to be so upset? GP surgery told me I would be removed from their list if I don't have a smear test

[veryworried29]

Namechanging uber-regular here.

I received a text from my GP surgery which said "Please confirm address by phone. If not you will be removed from surgery list."

I rang immediately and was told that if I don't come in for a smear test then I will be struck off the surgery list!

Dh and I have been with this surgery for 18 years and our children since they were born.

I don't feel I need a smear test. We very rarely have sex and when we do it is always with a condom. I have had years of clear smears before me.

I find them horrifically unpleasant, in the same way that some people are phobic about the dentist, infact think I may have a form of vaginismus (sp?) hence the lace of piv sex.

Tbh, it almost feels like I must agree to be raped (sorry for emotive language, but this is how it feels to me) in order to keep a place at my GP surgery.

I cannot begin to describe how upset I am about this. There have been tears.

I'd be grateful if you could bear this in mind when replying ... I know this is aibu, but I do feel I have a genuine aibu to run past you all with this one.

Whilst many of us wouldn't go without having a smear test, I personally don't think many of us would agree with people choosing not to being kicked out if the surgery.

I support an individuals right to choose.

OP- I think what's happened to you is awful. It's up to you if you have a test or not.
I once went to a GP when I was very unwell- dizzy, shaking etc. he wanted to do a blood test. My smear was due around about then - but not overdue. He told me I would only get the bloodtest if I had a smear at the same time. I didn't bother with the blood test changed practices and had a smear.

Obviously smear tests are highly advisable but if you are certain that you will not have one then put your withdrawal of consent in writing to the surgery. They can put it in you file and remove any medico-legal concerns they may be having.

Out of interest, who told you you will be struck off for refusing? I would be having strong words with your GP about informed consent to medical procedures if I were you.

If they re worried about their QOFS and that their uptake is not enough
for them to get their money then you can ask if they have a refusal from you can sign, my Mum did this when she was getting letters and invites, she signed a form at her GP and the invites stopped, however by signing this she was taken from the list of the GPs 'qualifying patients' so the surgery still got their money and she could change her mind.

What ever people think of the importance of smear tests no surgery has the right to remove you from their lists if you take up your LEGAL right to refuse any examination or procedure.

Fucking hell would they do that to a man who refuses to have his balls checked or a rod stuck up his willy just so a surgery can make money - I don't think so

sorry form not from

It is absolutely your choice, and your GP surgery is completely out of line here. They are not allowed to remove you from the list on these grounds: you have made an informed choice not to attend, and that is that.

However, can I address some of the points that have been made about smear testing in the under 25s. I understand the concerns here, but I think they come from a misunderstanding of how cervical cancer works, and how health programmes are put together.

Cervical cancer is caused by infection with HPV. This is a very, very common sexually transmitted virus, that most of us women get at some point in our lives. HPV causes changes to the cells of the cervix, which show up on a smear test. However, in the vast majority of cases, these changes go away of their own accord, as the immune system fires up and clears the infection. It is incredibly rare for the changes to progress to cancer in women under the age of 25.

Screening programmes, like all healthcare, are based on a cost/benefit analysis. The benefits of any process have to outweigh the harms.

If you test young girls under the age of 25, you see a hell of a lot of cases of HPV infection, the vast majority of which will resolve normally without any treatment at all. You see a vanishingly rare number of cases of cervical cancer. So if you start pulling all women who have signs of HPV in for treatment, you are going to be worrying (and possibly treating) literally thousands and thousands of women for no benefit at all.

It is very sad that some women get cervical cancer at an incredibly young age, and we need to do more research to find out why in a very tiny number of cases, this disease starts so early.

I have stopped having both smears and mammograms and I'm still with my GP. They're perfectly happy about it.

Call them up and ask them to 'exception report' you on their system so they still get their QOF points, ergo funding.

You can turn up to have a smears a a sexual health clinics without an appointment, it doesn't have to be at your GP. They don't know you haven't done this. Plus it's your choice. (Not one I'd recommend, but nontheless your choice).

Although I think they're being heavy handed I do think the regular smear thing is for your own good. Would you refuse their help/assistance too if god forbid you had a bad result ??

op. Who is the letter sent by and who signed it? [Dont tell us specifics]

LaGuardia is known fro being harsh. So dont take notice. She isnt being personal to you.

If you dont get joy from the GP surgery, take it to the local media.

'Fucking hell would they do that to a man who refuses to have his balls checked or a rod stuck up his willy just so a surgery can make money - I don't think so'

There are QOF (funding) points related to asking male patients about erectile dysfunction - not quite as invasive but still fairly uncomfortable!

No a doctor can't remove for refusing treatment but they can do if they claim the doctor/patient relationship has broken down what I was saying is that the ops attitude towards the surgery does make it look that way. No they shouldn't do it, yes it is bullying and intimidation but it doesn't mean it doesn't happen.

Sadly professionals who deal with vulnerable women often make verbal threats that they are unwilling to put in writing, still less actually carry out. In this case I would bet it is something they get paid for or the usual tick-box, quota-fill mentality that professionals seem to have these days.

And if they really would strike you off for that then I submit they are not a sufficiently honourable medical practice that you should even want to be their client. So let them carry out the threat and see how it sits when you tell the world what they have done and why.

Many years ago I was pressured to keep medical appointments that I did not wish to. And my personal circumstances (complicated involving my then young son) made me not to want any immediate confrontation. So what I did was to make the appointment, and then, a little over 24 hours prior telephone and at a time that I knew calls were going to an answering service plebeian and telephone to cancel it due to an unspecific family emergency. They invariably never wrote and that was an end of the matter.

Harassing telephone calls from professionals are best simply not returned. Let them write if they have something important to say.

When I read the OP about being 'removed from the surgery list' after refusing a routine smear test, I wondered if they meant removed from the list of patients who will be contacted to come in for regular smears.

But it has since been clarified that they did mean removed from the GP's patient list, which really surprises me, because as I said upthread, I no longer have smears or mammograms and it's not been a problem.

OP, speak to NHS England (assuming you are in England)

I have had a couple of issues with surgeries putting in these ridiculous policies. One where they refused to let me have a repeat prescription for the pill unless I had a smear, and another where a surgery refused to let me register unless I had my height, weight and blood pressure checked at an appointment which could only be taken during working hours, necessitating a half day off work.

In both cases, it was so they could record as having provided services which they get paid to deliver, and meet targets.

For the registration issue, NHS England assigned me a contact, who directly phoned the surgery and told them to wind their necks in (technical term ) and solved it.

It is absolutely wrong that they can blackmail you like this, and I'm staggered that other people are trying to defend the rights of the surgery to do this.

You have reminded me op I am a few months over due for my smear test.
I am nearer 50 than 40 and note once I hit 50 smear tests will be every 5 years rather than every 3. Why is that? Does the risk go down with age?
Anyone know?
Thanks!

jacks the GMC use refusing a cervical screening as an example which they can not remove someone. To do so would be considered unfair and the fault of the surgery not the patient. In this circumstance you would have grounds to complain and ultimately take your GP to an ombudsman if they failed to make efforts to resolve the situation.

mackrel but are men sent letters and invites on a regular basis for those procedures to be done even if they have not consulted their GP about any problem - my OH has never been sent anything to ask him to have a test 'just in case'

Struggling - I am not sure you are right about cervical cancer only being caused by HPV infection. I did a quick google, and Cancer Research UK say that, whilst HPV is the main cause of cervical cancer, they cannot say for sure that never having had sexual contact with a man will protect you from developing it.

And a welsh health authority leaflet said that women who haven't ever had sexual contact with a man should still have a smear test, because it isn't entirely clear what causes cervical cancer - though HPV is a major factor, it might not be the only one.

Other sources seemed to be saying that someone who is not sexually active would not need a smear.

It seems that the OP got a text asking her to confirm her address or she'd be removed from the GP's list. Nothing about smears.
Perhaps she's had letters and not responded so they wanted to check she hadn't moved.
Then when she phoned she was told that she had to have a smear test or be struck off. Perhaps whoever she spoke to (? a receptionist) gave wrong information.
The problem with phone calls is that people can deny saying things.
Best to write to the practice manager asking for clarification. You need to have a record of what's been said. I've worked in a GP practice and never heard of anyone being struck off just for not having a smear.

I'm always told I don't need one - sometimes get asked if I want one but have always turned it down (been eligible for three years and see GP two-four weekly, nurse fairly regularly etc). Most HPs up here (Scotland) seem convinced you don't need it if you haven't had sex.

ender "It seems that the OP got a text asking her to confirm her address or she'd be removed from the GP's list. Nothing about smears.
Perhaps she's had letters and not responded so they wanted to check she hadn't moved."

Yes, that's a very good point. If the letter said something like "We recently wrote to you regarding a smear test and have not received a reply, please contact us confirming you address or you will be removed fom the surgery list" that may have lead the OP to believe it was because she didn't go to a smear test, whereas the surgery just wanted to confirm that she hadn't moved because they'd had no response to a letter. Obviously if they still got no reply they would assume the patient had moved and taken her off their list. That seems entirely logical.

Oh well, the OP's left the thread, I know, but I wouldn't be at all surprised if the info from the receptionist was incorrect. Maybe the receptionist misunderstood the reason for the mention of 'removal from list' too.

I've come back to the thread as I've had some kind pms and cooked the children's dinner.

Gruntfuttock - no, I was clearly and firmly told (not in a nice way) by the receptionist that I would be taken off the surgery list if I didn't have a smear. She said it wasn't their choice, they had contacted me (by text) to give me a chance not to be removed. The text asked me to ring them to confirm my address, which I was happy to do, I was not expecting to be bullied into making a smear appointment. I am not sure who the directive comes from if not the surgery then? I thought it was the health authority but I read further down the thread that health authorities don't exist any more .

I was so shocked and angry I just made an appointment.

My relationship with the surgery has not broken down. I have probably been there 4 or 5 times in the past 5 years on my own behalf, and of course I will have been in plenty of times with my children.

My children had all their immunisations at the surgery. I have had a mammogram which I assume will have been copied to them!

I was last there (for me) about a week before Christmas when I'd burnt myself cooking.

You'd be surprised. We had to dissuade a (male) GP form sending out letters to women who had not come in for smears that he would have to assume they were mentally unstable and take appropriate action. Then again he was total fruit loop.

If OP has not been to the surgery on her own account for a while she may be in danger of becoming a 'ghost patient'. Sugeries can be heavily penalised for not weeding these out - they have a patient on their lists who does not use the surgery (moved, died etc). Certain types of jobsworths take this a bit too far sometimes.

As for do this or we'll strike you - yep. In some surgeries where there is a really low uptake of something they can lose money, get penalised or worse, get special training. This can lead to some very weird compromises being offered and sometimes just barefaced threats.

I was going to say I am happy to be out of such daft red tape, rules and regulations - but I now lecture in FE :D