Wednesday, September 12, 2012

An extremely biased first impression of the NHS

Ah, the National Health Service. Its praises have been sung as a triumph of the British nation; it was even singled out for particular distinction during the opening ceremonies of the London games. During an information session before I left, an Edinburgh representative assured us that we would not need insurance in Britain--the NHS would look after us. How delightful, I thought, how utterly different from our deeply flawed and often prohibitively expensive American system.

I've had some personal contact with it now. Here's what happened...

I had a lovely time talking and laughing with some new friends last night, and assumed the tightness in my throat was from that. When I woke up to a sore throat, I realized that was wishful thinking. Ah well, I thought, I have to register with a GP anyway. (Does that seem a little...intrusive to anyone else?) So I looked up the nearest GP on the NHS website--it so happens to be the University Health Service--and gave them a ring.

"Hello," croak I in the voice of a dramatic reinterpretation of Darth Vader done entirely by frogs, "I'd like to register with the University Health Service."

"Yes, you can register between 9 and 4 today or tomorrow," the curt voice informs me.

I'm looking at the address on the web page, which says "Bristo Square." This is one of the main squares for the university and has lots of buildings on it. I've walked through it several times during the last few days and never noticed a building with "Health Services" on it. "And where are you located?" I ask.

"Bristo Square." Followed by impatient silence.

"...Right." On to the second topic of concern! "I actually am sick right now. Is there any time I could see a doctor today?"

"No, you won't be able to see a doctor for a few days," the nurse answers. "Okay? Bye!"

Not having anything else to do, I head to the Health Services Center, finding it with the help of a Fresher's Week volunteer who points me to the poorly marked doorway. I sit in an unsettlingly pink, sparse basement room to fill out my paperwork and wait in the line, and when I get to the nurse who checks it...

"Everything in order, that's you sorted!"

"So," I try again, sounding like I had gravel for breakfast, "I have a sore throat and I'd like to see a doctor."

The nurse stares at me, pulls an I-don't-think-we-can-manage-that face, and asks, "Well, is it urgent?"

Is it urgent? Seriously?

Yes, I understand they're busy--there's a long line of people waiting to be registered. But honestly, for the entire 30,000 students at the university, all they can muster is three harried nurses doing paperwork?

And really, how badly sick do I have to be before I qualify to see a doctor--or even a nurse--if there even is one on site actually treating patients? Do I have to be coughing up mucus? Blood? Spurting brain fluid from my ears? Missing a limb? At what point do I reach the required urgency threshold?

I'm not easily panicked by illness and I've had a sore throat many times. As I have pretty much no other symptoms of a cold--no runny nose, no congestion, etc--what I really wanted was a strep test or a doctor's diagnosis about whether the sore throat was likely to be bacterial or viral. If the former, I could get a prescription for antibiotics; if the latter, I could wait it out in peace. Also, the last time I had a sore throat and went to a GP, they found a tumor back there, so there's that as well.

Instead I was dismissed up to the the pharmacy, where the pharmacist gave me some anesthetic lozenges. It's definitely gotten worse since then--coughing and a headache, for instance. I'm not in crippling pain, of course, so I guess it still doesn't count as "urgent."

The point is this: I brought many exchange students to the Health Center at Western over five years working with the AUAP, and went there myself a few times. No matter how busy they were, the nurses would take your information and get you on the list to see someone. Sure you'd have to wait, and they would often just go, "It's a cold, have some cough drops and get some rest," but they never turned anyone away, even my students fresh off the plane from Japan, barely able to speak English. And I have never, ever seen them look at a sick student, purse their lips at a request to see a doctor, and say, "Well, is it urgent?"

So as for the NHS, color me unimpressed.

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