What constitutes life today? What is a home? What is work, what is a school? Where are they? Where are we? What are we?
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'I think you know what the problem is just as well as I do.'
Outside, in the yard, the rubbish piles up.
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A 5-year-old clicks through exercises on a laptop. Last week she had a high temperature and understandably would not submit to a lateral flow test, so this week she is not allowed to go to school or see other children. Having reported the symptoms and accepted the consequences (for fear of worse consequences if he didn’t), her father asked, via the online portal through which the teachers communicate with parents, for some materials to be provided relating to the topics listed for this week. He was sent a generic ‘isolation timetable’ dating from the previous term (when the child was also off for a week) consisting of some CBeebies links and suggestions such as making a rocket out of recycling, and tersely told to look up resources online. The implication was that to expect anything more was unreasonable. Yes, this is a common and predictable occurrence, yes we have a range of resources at our disposal, and yes the child’s absence is due not to illness but to government policy. But, well, we are very busy. In the absence of a negative test result, the responsibility for your child’s education has been passed over to you. Thank you for your co-operation.
Luckily the father does not have to ‘work’ during school hours (actually how much this is luck and how much a matter of being excluded from paid employment opportunities due to childcare responsibilities is something of a grey area), so is ‘free’ to set up and supervise the child’s learning, cajole her into maths and phonics, tend to her needs, clean up after her and make desultory attempts at housework. In the bedroom the child’s mother works full-time for a large public sector organisation. Her desk is a window sill. A rubbish-and-dogshit-strewn patch of turf behind the block counts as a communal ‘garden’. The wifi sags under the strain of homeworking and homeschooling. On weekend mornings he works as a cleaner. He used to write.
In the evenings they watch the news.
Targets
are being missed in the rest of UK too, with some seriously-ill
waiting up to nine hours for an ambulance.
Investigations are ongoing into deaths linked to delays in a number of areas. These include:
A
person died following a cardiac arrest after waiting more than five
hours in the
back of an ambulance
outside Worcestershire Royal Hospital
He tries to picture Hugh Pym languishing on an NHS waiting list, Owen Jones opening a DWP brown envelope, Ayesha Hazarika on a rail replacement bus service. It is impossible.
He goes outside to the yard and flings another full rubbish bag on top of the overflowing wheelie bins. Does Laura Kuenssberg have to put up with his? He wonders as he goes back in.
The child is not eating properly. She refuses all but two types of dinner offered to her. She will not eat any vegetables. Whole meals are thrown away. The problem has been going on for over a year. People say it’s just a phase.
He phones the GP surgery. Do they have a dietitian linked to the surgery who can dispense advice? (Not to actually see the child. No-one expects that any more, except in A&E or cancer wards.) The administrator goes to check.
As he waits on the phone he looks out of the window at the heaps of rubbish overflowing from the communal bins, like a stinking cliché of social decay. How long has it been now - three weeks, four?
There is no dietitian. It will need to be a referral from a GP, who will need to speak to you. You will need to phone at 8.15am to make a same-day appointment.
The surgery has been run this way since before the pandemic. It does not operate a proper appointments system. Anyone who wants to see a GP must ring at 8.15am - on the dot, not a minute earlier (answerphone) or later (engaged) - and try to get through to an administrator, who will ask a series of questions and decide whether a slot can be allocated on that day. Now of course, in the pandemic era, the prize at the end of the 8.15 phone-in lottery is invariably not an in-person appointment, but another phone call.
This means patients become rivals in a competition for spaces, who have to be ready to play the game, guessing the right time to ring and upselling their distress to get a slot. This system is regarded as completely normal, and anyone who takes issue with the surgery for imposing it is deemed unreasonable. The ‘appointments’ are not even really appointments; a five-minute phone call will be scheduled between, say, 11am and midday, and the person has to wait near the phone and be prepared to drop whatever they are doing when it rings.
It is difficult to think of a system more likely to discriminate against people with mental health problems, and to exacerbate those problems. If someone is suffering from depression and already feels worthless, let alone ready to push past other people to get help, this system will not enable that person to seek support, it will do the opposite. If you are already suffering from anxiety, waiting for the clock to tick round to 8.15 and scrambling to get through, then winning a few moments of clinical attention but still not knowing when the phone will ring or if you will miss the call and lose your slot (as has happened to people, for instance with physical disabilities) is guaranteed to cause huge distress.
The deterrent aspect also encourages people to put off addressing health problems - with themselves, or with their children - until they become more acute, and require more intervention, take up more resources, create more stress and long-term complications, and lead to less time for routine appointments. And so it goes on.
None of this is of any interest to the administrators. It’s just how it is, sir. As for the clinicians, who knows? They are so remote and their time is so mysterious and precious that every second has to count towards the immediate issue.
Hello, you are through to the NHS. We cannot help you. Please do not attempt to visit your GP surgery. Stay at home, or go to work. Good morning, this is the NHS. Please do not use our service if you can avoid it. Press 1 to continue, or hang up. Good morning, you are through to the world-renowned, world-beating NHS. All our staff are very busy saving lives right now. If we leave our duties to answer your call, someone in real need could die as a result. Do you want that on your conscience? If the answer is ‘Yes’, please hold. If the answer is ‘No’, please don’t bother us. There are apps, there are websites, there are over-the-counter pills. Why not use them? Good morning, this is the NHS. Have you considered going private? Good morning, you are through to the NHS, the UK’s leading heritage healthcare brand. If you need us, this means you have failed to keep yourself well; just like if you are claiming welfare benefits it is because you have failed to keep yourself financially healthy. Please hold. We are very busy. You, evidently, are not. Thank you for your understanding.