Monthly Archives: September 2012

Patient choice? My arse

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Ding dong time this afternoon with the Practice Manager (PM) of our GP surgery. They’ve introduced a crackpot system where you can no longer book an appointment with a GP. You have to arrange for a GP to call you back that day to assess your need for an appointment. It’s all in the name of patient centred care and choice.

So I had a 30 minute call with PM  who’d swallowed the health policy rhetoric manual but could not explain why I couldn’t make an appointment without a screening call. The gig was that I could agree to a GP call-back and potentially get an appointment the same day, or I could be allocated a loser slot, out of hours on a Tuesday night or Saturday morning.

In response to the (numerous) concerns I raised, she tried to persuade me that GPs were so flexible in this new system that call-back could be arranged to coincide with tea-breaks for people at work who didn’t want to discuss symptoms in front of colleagues, and that an online option existed so patients could type their concerns quietly. No reflection on how unrealistic or burdensome this was.

Yes, in some contexts of course it’s fab to have the option of managing some health related issues by phone. I howled for that when a GP rigidly insisted on ‘seeing’ LB in the surgery before re-referring him to neurology after he’d spent a night in A&E recovering from a massive seizure. But not a blanket screening system. That’s just crap.

Eventually, she suggested making an out of hours appointment in 2034. I told her I’d just crawl off into a corner and quietly die. She didn’t budge. It was screening call or crappo appointment. That was the system. I said I should probably contact the local paper about it. She booked me an ‘in hours’ appointment in a few days with my GP.

So, this new system is also going to feed into and reinforce health inequalities highlighted by, and remaining/increasing, since the Black Report. Fucking great.

Of Gerards and Geralds

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I know I’m jumping around a bit with my trove of old diaries, but my 17 year old self having a holiday pash made me chuckle. Not least because I shift from ‘Got up.. dressed..went to bed‘ type accounts to an exercise book filled with ethnographic reflections that Margaret Mead would be proud of. Description, narrative, sketches, music, food and interpretation. Of a two week coach/camping trip to Biot.

It was a cheapy cheapy cheap cheap holiday with three school mates; Mandy, Louise and Tamsin. A two day drive from Gloucester Road bus station, central London, via a night in a campsite ‘near’ Paris, to a craphole campsite in the South of France.

We fell into a happy routine in our fully equipped tent [brown plates, cups, a gas stove which collapsed, a table, 4 plastic ribbed chairs, metal beds with blue plastic mattresses], daily walks to the beach [quite a long walk, over a bridge over the motorway then turning right down a fairly narrow winding road, passed the Camp de Pylon (the other Nat campsite). We then had to cross one main road, go past JR’s through a tunnel, then across another main road to the beach], nosh (tinned ravioli, yoghurt, cacolac) and the campsite bar/disco.

The range of characters included the punks; really nice. 2 couples. Alison and Roger (peroxide blonde) and Sharon/boyfriend. Alison was ill most of the time with diarrhoea and sunstroke. The two couples didn’t get on very well. They lost £200 in Antibes and got left behind at the end of the holiday.

But what about the pash??? Gerard. From Clitheroe. Touring Europe on a motorbike with Vernon [very kind, paranoid about his age, lived with his mum, fell for Mandy big time] and Paul [27, drunk all the time, looked like Starsky and disappeared on Saturday morning and didn’t come back]?

Well. Turns out he was Gerald and not Gerard. And piecing together the story, with the detail provided and hindsight, he played with my 17 year old feelings with cups of Oxo, the odd slow dance to ‘Still Crazy after all these Years’ and general shite treatment [Gerald walked passed me without speaking and spent the evening with the posh girls/Gerald asked me to stir his oxtail soup].

Sigh. Maybe, just maybe, this tale of sun, sea, Oxo, love and leg warmers suggests very early signs of a sociological imagination.

Thanks to Kate Bielby for pointing out that all Gerards turn out to be Geralds in the end.

LB and the school bully

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“LOCK HIM UP. LOCK HIM UP AND THROW AWAY THE KEY!
HE’S AGGRESSIVE.
HE’S A DANGER TO SOCIETY.
HE’S A BULLY.
HE’S CLINICALLY INSANE.
AND.. AND… AND…HE WATCHES TOO.MUCH.TV.”
“LB, what happened at school today?”
“Nothing Mum. Nothing.”

 

 

My any year diary

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On a horrible, rainy, cold, early Autumn Sunday, I’ve had a right old cringe-chuckle diving into the box of diaries and old letters we found in the recent loft clear out. There is so much evidence of the laugh riot I was growing up, but in case you still had doubts, a couple of tasty morsels from my any year diary;

April 6th, 1978

Woke up. Sam had to do all the washing up. Started my school needlework (what a mess). Sarnies for lunch. Had my haircut. It’s really short. Ugh. Washed my hair, looks nicer. Read. Peeled spuds. Dad did some of our rockery. Mash, liver, bacon, peas, jelly. Watched TV. Patchwork. Read in bed. A lovely sunny day but rather windy.

The same day, a year later, I went to the Tennis Club Disco with the two Mandys and Claire. Sparing you the ‘woke up’ and what I ate routine, the disco took an exciting turn;

It was quite good. This boy danced with Mandy three times. His name is Peter. She gave us a lift home. Bed.

I (I think I) started to mix it up a bit, the third year. For example; a formal declaration of my diet intentions glued to the inside cover;

Hilarious. With a bucketful of cringe. And nosh of course.

The foyer

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I randomly decided to pick LB up an hour and a half early from after school club yesterday. And found him sitting patiently on a chair in the foyer. Alone.

“WHADDAYADOINGSITTINGHERE LB???“
“Waiting Mum.”
“Waiting?!! WHY AREN”T YOU IN KIDS CLUB?”
“Dunno Mum.”
“What are you waiting for?”
“You Mum.”

I rang the kids club staff on the internal phone (you have to ring and speak to staff).

“Er, I have LB here. In the foyer on his own.”
“Ah, is he there? We’ll come down and get him.”
“GET HIM? I’ve got him! What’s he doing in the foyer on his own?!!!”
“We’ve been waiting for him to come from football. Usually he’s brought up to the hall after football by school staff…”

After this exchange on the phone (???) we left and the service provider running the kids club texted me disclaiming any responsibility ending with “..we are not at fault”. It was the school’s responsibility. Lovely.

This morning, the school liaison officer (SLO) rang, hugely apologetic. It will never happen again. LB had told a staff member that he wasn’t going to kids club that afternoon, I was picking him up. He had to wait in the foyer. Whoa. Cheeky monkey or what? (He doesn’t  like after school club and was pretty fixated on getting Eddie Stobart Series 3 in the post).

Or, as the SLO suggested, was the dude a bit psychic?

I asked LB what he thought about what had happened, at bedtime last night.

“I hate the foyer Mum.”

Of tits and trolls

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Two hugely inflated ‘stories’. Pics of ‘royal tits’ for sale? I’m not condoning the practice at all, but really, if Will, that strange talking palace and the media had stopped banging on about em, would anyone have really cared? The photos can’t be untaken, and once in the public domain, will never disappear. Get over it*.

Then trolls. A ‘phenomenon’ that appeared with social media, particularly twitter. Interpreted by some as a form of cyber bullying which is serious, of course, but the label seems to be applied to any bit of tongue in cheek banter, or edgy comment, that before ‘trolls’ were constructed, would have been ignored. Twitter, handily, provides a tool for dealing with anyone who you might find offensive. The block button. Press it and move on.

*And maybe get on with something.

The why? question

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LB has become adept at answering most questions “Yes“, “No“, “Don’t know” or “All of them” in typical teenager fashion. We’ve been pushing him on this recently (not least because it’s pretty boring).

This morning (as with so, so many mornings);

“Mum? I love lorries Mum.”
“I know.”
“Mum? I love lorries Mum…”

Usually at this point I say “I know LB. Do you know how I know?”
And he answers “Because I’ve told you 25,000 times, Mum.”

This morning I mixed it up a bit;

“Mum? I love lorries Mum.”
“I know.”
“Mum? I love lorries Mum…”
“Why do you love them?”
“Dunno Mum.”
“No, think of why you love them.”
“Dunno Mum.”
“C’mon LB. Try to explain to me why you love lorries.”
“Because. Because…… Because of me, Mum.”

Love him.

The letter

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So, we get back from a nice weekend away, with the sun still shining, and there’s a letter from LB’s Transition Care Manager (ASW).

I am writing to confirm that we have been successful at panel and that your indicative budget is xxx per week or xxxx for a full year. I understand you wish to receive the budget as a direct payment and manage the account yourself. I enclose a support plan that needs to be completed before any money is released. I’m happy to start the support plan for you as a draft and then we can arrange to meet to discuss any questions you may have.

Well, I have quite a few questions.

Kicking off with who is the we? Given ASW has never met LB*, I’m not sure who it refers to?  I’ve met ASW for about 20 minutes in total and she ain’t ever met LB, so seems a bit too familiar for my liking.

And why were we successful?  Was there ever a question mark over the need for an adult care package? I find it pretty offensive really, suggesting we somehow won something. Or is this a (waste) product of current government welfare reform. WE have been successful in the wider context of cuts. Great.

What is an indicative budget? If these terms are going to be used, they should have some sort of explanation or it is meaningless (and frustrating).

Is this budget for just the period while LB is still in full time education or indefinitely? If the latter, does that mean that LB will have his case closed once this care package (xxx a week) is in place?

And if yes, how the fuck are we supposed to manage our lives, with full time jobs, around the equivalent of 10 hours a care week?

That’s it really. I’m not going to bother repeating the way in which careless, jargon filled communications like this are experienced.

Transition really is shit.

*I know.

Carer Assessment

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The long awaited Carer Assessment form turned up recently. Regular blog readers will know that I’ve been a bit confused about this assessment, and wasn’t really sure if I’d had one or not. Given that LB is 17 and it was introduced over five years ago, I thought I probably had really [must have surely…?], but I hadn’t.

So. A Carer Assessment turns out to be an A4 piece of paper with statements and prompts on both sides. No instruction, no guidance, just a piece of paper. Not sure I need to say much really. It kind of speaks for itself. I’ll just flag up the bottom of the page (pictured) ‘Any financial problems‘ section, which has got no space to write anything other than ‘yes’ or ‘no’ but includes the helpful prompt; ‘Are you receiving the right state benefits for example?‘ Er, you tell me matey,  And mention my favourite prompt under the ‘How you feel about continuing to care’ section on page 2; ‘What would happen if you couldn’t care any longer?‘ Er, you tell me matey.

Not sure which dozy bunch came up with this ‘assessment’ but if I was marking it as a student assignment, it would get a big, fat fail.