal experience from acute spells of an inflamatory disease, I find significant improvements in comfort/mobility/colour have taken me by surprise, sometimes just 15 minutes into doing this “time-out” or “time-in” or “just-sitting” or “just-breathing” or “just-standing”… there are endless ways and means.

    Im not saying its a sure fire supercure all, but it is definitely worth doing. I stupidly dont employ it anywhere near as much as i should, i just resort to it when ive ‘had enough’ discomfort, it always does something and can be amazing.

  • Mary - for Truth and Justice

    Some of what’s coming on April 1st, 2013. 12 pages of jargon. Understand it if you can. Earl Howe Health Lords does. He signed it at the front.

    Capital with open talons is swooping down to take the prey.

    Correspondence with some of those in the House of Lords and with the Clerk of the Parliaments. The latter did not acknowledge it or reply.

    13 March 2013

    Dear Lord/Lady…..

    I have written to the Clerk of the Parliaments previously (below) about this, which is of great national importance.

    A few weeks later, and after some debate, my concerns are as great as ever. I have just skimmed –

    The National Health Service (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013
    Made 6th March 2013 Laid before Parliament 11th March 2013 Coming into force – 1st April 2013 (We note the very unseemly hurry)

    I cannot study it; the language is opaque. It obviously requires the most careful analysis by competition and constitutional lawyers.

    I am certain there is bedlam in view. Those sick and distressed people without much money will be going cap in hand for care.

    It is obvious to me that if these ‘reforms’ (Goebbels word) were to be introduced with some ‘nous’ applied, UK procurement and EU competition law would be set aside until the CCG/provider system had bedded in well.

    I was speaking to a senior financial analyst in a PCT the other day. He no longer enjoys his work. He say the CCGs are not getting to grips with their financial responsibilities post-April 1. With all the meetings, contract papers etc, I foresee chaos and harm coming to sick people and to OUR NHS.

    Yours sincerely



    22 February 2013

    Dear Mr Beamish,

    I learn that the Lords’ Secondary Legislation Committee will be discussing the regulations laid by the Government under Section 75 of the new NHS Act 1 at their meeting on 5 March.

    These regulations are far reaching and if passed they will ensure the rapid ‘privatisation’ of our NHS. During the passage of the Health & Social Care Act through Parliament ministers constantly reassured members and the public at large that there was no possibility of NHS services being forced to be put to the market, and that the health regulator Monitor would not have powers to enforce such a move. It followed that the NHS would not therefore be subject to EU competition law, and therefore no irrevocable change in its status was being made.

    However, an examination by experts of the new regulations reveals that local commissioners, the new Clinical Commissioning Groups, will have no power to resist Monitor’s demands. These CCGs will be less able to introduce criteria ensuring high quality of service in addition to cost criteria, into the contracts they are required to let. Consultation with local people about the plans of the CCGs will be hollow.

    Since this is in direct contravention of what was said to Parliament, I hope you will be able to use your good offices and standing to ensure their Lordships know that these regulations merit very special attention.

    Yours faithfully,


    1.The National Health Service (Procurement, Patient Choice and Competition) Regulations 2013) made under Section 75 of the Health & Social Care Act 2012)

  • Mary - for Truth and Justice

    This is Paul Bate the health adviser in Cameron’s policy unit and therefore influential.

    ‘Paul Bate is returning to the PM’s HQ, having previously served in Tony Blair’s Delivery Unit under Michael Barber, alongside Greg Beales (who according to Guido Fawkes’ report, is now a speechwriter for Ed Miliband.

    This would have been during the period when Monitor chair David Bennett was the non-political Chief Policy Advisor to Prime Minister Tony Blair and Head of the Policy Directorate and the Strategy Unit in 10 Downing Street.

    Isn’t the Conservatives’ Tony Blair fetish getting serious?

    First, David Bennett to chair Monitor; then failed attempts to get Alan Milburn to chair the NHS Commissioning Board, as HSJ revealed). They can’t afford Simon Stevens, which must be annoying for them.’


  • Mary - for Truth and Justice

    Conflicts ‘rife’ in new GP groups

    More than a third of GPs on the boards of new NHS commissioning groups will have a potential conflict of interest, an investigation suggests.

    The BMJ says 426, or 36%, of the 1,179 GPs it looked at – who are in executive positions on boards – have a financial interest in a for-profit health provider beyond their own practice.

    Their interests range from senior directorships in firms set up to provide services such as out-of-hours GP care, to shareholdings in large private health firms, such as Harmoni and Circle Health.


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