After yet another wholly unsatisfactory experience with our local health centre, I am reminded, not that I needed reminding, of the mess our NHS is in. I am not some kind of health Luddite who wants everything to be like it was 50 years ago and I actually like the way some aspects of local health system work, but this week, not for the first time, I felt like nothing more than a number rather than a real person. Here’s why.
I am in the process of having the level of my antidepressant prescription reduced by one of the GPs in our practice. The GP, who has been in the local health centre for some time now but I have never met, says that my meds need to be reduced for reasons I didn’t really understand, even though my clinical depression has not improved one iota. Essentially, the level of drugs I am on for my mental health are having an adverse effect on my physical health, not least by way of weight gain. Well, I knew that but preserving what’s left of my sanity, straight after a belated ADHD diagnosis, was quite a high priority for me. Anyway, by way of an appointment down a crackling phone line (is there any other kind?), we agreed, AKA he told me, to reduce my drugs, first by 25%, then by 50%. At least I thought that until I got a call yesterday from a member of the “prescribing team”.
I had contacted the health centre, via the new on line service, because I was fast becoming short of antidepressants, long before the other mountain of medication that keeps me out of the incinerator at the local crematorium was running out. A member of the ‘prescribing team’ called me as I was driving across the city to discuss my query. I took it ‘hands-free’ (officer).
Essentially, the big question was this: why was I running out of antidepressants? It had been agreed that I needed to reduce my dose and I shouldn’t be running out. I explained, twice, how it was supposed to be working (see paragraph two, above) and I was far from convinced that the person at the other end had a clue what I was talking about. Anyway, they’re doing an extra prescription, presumably just in case I throw myself under a bus (I couldn’t afford to throw myself under a tax: have you seen how much they charge?) which I can pick up later this week. All this while concentrating on driving safely. Just what I needed.
Later, I sent another message to the surgery, asking them to copy the correspondence to the GP dealing with me to remind him what I thought we had agreed. But maybe I’m wrong and misunderstood? I’m not on so many drugs for nothing. I’ve heard nothing back about this, obviously.
Contrast this to The Old Days of my childhood. I lived in the Briz (Brislington) area of Bristol and our GPs were called Dr Mills and Dr Carmichael and they operated, as many GPs did, out of a regular house which had been converted to a GP surgery. You went through the front door into the hallway, turned right into the waiting (front) room and waited for the doctor to call you in. No receptionist, no tickets, no appointments; just a little doctor’s surgery. I very much appreciate that the modern health centre, complete with reception staff, an array of nurses, partner and endless locum doctors is more efficient in terms of overall health provision but here’s the thing: your local GP knew who you were, knew all about you, dealt with you as an individual. The GPs at my health centre have no idea who I am, the prescribing team, the same. I don’t feel like a patient: I’m more of a consumer, a customer and yes, a number.
If you are, like me, mental as anything, the GP experience is rarely anything better than horrible. The endless turnover of locums and the lack of opportunity to choose the GP to see means you have to tell your life story, or at least a dramatically scaled-back version of it, over and over again. Or, like yesterday, not at all. How can you tell a fucking member of the prescribing team all your fears and concerns and demons while all the time keeping an eye on the road, feeling like they want to end the call as quickly as they can? It didn’t seem like the right time to be saying my depression is rubbish at the moment and could you make some allowances for that? Meekly, I simply caved-in. There, in a nutshell, is the mental health journey, Talking Heads’ Road To Nowhere. Keep taking the tablets, but just not so many of them, Who are you again?
This is not our health centre’s fault. This is the road chosen by the politicians, in all likelihood because it’s cheaper to do things this way. From what I can tell, most health centres are a version, some better, some worse, of this. And today, my head hangs heavy on my shoulders and I am powerless to do anything about it.
I can’t think I’m the only one who feels this way. I’m muddling along, effectively treating myself, but with zero psychiatric skills. My best advice to all of you is to not get ill if you can possibly avoid it and getting mentally ill just means you’re likely to stay that way forever and a day.
