Postcode jealousy

Hi all. I've just been mildly ranting in a reply to another post about the meagre health facilities available locally. So this isn't a question, just a bit more foot stamping. Apologies in advance.

As I read posts on the site I am regularly taken aback by the resources available in some areas. People are offered tests and treatments and access to professionals that would be unheard of for others (me!). To be frank, I'm a bit jealous!

I've talked before about my minimal interventionist approach, so I know I'm whinging about not having something I don't want. Like a kid wanting a sweet they don't like... But it would be nice to have something decent to reject ;-)

It's taken me many years of quite serious AF to get to see a cardiologist for a brief chat. I haven't got a chance of seeing an EP, partly because there aren't any for miles and partly just because. I haven't had an ecg for 2 years or a scan, even though I'm a retired professional person so very able to negotiate on equal terms. My local hospital is scruffy, chaotic and makes you potentially very ill. Thankfully it's closing but it's not being replaced. I live in a densely populated area but we will all still have a difficult 60 minute trip to A+E.

My anger about this can't easily be addressed because we have a government the majority in the North detests and never wanted but cannot get rid of, and a totally biased funding regime.

But I'm not bitter :-)

ps. What's an AF nurse?

30 Replies

  • I do understand where you're coming from and empathise with your point of view. I wonder if you've contacted your MP to express your views about postcode lottery, or your Clinical Commissioning Group? I know this is not the place for the discussion of politics, but I do so agree with your "My anger ..... funding regime" sentence - and I'm in the SW.

    We don't have an AF nurse at our local hospital either, but I believe they are specially trained cardiology nurses who are more readily contactable than a consultant and who are able to offer advice and information to individual patients. I think they act as a sort of 'bridge' between patient and consultant. Others here with first-hand experience will be able to say more.

  • Thanks so much for your reply. It was one of those that you regret as soon as you press the send button.

    I was planning a light hearted prod, because actually I'm not really angry about any of this, because I've been trained to have really low expectations, but I must have tapped a deep vein of resentment lingering under the surface... but you have to bear in mind that I have a very dry and ironic sense of humour.

    Good job I was in a good mood.

  • I like dry and ironic so no need for an apology Minimalist . At least if you have low expectations then when something good happens it's a pleasant surprise. ;-)

  • We have Arrhythmia nurses at the Cardiology dept here in Bristol, I guess they must be the same thing? As Carole says, they are more contactable than the consultants. I phoned them once, you leave a message on the answer phone and they ring back within a few hours. I also emailed the consultant once, and it was a Arrhythmia Nurse who replied.

    I expect they handle the common, frequently asked stuff, and then escalate upwards as required.

  • Good morning Minimalist - your post brings to life what we read about, regarding the NHS in some areas and the possibility of a future many of us don't want. I don't think you are whingeing at all - at the moment you don't want the facilities but you should have a choice and, indeed, a right to a decent service.

    Contacting an MP would be the ususal first route in complaining but there is so much wriggle room with 'funding' and 'forward planning' blah blah that the letter would need to be very carefully (craftily) written. Have you got a good local paper not in the hands of vested interests? We have no arrhythmia nurses in Northern Ireland either, and we have a health service in crisis but we have dedicated consultants who seem to soldier on regardless in spite of the mess here.

    I sympathise with the feeling that a government is unwanted. Our government here thought that health, education, social needs and housing were so much less important than posturing and preening - it's almost a year since the Assembly met and they couldn't give a hoot about any of us. Not meant as a political statement - just a fact.

  • Hi Finvola. Thanks.

    As you acknowledge, they'll pretty much do as they like whether challenged or not. The local A+E closure has a massive campaign challenging the idea, which has the support of pretty much every person, group and organisation in the area, but it will still happen and is totally budget-driven.

    I've spent much of my life challenging social policy disasters but an AF sufferer with a stress trigger isn't much of a barrier...

    I was happy until I started on about it :-)

  • I feel I've had very good service up here in Cumbria, though we do have to travel. We have a 'Primary Care Unit' within 5 miles but A & E is 23 miles away in Lancaster. It's some years since I went to either. There's also Furness General in Barrow but I have never been there.

    I had an ambulance journey to Lancaster in 2010 and that set off tests and I was referred to an EP at Wythenshawe Hospital (some 90 miles away) and subsequently to Blackpool (55 miles away).

  • You're right of course. It's not like I'm in the Australian outback or anything...

  • Hi Minimalist -things like you are experiencing just don't happen in the north. I phoned my local hospital recently to see if we could be added to a "cancellation list" for an appointment, if one came up sooner than a scheduled one, and was told that "they don't do that "

    Could it be, that things we cannot see, are adding to the problems for our NHS as well? As I get older, I am tending to find things are never as black and white as I thought they were, sadly..... My dear old Dad used to say "there are always shades of grey"....

    Hope you can find a way through.... it seems to be hitting us all, one way or another....

  • ......and then there is Wales!

  • Yeah. You're right. I think I was being Northernist.

  • Nay, nay dear AF comrades ............ all good things come to those who wait - unless you are good at kicking ass ! But seriously, and to put things in perspective ( my perspective). The NHS as we have it to day is nothing like it was designed to be in the 1950's. There is so much medical crap being given 'for free' today that it is little wonder genuine needs are ignored, irrespective of age. When there is a vast section of the country who have a reasonable disposable income and can afford to pay silly money for spare time activities, who can afford overseas holidays etc etc, who can afford two homes it is really time the government stopped cutting services but instead increased NI contributions and increase tax. The money is there - use it. Also cut out non essential services on NHS, For those of us whose medical conditions that are self inflicted, perhaps over a lifetime - make them pay .for treatment. It is probably time for governments to consider a two or three tier health service. A bog standard health service (based on the original design model), a private health service ( for those that can afford treatment and who don't want to wait or for those who have abused their bodies over a lifetime and suddenly need treatment) and a stand alone age care service.

    For governments to say the age population caught them unawares is absolute piffle, aging and breeding as humans tend to do, is nothing new and it was obvious that overtime the population was gonna expand and make demands on 'the system'.

    Rant over - that's opened a can o worms !! :-o


  • The real can of worms there is "For those of us whose medical conditions that are self inflicted ... - make them pay .for treatment. ".

    Who is going to decide whether they are self inflicted? Did you play football and get injured? Well that's risk taking. You pay. Or you didn't do any exercise? Well no wonder you are unhealthy. You pay.

    You live near a main road? Well that's your choice. Lungs, cancer, run over? You pay.

    You didn't eat nothing but lentils and broccoli every day? no wonder you are ill, you pay.

    You had a glass of port at Christmas? Alcohol kills. You pay.

    Is my AF self inflicted? My dad had it at an early age so it's probably inherited. I've done a fair amount of intensive exercise, so it might be that, although that's probably also kept me healthy in other ways. I also like a drink, so I have no defence there. BUt who's to say for sure?

    It's a desperately slippy slope.

  • Pretty much what I was going to say.

  • I had my annual Cardiology check last week and asked about a referral to an EP. I was told there isn’t one here but cover is provided in Aberdeen a 3 hour+ drive away. Also one wouldn’t assist me as they would be looking to ablate and that is not suitable for me with my other issues - a moderately leaky mitral valve and slight ventricular enlargement. Also age I will be 70 in a few months. I have persistent AF now and told I have to live with it. Symptoms not too bad. Thoughts?

  • Well I'm in the south east of Manchester and am one of those whose GP surgery is excellent. I get a full set of checkups and tests for heart and asthma twice yearly, ECGs as needed to confirm anything my own machine has caught, and referals as needed. But I also research my condition properly and don't expect the GP to perform miracles, and always keep any visit to a short time by preparing what I am going to say. Indeed I've found it often better to type it up and give her a printout to read first so it ensures she's got the full details from which to ask any questions she needs.

    I've also never missed an appointment, something which horrifies me when I see the notice at the surgery on how many do waste the doctors time like this. If I was a GP it would be three misses and you're out.

    However I do avoid our local hospital and use the slightly further away Wythenshawe facility which has the North West Heart Centre there with a wide range of cardiology expertise and they've always dealt with me superbly.

    So I think I can say that a) I am extremely lucky and b) it most definitely isn't a North-South issue. I also don't think it's a flavour of government issue as we've had all the same complaints no matter which lot are in power.

    Also a friend in Kent has to travel an hour and a half into the centre of London constantly for appointments as it seems all the hospitals outside London don't have any expertise and refer anything serious into London which seems utter madness to me so I am glad I do live up North !

    Finally given that all GPs get the same payment per patient, and we possibly have larger numbers of the aged here than many areas, I really don't understand why my surgery is so good when others are patently so awful. It can't be a lack of resources as others imply as otherwise mine would be equally bad. Indeed my neighbour uses the other surgery available at our address and is always complaining about them so I suspect in the end it is mostly down to how good the actual GPs are, with the best ones taking up partnerships in the already proven best surgeries as older GPs retire.

  • Hi Mike I live in Kent and I can confirm any operations/procedures that are not emergency are referred to St Thomas’s in London. However having seen their services first hand through my 80 year old father having heart valves replaced. I would recommend them to everyone, their one to one care was superb. Deb

  • I live in the SE about an hour from London but it took 4 hours coming back from hospital in London in the rush hour. My GP surgery is very good considering it has a huge area to cover. Having said that it took 4 months after I had been referred to see a cardiologist but after that my ablation in London was very soon after. I had permanent AF for 10 months before I saw him. Was discharged from hospital too soon after a complicated ablation, and became an emergency. Ambulance to local hospital and then back to the London Hospital. Unfortunate. Having said that my treatment was excellent.

    It is impossible to have experts in all hospitals. You have to be prepared to travel to get to them if you want the best treatment. Some people in some parts of the world have to go to different countries to get treatment - that is if they can afford it. I know I am lucky in this part of the world. Anyway we all in England are lucky. Just imagine how much treatment you would get in certain parts of Africa or Asia or South America, or the Middle East etc?

    You cannot blame the government. We are in a debt crisis. We owe trillions. The NHS is one of the biggest employers in the world. It was never set up for what it does now. More and more conditions are treatable many of them very expensive. There are more and more demands upon the NHS. It will never be able to fund them all. There is just not enough money to do so and there never will be in order to keep up. People are living longer and demanding more.

    I agree with Mike 11 the NHS is funding all sorts of conditions which I believe should be self funded. There are far too many missed appointments. There are far too many trivial demands upon the NHS. Too many people want prescriptions for things they could buy over the counter. There is too much tick box and paperwork and make-work in the system which is too large and cumbersome.

    Other parts of the world seem to work well but people do pay more if they can afford it which is as it should be. Why should people go on expensive holidays, smoke, drink, etc but expect not to pay or at least contribute towards their treatment? Why should we fund treatments which are needed as a result of lifestyle choices without asking for a contribution from the patient?

    There are far too many people making demands and insisting on rights. Whatever happened to duties? People should be realistic about how much the country can afford. We are paying billions and billions to service the accumulated debt which we have been running up for years and years. I believe the last time we made inroads into our public debt was under Thatcher and we all know how popular that made her. There that has made me very unpopular but it needed saying. We are not living in cloud cuckoo land but in the real world where things have to be paid for. People can promise the earth but the debt chickens come home to roost and it is the next generation which has to pay for the extravagance of the previous one which is not fair.

  • Wow

    A breath of fresh air

    Good for you GrannyE !

  • I have a gadget Kardia Alivecor which is very small and which sits on an elderly IPhone which takes an acccurate ECG in 30 seconds. It is excellent. Is very easy to use and carry around and you can write notes to go with it. You can save it and show it to your doctor or even email it to him. I got mine for just under £100 at Amazon. I can thoroughly recommend it.

  • I think Mike11 has nailed it there. At my GP practice, I rarely see the same doctor twice, and they seem to migrate in and out at random. However, there is usually one available within a week, and urgent attention can be had if you put enough pressure on the receptionist. Having a clear cut prepared statement of what you need is the first requirement.

    My practice now insists on setting up appointments online, but if you wish to see a particular GP you might have to wait for up to three months. I just take the first appointment available with whoever. The service seems quite variable, as it is down to personal style and beliefs of the person you see, but I'm learning to cope with that. The rules permit you to ask for a referral 'out of area' if you wish, but only once you have the agreement that you need to be referred.

    Yes, we are lucky in the North West to have such expertise available at the Blackpool cardiology centre.

  • I'm quite wary of simple solutions such as blaming everyone else for going to the GP unnecessarily, or missing appointments. It's easy to assume everyone else in the waiting room's problem isn't as important as yours. And missing appointments is bad, but you don't know other people's circumstances - they might be unwell, or medically forgetful, or have other problems you don't know about. I don't think the NHS would suddenly be flush with cash if these problems were magically solved anyway.

    The real debts we are leaving future generations are run down health services and education, fewer job prospects due to lack of investment, and unaffordable houses. They are much worse than some numbers on some government bank account.

    Blaming other people, not the government for the state of the NHS is like blaming young people for not being able to afford a house because they eat too many avocados!

  • Well said

  • I have always felt that a good rant is cathartic! I can sympathize with your predicament, but luckily I’m in another boat. Keep advocating for yourself, and good luck!

  • Well, that rattled a few cages...

    Thanks to everyone who sent supportive comments.

    Despite my mini-whinge about not having access to services that could save my life, I am very grateful for the services I do get. However, there is no doubt that there are massive variations across regions, and NICE and the NHS both recognise this and have produced an 'Atlas of variation' to help them understand it (and quite possibly do something about it?). This includes variations in the availability of technology.

    I'm happy with the services I receive, but would like to receive as many of them as is fair. I am grateful that I live in a developed country, and I know we have been left with a shortage of money after ensuring a comfortable future for rich gambling bankers. Still, I have paid into an insurance policy for 45 years (N.I.), and my contributions have been the same as those made by an identical person in another region.

    It seems fair that I should get an equivalent access to those services, and currently I don't. I have a right to take my insurance provider (Govt) to task about it, and to change my provider if they are a bunch of charlatans. Unfortunately the system is rigged in such a way as I can't do that.

    But, as I said earlier, I'm not one to be bitter 🤢

  • So Minimalist, are you going to sate our curiosity? A densely populated area 60 minutes to A&E, which is under threat of closure?

    M62 corridor?

    Do you feel out of area NHS referrals are a partial solution to our problem in the North?

    Please don't tell me you live in Lincolnshire, which might be a match but definitely isn't in the north (-:

    Bring back Maggie I say. No one of her calibre on the political scene just now. Though Ruth Davidson could be one for the future.

  • I'm moving to a remote island and will cure myself with roots, berries and grubs and make poultices out of chewed up promises...

  • A few years ago the welsh assembly was confronted (regularly) with the awkward fact that a lot of heart patients were dying and a pot of money was produced to sort out the waiting list in 2014. I was a fortunate beneficiary of this munificence and duly found myself despatched to the Royal Brompton for open heart surgery - a proficient and expert group of people situated in the heart of London. Many thanks to Dr De Souza and his team.

    Moving on 3 years the Royal Brompton (a world renowned centre of excellence) Is slated for closure, with lots of plausible reasons being given. However I can't help feeling that as it is situated in centre of Kensington, it makes it a prime target as a multi million pound redevelopment site.

    As long as everyone swallows the low tax (Amazon, google, etc), tax relief for the rich, trickle down from the rich to the rest, public sector bad, private sector good, you can slowly but surely kiss goodbye to nhs as it becomes a privatised shell run by large multi nationals for profit.

    It doesn't have to be this way. If you look at the continental governments and their way of organising their health care (and tower block building regulations) is far superior - but - money is required and if it is not paid through taxes or private insurance contributions, it has to come from somewhere. Got a mirror handy?

  • Oh. You old cynic you... that couldn't possibly be true.

  • Yeah, you can sort of understand it happening in America where people have literally voted for someone who has openly told them he'd be taking their healthcare away to give tax breaks to rich people, but it's still happening here too, albeit more insidiously.

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