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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  • barbara

    This is not unusual now Craig. I waited 12 weeks for a biopsy for skin cancer and twice visited my GP regarding the lengthy wait. The GP trainee suggested “when all this is over write a letter but don’t complain tell them how you feel.”
    Time for an English Spring?

  • Holebender

    It isn’t clear until your penultimate paragraph that it is the NHS in England you are writing about. You make the standard UK media mistake of talking about “the NHS” as if is were a uniform UK-wide body. It isn’t.

    My wife has hereditary heart problems and has already lost two sisters to heart disease so I have some inkling of what you’re going through. It’s easy for me to say, but getting yourself worked up about it is only going to make your situation worse. Perhaps your GP could prescribe a mild sedative to help with the anxiety?

  • Hannibal

    If you are really worried, come across the Channel and see a doctor in France. I had high blood pressure diagnosed and was given a full work over within two weeks…. this included the use of radioactive tracers in a body scanner. All for 500 euros.

  • mike cobley

    I was going to make a similar suggestion to Hannibal, namely heading north to Scotland if you have relatives or friends to stay with, and avail yourself of the services here. If they’re up to it.

    Must say this grim account only proves the point that over the last 30-odd years the NHS has been set up to fail, by the Thatcherites, the marketising fools of New Labour, and now by the openly market-zealous dogmatists of the Coalition. Without the dedication and skills of the staff, nurses and doctors, the NHS might have collapsed well before now.

  • Chris

    ‘Hannibal’ has it right, with a serious heart condition going untreated is not an option, your health is too important to be left to a standardised drugs regime with all their side effects. You’re near the channel ferries so get on one and go see a French doctor/cardiologist now. Medical ‘tourism’ may be far from ideal but it’s darn site better than expensive and slow NHS when you’re that unwell and need attention. Besides, I’ve found the standard of treatment in France and elsewhere in Europe can be very good. Good luck.

  • iain taylor

    I had a suspected heart attack last summer. Turned out it wasn’t. My 17 y-o son had a blood clot in his brain the summer before. Fine now, but very scary at the time. Your experience reflects mine (in Scotland). Abject patient care. Throw in a couple of bouts of racism to boot.

    My OH is a German GP. She was closely involved in both situations, and without her, we’d both be in your position. She is utterly horrified by NHS standards. Heading for 3rd world fast.

    As a footnote, in Germany the doctors don’t get such a good deal but the patients get a much better one.

  • John Goss

    I like the joke at the end, douse it in petrol and burn down the Cameron residence!

    Exactly 12 months today I was released from hospital after having had a triple heart-graft bypass. Apart from the time waiting in hospital with nothing happening (1 month) my experience was more like your 2004 episode. It has left me with nothing but praise for the NHS. One of the sad things about the NHS is that it is in decline because the various neo-con governments favour private healthcare though they all claim the NHS is safe in their hands, they really believe in privilege. So private patients get preferential treatment, get their results faster, and get more attention. Does the Queen or Tony Blair have to wait to go into hospital? But the downside of their preferential treatment is that it pushes those without the means to jump the queue even further behind. What can you expect from people who look and behave like leeches?

    Like you I suspect Margate is not as efficient as London or Birmingham. Cities tend to attract medical staff and they have all the teaching hospitals too.

    Sorry to hear your recovery is taking longer than it ought. If you are suffering palpitations and feel you are not getting the proper treatment go along to the overstretched Casualty department of your nearest hospital and ask to be seen. You will probably have a long wait, but not months. And it could put your mind at ease.

    Just one piece of advice that everyone ought to know. If you think you are having a heart attack, dial 999 and tell them you are not well, and explain the symptoms. Even if you are not they will check you out and do a cardiogram to see if your heart is performing properly. If it is not they will refer you. If it is functioning normally they will not be upset that you called them. This service is part of what you paid your NHS contributions for. If you are on your own, say out walking your dog, and you feel you are having a heart attack and you have a mobile with you call 999. If you have no mobile and nobody else is around there is a theory that if you give some chesty coughs it stimulates the heart to empty the chambers of blood.

    When you left hospital you might have been given a Nitrolingual Pump Spray. This could also save your life in the event of a heart attack. Carry it with you. It is sprayed under the tongue. If you did not get one of these ask your GP if it would be suitable for your condition.

    I realise that most people probably know all this and I am not writing for their benefit but for those who do not know.

    Hope you are soon feeling your old self again, Craig Murray. Recovery takes time. But never be worried about calling out the emergency services.

  • nevermind

    After reading your, only too normal, story of mission creep in the NHS, I have to agree with Hannibal.

    A friend was ill with an acute hernia, i mean acute to the effect that he could only be one handed as the other hand was constantly stopping his guts rupturing. Sitting in his chair he told me that he had a three month appointment to see the consultant who then would recommend treatment.

    Seeing him in such a state, I suggested a trip to Hamburg on the ferry, and a collapse in a public area, restaurant, pub, customs and excise, or the harbour itself. He was in hospital and under the knife within 24 hrs. of arrival. The reciprocal healthcare system between E$U states works better than the respective national systems.

    Please befriend someone locally with a helicopter, or even become familiar with the nearest ferry services, its only one hour from Dover and get yourself some deserved treatment.

    take care of yourself!

  • DomesticExtremist

    All part of the Tory aim to return to
    the days when the waiting list was greater
    than the life expectancy of the patient.

    For each unnecessary death, Jeremy Hunt
    can get up on his hind legs and pontificate
    about the ‘monster that the NHS has become’.

    Mission accomplished…

  • Cryptonym

    Lang may your lum reek, Craig. Don’t even think of pegging out. Laughter is still the best medicine. You might be able to find online a downloadable (8-9MB) pdf version of the BNF, British National Formulary, though often a year or two out of date, to look up these drugs, including side-effects, (I think there’s a typo, Flecainide is the generic, not Flecanide) though it is a hypochondriac’s handbook and frightening in parts. The internet is probably the last place to seek medical advice, and your health is a private affair. It seems quite a concoction; IANAD, but to me minimal pharmaceutical use/dose is a worthwhile aim in itself, essential always are diurnal habits, warmth, good diet, easy exercise, morning sun and air.

  • Mary - for Truth and Justice

    You have it exactly right Mike Cobley. Our NHS is under attack. The privateers are on their way in larger numbers too come April.

    In Surrey, Branson’s Virgin Care took over community health services for a five year period. That includes community hospitals, breast screening, school health services including dentistry, sexual health services and many other strands. Now they are saying that they will only continue with routine breast screening and that any patients suspected of having breast cancer ie the really important and most urgent cases, will have to be found accomodation in other NHS centres. In other words they can pick and choose.

    Virgin Care now have a massive presence elsewhere in the NHS across the country.

    Last night I was reading up about Belmarsh and saw that a company called Interserve built the £110m ISIS prison for young offenders, within the Belmarsh complex, two years ago. I do not know if it is yet another PFI.

    There are over 660 inmates. There is a fingerprint registration system in when prisoners are moved around. This fails frequently and when it does, there is a lockdown until every prisoner has been manually checked to be present.

    There are NO healthcare facilities within ISIS.

    I also read that the same company Interserve, chairman Lord Blackwell (one time head of Bliar’s policy unit) has just been given a £300m contract to run cleaning, catering, security and maintenance, etc by a cluster PCT in Leicestershire.

    ‘The contract, which is worth around £300 million, will support the improvement of the buildings and facilities used to deliver NHS services to thousands of patients every day, as well as significant savings for the NHS.

    Interserve will be responsible for delivering facilities management services to the Trusts, including catering, cleaning, maintenance and security across more than 550 NHS buildings and properties, totaling 490,000 sq m and nearly 3,100 beds. The contract also includes a new partnership with Interserve to make the best use of the NHS buildings and estate and support the NHS in delivering major modernisation projects.’

    http://www.interserve.com/news-media/press-releases-and-news/2013/03/04/2019/business-as-usual-for-facilities-and-estates-management-at-local-nhs-trusts-

    The last sentence of that PR piece probably means building housing estates on previously publicly-owned NHS land.

    The ConDems have opened wide the NHS doors for the privateers, along with the likes of their think tanks, Accentures, Price Waterhouse Coopers and KPMGs, to enter.

  • Abe Rene

    Maybe a strong cup of tea would help when you feel awful, says this ignorant non-medic. Suhayl, where are you?

  • Techno

    We have all the socialists in here with their typical scaremongering that the problem is the NHS being privatised, yet this is despite 13 years of Labour pouring money into it. Also, the coalition have not cut the budget it is, in fact, still increasing.

    As another commenter noted, you get better treatment in France and Germany, where there is a mixture of private and public treatment. Socialists are so stuck to their dogma that they simply can’t accept that some aspects of healthcare are better supplied by private companies under health insurance schemes.

    It is too late for me. My dad’s death in an NHS hospital and the continuing bad reports coming out of it has led me to take out Private Health Insurance. I want to do everything I can to stay out of an NHS hospital. The other day somebody accused me of “underming the NHS”. This just makes me laugh. I still pay for it out of my taxes and if I need an operation my insurer will pay for it, thereby relieving the NHS of some of the cost.

  • John Goss

    Techno, somebody who went to school with Margaret Thatcher noted that however early she, or anyone else got to the school canteen, Maggie was at the front of the queue.

  • Mary - for Truth and Justice

    I am so sorry Craig. Rest and sleep in the meantime if you can. You have been travelling a lot lately. I would not go rushing across to the continent either. Your GP is the person to whom you should be addressing your worries and they should act urgently. Be polite and persistent or perhaps Nadira could intervene.

    I am sending a copy of your piece to the Chairman and the CEO of the Trust that has you in their care. Hope that is OK. Say no if you would rather me not do this.

    http://www.ekhuft.nhs.uk/patients-and-visitors/about-us/boards-and-committees/the-board-of-directors/nicholas-wells/

    http://www.ekhuft.nhs.uk/patients-and-visitors/about-us/boards-and-committees/the-board-of-directors/stuart-bain/

  • Techno

    “somebody who went to school with Margaret Thatcher noted that however early she, or anyone else got to the school canteen, Maggie was at the front of the queue.”

    ^^^^ completely made up story ^^^^

  • John Goss

    And another thing, those old enough to remember the good old days when utilities like Gas, Electric and Water were publicly-owned will confirm that bills did not increase year on year out of proportion with income. Today they are privately-owned and completely out of sync with incomes. Profit is the driving force. In a month they will be talking again about a hosepipe ban. Private enterprise is laughable in its delivery of services but its bills make poor people cry. Everything is down to profit. Bankers, shareholders and other great big fat-cheeked and greedy leeches that suck on the poor and starving householders have left good people in debt trying to cope in an unequal world. Let’s sing it as it ought to be sung!

    http://www.youtube.com/watch?v=WSIUf2hD6Io

  • Habbabkuk (La vita è bella!)

    Craig

    Very sorry to hear your story and my best wishes to you. The situation you describe -especially the waiting times and the lack of communication – are of course unacceptable.

    I second those who recommended you nip across the Channel (Eurostar to Lille or Brussels). And btw I seem to remember reading somewhere of people who went to the continent for (more rapid) treatment and obtained – as a matter of right – reimbursement of the medical costs incurred from the NHS (perhaps the waiting times were longer in their case, but this might still be worth checking out.

    Good luck.

  • Cryptonym

    Techno, there can be no part of healthcare ‘better’ under one or another means of funding, it should be consistent and of the highest quality no matter the background beancounting. It is preposterous to suggest that because something is ‘private’, i.e. run purely and entirely for profit than public utility or service, it must indefinably be better. Money invested in the health service, or any public good, nowadays largely pours straight back out again into greedy hands, than touches the health service at all, the private sector the biggest leech-like parasite that eventually kills any host it latches to.

    Private Health insurance, as you fail to comprehend is not an option to the majority in this country who can hardly, feed themselves, heat their homes or even keep any roof over their head. Just because you are spectactularly privileged, obviously means that extrapolating anything from your from your position to the general population is absurd.

    Behind such privilege in the gormless free-market ideologues such as yourself is often found inherited wealth and behind that, not business acumen but criminal acumen. Glib shysters engaged in wholesale theft from the commons, from the many to the few, inherited traits and disposition to milk your fellow man without conscience or compassion. A psychopath.

  • Dcanmore

    What we’re seeing in England is gradual privatisation. Departments one by one are being run down through funding cut backs to make them viable for take over by private companies. At first it will be a ‘partnership’ hybrid to ease the concerns by the general public, some private money investment for a public service, then that partnership will grow in favour of the private company until the entire department is now effectively privatised over period of four or five years. Last week in London, I saw for the first time NHS ambulances with the legend: “NHS ambulances in partnership with G4S”, with G4S branding. Oh the irony with ex-Labour Health Minister and former communist/marxist, Dr John Reid (Lord) as a non-executive director and chief advisor of the global security company.

    @Techno … the Tories are not interested in a French or German style system, they want a US-based healthcare system where the NHS is taken out of public funding altogether and NI is replaced with private insurance in which, no doubt, premiums will be ever more expensive to pay for year on year like rampant energy bills. Of course, just like Lord Reid, the politicians will be lining up for their new jobs as directors of these private companies while the City of London reaps in the costly premiums.

  • John Goss

    I don’t know who you are Techno but I don’t make things up. I’m not Theresa May. It was either the Observer, Guardian or Independent where someone who went to the same school as Thatcher made the remark. Whether she was telling the truth is a different matter.

  • Tim

    Get on the ferry

    And when you come back think about why we can’t use this model in the UK

  • Tim

    System ate the link – so here’s as much of the text as fits (from 2006):

    UK patients forced to wait longer than they should for NHS treatment are entitled to reclaim the cost of being treated in Europe, a court has ruled.
    The European Court of Justice said the NHS must refund costs if patients waited longer than clinicians advised, even if waiting time targets were met.

    The court was ruling in the case of Yvonne Watts, 75, of Bedford, who paid £3,900 for a hip operation in France.

    But it said in her case UK courts would have to decide if she got a refund.

    Mrs Watts said the news was “wonderful” and that if she got the money back she would donate it to a medical charity.

    The case, which centres on the definition of “undue delay”, could have a significant impact on the NHS.

    It will allow any patient facing an unacceptable delay who has the funds to pay for an operation upfront to seek treatment abroad and recoup the costs from the NHS.

    The Department of Health said it did not expect the judgment to make a big difference to the numbers travelling abroad to receive hospital treatment.

    But it has already said it would be issuing new guidance on the issue in June.

    Mrs Watts said: “I welcome it for what it means for other NHS patients. That’s why I did it.

    “If other people have to have hips done and have to go abroad, they’ll be encouraged.”

    Her solicitor, Richard Stein, said their victory would now act to regulate possible cutbacks in the NHS and increases in waiting times caused by financial constraints.

    It should also help to make sure that the concept of “undue delay” was based on a medical decision, not just an arbitrary timeframe.

    “ I welcome it for what it means for other NHS patients. That’s why I did it ”
    Mrs Watts

    The European Court of Justice in Luxembourg was asked to rule on the case after the English Court of Appeal sought its guidance.

    The ECJ said the UK government wrongly interpreted patients’ rights to access services in other EU countries.

    It said just because waiting list targets had been met did not necessarily mean that a patient had not had to wait for an undue length of time for treatment.

    Instead primary care trusts must ensure a patient’s waiting time “does not exceed the period which is acceptable in the light of an objective medical assessment” of clinical need.

    ‘Flexible targets’

    The court added the degree of pain the person is in and the nature of his or her disability must be taken into account.

    Also waiting time targets must be set “flexibly and dynamically” and reassessed if there is a deterioration in condition.

    “ We need to understand the full implications of the Court’s judgment before we make any changes ”
    Department of Health spokeswoman
    As authorisation for reimbursements of costs was usually sought before treatment was obtained, the primary care trust would be the body to decide on whether the patient was facing an undue delay.

    However, the court found that it was for the British courts to decide whether Mrs Watts faced an undue delay and thus whether she should recoup her costs.

    High Court battle

    Mrs Watts, who is severely disabled, was told in September 2002 that she needed a double hip replacement and that she would have to wait around a year for the treatment.

    But by the end of January 2003, her condition had worsened and a consultant said she should be operated on within three or four months.

    The primary care trust again then refused authorisation for treatment abroad saying she could receive it on the NHS within the “appropriate time”. This was upheld in the High Court.

    But she decided to go ahead with an operation in the French town of Abbeville in March 2003 nonetheless.

    HAVE YOUR SAY
    “ The NHS pays for patients to be treated privately in the UK, so why not pay for treatment elsewhere in the EU ”
    David Butler, Glasgow

    There then followed a High Court battle between Mrs Watts and Bedford Primary Care Trust over the cost of the operation.

    Changes?

    Both Mrs Watts and the Department of Health then appealed to the Court of Appeal, which referred the matter to the European Court of Justice.

    A Department of Health spokeswoman said: “We expect to continue with a system that requires any patient who wants to travel abroad for elective hospital treatment, paid for by the NHS, to be authorised to do this by their local healthcare commissioner before they receive treatment.

    “However, we need to understand the full implications of the court’s judgment before we make any changes to the systems operated by the NHS.”

    Bedford Primary Care Trust said it had applied “sound clinical judgement” at all times in the case of Mrs Watts and stressed the ruling did not decide whether she was eligible for a refund.

    The Court of Appeal will decide whether Mrs Watts has her costs refunded.

  • gremlins3

    Part of the problem is that you have not been told very much about your condition and nothing about your test results. Have you considered exercising your right to see your medical records, either informally by email or letter to the GP and hospital, failing which a SAR?

  • Mary - for Truth and Justice

    Such touching and insincere concern at 1.29pm from the entity who would wish this blog to be brought into ridicule and ultimate closure.

  • Mary - for Truth and Justice

    11 minutes earlier to 1.29pm this idiotic comment appeared on the previous thread. Illuminating or what?

    Habbabkuk (La vita è bella!)

    10 Mar, 2013 – 1:18 pm

    To all my admirers :

    No more from me until this evening, I’m afraid!

    Must go out for a spot of lunch and then getting ready for a thé dansant at the Duchesse de Guermantes’.

  • Tim

    @DCanmore – your reply to Techno – true up to a point, which is that NI should have nothing to do with the NHS. HMT regularly steal part of the NI fund with the excuse of paying for the NHS, but in fact entitlement to NHS treatment is independent of whether you have ever paid NI. Entitlement simply depends on whichever NHS area constitutes your place of habitual residence. One reason the UK has about the cheapest healthcare in the OECD is precisely that the financing is almost entirely decided by Government – so the money follows arbitrary central planning and does not, as in (even a mixed) insurance system, automatically follow the patient.

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