To think this letter from gp was really rude?

[ariane5]

Dd2 has a lot of health conditions and is frequently very unwell.

Last sat (2nd) she was terribly poorly and our gps were shut so we took her to the ooh walk in and she was prescribed antibiotics.

On monday she was worse and woke up at 3am in the morning extremely ill and with high blood ketones (she is diabetic) so dh took her to a+e, she was let out the following morning.

Yesterday I received a letter from our gp and the more I read it the ruder it sounds.

"I noticed you took dd2 to a walk in centre on monday. I am concerned and disturbed by this. We have her records here and can provide better continuing care. I am worried as to why you felt it necessary to take her immediately to a walk in centre"

"Please make time to explain this to us, make an appointment or telephone as this issue needs to be discussed"

For a start dd2 went to a+e not walk in early tues morn-surely if information has got through to gp then it would have stated the time date and reason?

I don't understand why they had to write a letter like that, would have been much easier to phone me and clear it up.
It has made me really annoyed.I feel like phoning tomorrow and telling them to check their facts before writing a letter of that tone.

AIBU?

This letter is just an example of sloppy, somewhat paternalistic practice that would be frowned in by the RCGP, methinks. You need to establish the facts before you fire off form letters that might upset people, especially in the case if the patient who was supposedto justify an ambulance trip for her dying father.

It's classic divide and rule, isn't it?

The CCGs create a game of beggar-thy-neighbour for the GPs.

The GPs have a go at patients (and that letter was way over the line of seeking information or trying to provide better care - highly emotive language and claiming GP care was better, 3am or no 3am).

The vulnerable or conscientious patients respond to the letter by not going to OOH of A&E.

The inquest blames the patient for failing to take personal responsibility for their care.

Politicians' hands are clean, and NHS cuts and privatisation continue apace.

Plus for an added bonus, the population responds (as Tee's already suggested) by going private directly.

Win win win, for the ideology of rolling back the state and for the private health industry's bottom line.

Lose lose lose, if you're chronically ill, vulnerable, or just poor.

Oi, Red, I agree with you that there needs to be resistance, but I don't think attacking individual GPs who are between a rock and a hard place is terribly useful.

Red I am reporting your post. I was trying to explain some of the politics behind GPs action these days. I'm trying to explain to people who wouldn't be in a position to know, what the financial pressures are on the NHS during this recession.

I don't expect to be told to "fuck off".

Sadly it seems you have more interest in ranting and raving than understanding. You don't know me or my life, and yet you happily sit in judgment. Perhaps if you have so much emotion and energy, you could take the matter up with your MP and launch your own personal campaign.

imagine - what is the BMA doing about this? Presumably GPs are asking them to lobby the government on their behalf. If not, they should. The BMA are very vociferous about issues such as pay and pensions which can - rightly or wrongly - affect the public's perception f GPs generally.

Successful BMA involvement would be a win - win for patients and address the "GP bashing" you refer to

Lose lose lose, if you're chronically ill, vulnerable, or just poor.

Absolutely.

And imagine, getting that post deleted just proves to me that the truth hurts and you don't want to see it. Nothing more, nothing less.

The NHS is supposed to provide universal care for the most vulnerable and needy. Its not the case anymore. Its time we all just bloody admit it.

I can't actually afford private care, BTW, and I have several chronic conditions.

Someone in the medical community needs to stand up and start shouting. But, obviously, it isn't going to be GPs, based on Imagine's posts.

So the rest of us slowly die. Lovely.

Imagine has provided solid, inside information about the situation and also suggested something we can do about it, why is she being attacked? The posts were interesting and gave some insight into why the OP received such an upsetting letter.

Red please be realistic about what individuals can achieve.

Some organisations have unions. They pay union fees, which fund the people who run the union. Their jobs are to look at working conditions and "rally the troups" if something needs to be protested against. It's a big job for many people. Getting a large group of people to reach an agreed decision on a plan of action involves a huge amount of time and liasion and discussion to reach a consensus. Those at the coal face simply don't have time to coordinate such a response. This isn't an excuse, it's a statement of fact, and applies across the board in all institutions.

Our unions (BMA and RCGP) put up a bit of a fight but not a huge amount. They fight a bit, and sometimes they win a bit, as with the recent stalling of private bidding plans. But the government are determined, and they have power.

I am as sad and worried about the NHS as anyone. I work in it so I see first hand how the cuts are affecting people, as well as seeing my own family affected by service reduction.

But please don't attack me for the state of the NHS. I don't make the rules, I just try and see patients and do the best I can for them, within the constraints imposed on me by politicians and their tiny cheque books.

OP if you're still reading, I don't think any GP would argue with what you did given the circumstances, and the wording of that letter was very wrong. They need to be taken to task for that.

I don't think I'll post again because I do find the very angry posts quite upsetting.

thanks for answering imagineJL
I had no idea this happening.

That's one paranoid GP!

Seeing as an enormous number of GPs can afford to work part time, it's hard to be completely sympathetic to their claims as a collective professional group of overwork. Sorry GPs.

"Seeing as an enormous number of GPs can afford to work part time, it's hard to be completely sympathetic to their claims as a collective professional group of overwork. Sorry GPs."

This.

And, imgaine if your unions are ineffective, get rid of them. And don't say 'but I don't have time' whinge whinge whinge. Someone, who knows what is actually going on, because they are in the thick of it, needs to take a stand. Or we all lose out. The average NHS user can't. We aren't told enough. Not even in posts like yours.

I'm tired of the whinging and the 'not my problem/can't do anything' attitude all over the world.

What if Ghandi, or Martin Luther King, or Rosa Parks had had that attitude? Where would be today?

Agree the letter is not using the nicest of terms and could have been phrased much better. but good for the GP showing concern for a paitent....
I would yes contact them , explain why you went ( erm your dd was getting worse and you needed medical advice there and then)and I expect they will probably apologise .. I could be wrong but why would the gp have bothered writing to you if he / she wasn't showing some concern for your daughter?

Doctors are SUPPOSED to be the advocate for ill and vulnerable patients in a socialised health service like the NHS.

If they are more concerned about their jobs and their own necks then are failing in their duty under a socialised system.

I am realistic about things. I am realistic that whistleblowing and collective opposition to proposals are effective. IF the people concerned and know and are in the system are prepared to take action.

Its whether they have that will to do that, that is the issue, not whether it is a realistic way of changing the system.

Thank you ImagineJL for coming and sharing your experiences. I'm fortunate that me and my family currently have little call on the NHS, but your account of what is going on is deeply disturbing. You always imagine they will be there for you when you need them (my father was a GP many, many years ago and put his patients' welfare above everything). I know in the abstract that this government is damaging everything that was good about this country, but your post was really interesting.

Sorry you got abused for it.

The letter doesn't sound very professional. I cannot imagine a professional writing in such a dramatic style as to say they were concerned and disturbed and worried as to why you sought medical attention.

Would their first port of call not be to follow it up with the OOH surgery rather than send an insulting letter to a patient?

If I was you Ari I would be changing GP's.

Gosh don't pick on imagine. I have been doing various bits of work (sort of) with GP's recently. They're, on the whole, a decent caring bunch who have every area of their work interfered with. If for example they don't want to prescribe you statins because they think the evidence is limited and they may do harm they will be penalised financially for not doing so. This is the same.

Blame the succession of govts who have treated patients as tins on beans to be traded with. The rot set in when people like McKinsey were paid millions to improve efficiency within the NHS - whilst failing to understand that patients are not homogenous beings and they come with different degrees of complexity.

I'm just back from the hospital with ds1 - so will probably get sent one of these this week. This started with a misdx via a telephone triage (another favourite in the new NHS) - which means he has probably spread it all every where as well. He also now has a shed load of medication that he prob wouldn't have needed if treated earlier. (He did also see a sch

School nurse paediatrician & GP this week. As well as 3 phone calls to the specialist A&E dept so we took a whole to get there!

I think you should respond with honesty, say you understand the practice is liable for costs whenever you attend ooh and a and e, which is why you have never used either as a first option. However the tone of the letter you received makes the patient/doctor relationship an uneasier one.

I am not sure what some of the posts on this thread are getting at.

As has been explained, GPs have to pay for/account for visits by their patients to OOH/A&E.

If the GP has been led to believe - as the GP's letter implies - that the OP took her DD to out of hours when the GP's surgery was actually open, ie chose the OOH service over a visit to the GP, then the GP:

a) if going to have to fund the visit
b) may be having to answer questions as to why the OP couldn't get an appointment for her child at the surgery during normal opening hours
c) may be having to answer questions as to why the OP had no confidence in the GP and went straight to OOH
d) is genuinely bewildered as to why the OP went straight to OOH as they have previously had a good relationship regarding her DD's care (this does come over in the letter)

The answer to all the above questions, is this - The GP's information is incorrect. It didn't happen.

The OP is NBU being offended by the letter, as it is rude.

But some questions being asked by the GP is justified given the information that the GP was led to believe.

I think it is certainly fair to be concerned that someone confused or vulnerable, or with poor literary skills could receive a letter like this and believe that they are being told off for going to A&E at three o'clock in the morning. After all, quite a lot of mumsnetters on here are leaping to that exact same conclusion.

The OP needs to draw this to her GP's attention, and stress that a phone call with the opening gambit: "Did you take you DD to out of hours at nine o'clock on Monday morning?" would have been far more appropriate way of handling this, and the matter would have been cleared up at once.

Which is, er, exactly what the OP was suggesting when she started the thread.

I always thought I was helping the GP by going to the walk in centre! For example there is one absolutely opposite my work so if I am struggling with what I call a minor ailment like earache I will nip in to see them. No bothering the GP no time or little time out of work for an appt. What a bizarre situation!

Is that really a direct copy of the letter? The English is quite poor.