To answer question one is as difficult as it can
be, due to the deep seated development of poor historical healthcare systems
over the last four decades that has led to silo divisions and a healthcare that
is not one service anymore. If the NHS were frozen, it would allow an
examination of how the health systems interact at this point of time, and
follow an individual who goes to a GP complaining of a non-emergency health
problem. In this early stage the GP may assess the symptoms and offer treatment
by the way of medication and ask them to come back if the medication does not
work. The pills do not work, the next stage may be to change the medication, if
there was any option and send a referral to a specialist. By the time the
referral leaves the GP surgery and reaches the specialists reception, assessed
by specialist team and a letter is sent out offering an appointment for
assessment for treatment could take weeks, today it could be months. It used to
be that anything in letter form sent to the person needing assessing was
duplicated and a copy sent to the GP for their records, it seems, that this
does not always happen, and the GP is unaware of what is happening with the
individual that they are responsible for. In the so called good old days GPs,
the local Bobby and religious bodies were the centre of every interconnected
communities, especially outside of the Cities.
The pressures placed on GP practises have increased
over the years to the point (before the issues surrounding Covid-19) that most
surgeries found the lack of doctors wanting to work in the community has become
more than difficult to meet the demand due to the lack of GPs. Each practice
have principal partners who get money from the NHS money pot supplied by the
Government, to pay for the services offered to the size of public they serve
including their wages, nurses, and support workers. In looking at the roll of
the GP must be a good place to start, to develop a first point of contact when
a person becomes ill, but is not an emergency.
The Accident and Emergency department is another
system that was set up to deal with Trauma and acute illnesses that needed to
be assessed right away, but today it seems like a defector GP surgery, because
the individual cannot get seen by the GP in a timely manner. Before Covid-19
and their variants’, which became a pandemic, we had the yearly bout of flu.
Being an epidemic not carrying the scary tag of a pandemic, still clogged up
our hospital system several times a year for weeks on end, with many thousands
of people dying from flu every year. With hospitals, care/nursing homes, and
with highly populated workforces becoming hot spots for the flu virus to
propagate and spread from one person to the next. Viruses have been with us for
as long as we have had populated communities where people travel in and out
moving from one to another. Every-so-often one of these viruses mutates into a
bug that many in the community have no immunity and become affected. Why some
people get effected and some are unaffected is still a mystery and get over it,
but some die. If we knew why that it affects some people differently, we would
be well on the way to minimise the effects on populations around the world ever
year.
Now we have reached the world of silos, different
departments that specialising in the skills necessary to provide assessment,
treatment and recovery for a wide range of human defects or trauma that needs
to be repaired, if not would lead to deformity or death. The list is now so
long it is no longer Medical, Surgical or Orthopaedics, which you would
generally find in hospitals in the 1960s and 70s, let’s just say that it is now
complicated with so many specialists the importance of holistic care with the
complex problems of comorbidity or dual diagnosis have taken a back seat, as
there seems not the time to treat everyone in a timely manner. The question has
to be asked who makes the decision of who gets treated, with the development of
very long waiting lists. Who is standing up for the families for those who die
before being assessed by a specialist?
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