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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Such Low Expectations in Health Care

28 replies

QualCheckBot · 21/08/2019 17:31

I've just been to the pharmacy to collect my prescription. Its for HRT, high blood pressure medication and an asthma inhaler. The pharmacist as usual could not leave me in peace to deal with the assistant and had to butt in with the usual "do you pay for your medicine?" type questions. Fair enough, but I said quite quickly that I did, but she persisted, as if she thought I might have forgotten. Then as I was paying, she suggested I get a pre-payment certificate. I said thank you, but I couldn't be bothered. She persisted once more and said, somewhat patronisingly, that she would "just give me the leaflet to look over when I was at home anyway, so I could make up my mind". I told her that I would do it online if I wished to, but since I didn't and I don't get that much medication anyway, I wouldn't be bothering.

Appreciate she is trying to be helpful but it came across as patronising and interfering.

The prescription itself is a wonder. A couple of years ago, I was surprised to find that I had high blood pressure while suffering from a kidney stone. Medication was prescribed and after taking a minimal dose every day for 3 weeks, I passed out after suffering blurred vision and weakness for some days. Went back to the GP, blood pressure still high according to the readings in the surgery but when I take my own measurements at home it is consistently normal - low, and has been as low as 85 over 55. The reasons for this will be explained below.

My smear test last year. The nurse couldn't find my cervix, announced that it has shrunk as "this is common in ladies your age" and also told me that I could expect to suffer dryness.

Now, lest you think I am an aged pensioner with these experiences, I am not. I am in my late forties with a troublefree menopause, an active sex life and participate in a competitive endurance sport. I look young and fit, certainly more so than the health professionals dishing out this unwanted advice. The low blood pressure is typical for me after a race, when I'm relaxing in the evenings. If I took the medicine in the way originally prescribed, I would have suffered ill health. Thankfully the GP has suggested I take 1.25mg every second day and not at all if I have done particularly strenuous training that day. It took over a year, a change of requested GP, a letter to the surgery complaining and being talked down to by the original GP to get to this stage.

I used to live in another European country until 2 years ago and the contrast with expectations in the health service was stark. I find the NHS approach that I have experienced patronising and depressing in equal measure. Am I unreasonable?

OP posts:
pottedshrimps · 21/08/2019 17:48

I agree. I have a bone spur on my right foot due to midfoot hypermobility. I was sent for an x ray. When I turned up for it the form from the gp had left foot on it. The radiographer asked if I was sure it was my right foot 🙄 he then had to phone the surgery to get permission to change it to right foot on the form. You can clearly see and feel the bone spur as it's on the top of the foot.

I had a male gp explain to me that the dental antibiotics for an abscess I had been prescribed couldn't possibly have helped my bile duct pain when I told him that they had helped. A few months later I was telling the same tale to the female gp and she explained that antibiotics are indeed prescribed for just this problem and that's why the dental antibiotics had helped. She then proceeded to prescribe some for my bile duct pain which helped settle it down.

Patients are treated like bloody idiots. I'm a qualified nurse as well which is even more demoralising.

SirJamesTalbotAndHisSpeculum · 21/08/2019 17:55

If you get regular HRT and asthma inhalers a prepayment certificate could save you a lot of money.

I do hate pharmacists generally though.

At my GP's surgery I know which GP to avoid (as she is a cow) and I usually take my problems to the Advanced Nurse Practitioner as she is the most useful and well-read person at the surgery.

bridgetreilly · 21/08/2019 18:33

The pharmacist has to ask whether you pay or not so that they know whether or not to charge you. And since you were getting multiple prescriptions it seems perfectly reasonable for her to point out that you could save money by pre-paying. Lots of people don't realise that. I don't see anything patronising in her behaviour at all.

The GP treated your high blood pressure, working to tweak the dose until it was right for you. Was she supposed to magically know that from the start? I don't really understand your complaint here.

oldbuthappygothgirl · 21/08/2019 18:59

I'm not really sure what you expect either. The pre-payment cert would save you quite a lot of money. The pharmacy was doing her job.
Re the blood pressure meds, the GP doesn't have a crystal ball to know exactly how they will suit you. They start on the recommended dose based on your symptoms then adjust it from there. How do you expect to do it differently?
YABU OP, you come across as quite superior and patronising.

PookieDo · 21/08/2019 19:03

The prepayment certs do save you a lot

I have 4 regular items every month and at one point had 8! So I only pay £10 a month for the lot

Ilikewinter · 21/08/2019 19:05

Wow, I love serving customers like you, no doubt you came across as arrogant and rude...how dare the pharmacist speak to you and try to save money as you pay for your medicines.

PuffHuffle5 · 21/08/2019 19:06

I used to live in another European country until 2 years ago and the contrast with expectations in the health service was stark.

I agree and have experienced this too. What also makes me uncomfortable is this constant rhetoric that we should be grateful for the NHS and not complain because it’s ‘free’ and everyone working in it is just trying their best. That may be - but being ‘grateful’ doesn’t mean we should expect and accept low standards. Politicians saying it’s the ‘best healthcare system in the world’ are also completely delusional - it’s underfunded and in many ways poorly organised - no amount of great and dedicated staff can make up for that.

Sirzy · 21/08/2019 19:10

How dare the pharmacist try to save you money!

I have seen many a thread on here where people complain that pharmacists don’t inform them of pre payment options and now they are being criticised for doing so. They can’t win can they!

QualCheckBot · 21/08/2019 19:13

The pre-payment cert would save you quite a lot of money. The pharmacy was doing her job.

It wouldn't. I get 4 prescriptions per year. And tbh that needs to be reduced, since I now appear to be suffering from low blood pressure, even without taking the medicine for high blood pressure. I really don't care so much about "saving money" that I want to arrange a pre-payment certificate. I just don't. And if my prescriptions are altered yet again, since they have nearly always got it wrong in the past and yet more items are removed, I would end up out of pocket.

There is absolutely no expectation that a patient might, for instance, do more sport in summer than in winter. Or that a patient might cycle to the surgery, 6km away from their home and at the top of a hill. There seems to be no realisation that if you give a patient who has low blood pressure readings at home blood pressure reducing medication while they are doing 2 or 3 hour long cycle rides, it can be very dangerous. Vasal vagal episodes and feeling faint really isn't very nice. Even if you tell NSH doctors this, they don't take it in. The Nurse, exasperated at the GP, even previously suggested that I just take it every second day, but not to tell the doctor. This would have worked, but I didn't want medication on my medical notes that I didn't need.

I do not need explained to me repeatedly the benefits of a pre-payment certificate when I have indicated that I have made a choice not to get one, nor do I need leaflets pressed upon me to "read at home". I don't expect to get into an argument just by going to the pharmacy for a prescription. It is so, so patronising and interfering.

YABU OP, you come across as quite superior and patronising.

Being spoken to as if I'm hard of understanding does that to me. I did at one point contemplate asking my first GP whether she had Munchausen's by Proxy, but held back.

Its this one-size-fits-all, get everyone onto medication thinking that is so typical of the NHS. Such a waste of money too.

OP posts:
QualCheckBot · 21/08/2019 19:15

likewinter Wow, I love serving customers like you, no doubt you came across as arrogant and rude...how dare the pharmacist speak to you and try to save money as you pay for your medicines.

I was perfectly polite. I just don't want a pre-payment certificate! How is it "rude" not to want a pre-payment certificate and keep saying, politely, that you don't want one? IT wasn't even the pharmacist who was dealing with my prescription that said it, it was another one who walked over and butted in.

Is it actually now considered rude in the NHS to be healthy and refuse unnecessary medication?

OP posts:
TheRealShatParp · 21/08/2019 19:17

Get in touch with PALs and put in a strongly worded complaint about the unprofessional and rude pharmacist. She must not get away with this.

Spam88 · 21/08/2019 19:18

@pottedshrimps I can appreciate your frustration about the X-ray but I work in radiation protection in the NHS and the X-ray department absolutely did the right thing. I've dealt with incidents in the past where, for example, the referral says left knee, the patient insists it's their right knee that's the issue, so the radiographer X-rays the right knee. Turns out the doctor did want the left knee because they wanted to compare it to an X-ray image they already had of the right knee.

By all means be irritated at the referrer who failed in his legal responsibility to provide accurate information on the referral, but the hospital can't perform an X-ray on you that hadn't been requested.

NoBaggyPants · 21/08/2019 19:25

The NHS is far from perfect, but you're looking for problems that aren't there.

Wynturphelle · 21/08/2019 19:25

You've a choice for your care and your meds. Go private.

MadisonMontgomery · 21/08/2019 19:30

How unreasonable of people to try and help you when, clearly, you know better than all of them.

SolitudeAtAltitude · 21/08/2019 19:34

Op, it is simple, go private!

Like they (you) do/did in previous country.

It is not obligatory to use the nhs, some people forget that

WaterOffaDucksCrack · 21/08/2019 19:35

She must not get away with this. bit dramatic 😂

OP the pharmacist may be forced to ask these questions tbh. If it is that particular pharmacy's policy to do so then she must do it. If there was a mystery shopper or a complaint that she didn't then she's risking her job. You're not going to be worth her getting into trouble for.

Drogonssmile · 21/08/2019 19:46

OP, go private if it's that bad. I can't stand NHS bashers Angry

Sindragosan · 21/08/2019 19:47

It is not obligatory to use the nhs, some people forget that

Try living in the wilds away from London and getting comprehensive private healthcare. You will get some, it won't cover everything and not every specialist does private work. Certainly can't get a private csection around here, and no, I wouldn't want to travel to and from London heavily pregnant or with a newborn post-partum. Can't get private emergency care either, 3am in the morning a&e is your only option for serious issues.

QualCheckBot · 21/08/2019 20:31

SolitudeAtAltitude Like they (you) do/did in previous country

I'm unsure where you have in mind, but the European country I lived in had neither private nor NHS equivalent - there were several different non-profit making funds from which you could choose. It wasn't any more expensive than the NHS but was much quicker and gave a wider range of possible treatments.

WaterOffADucksCrack OP the pharmacist may be forced to ask these questions tbh. If it is that particular pharmacy's policy to do so then she must do it. If there was a mystery shopper or a complaint that she didn't then she's risking her job. You're not going to be worth her getting into trouble for.

Thank you for giving the most rational explanation so far. I did think too that the pharmacist might be of an age where she never learned to be comfortable using the internet. I would have thought she could have simply suggested that I could get a pre-payment certificate online if I changed my mind later, instead of pressing an explanatory leaflet on me. It really was very patronising. Of course I'm not going to complain about such a small issue though.

To the posters who have explained what a pre-payment certificate is - err, thanks. I think pretty much every reasonably literate adult knows what they are. I've had a 3 month one before in the past, when my asthma was worse than it is now.

I have actually used a private GP a few times, when I couldn't get Presnisolone for pleurisy or antibiotics for an infected bite from the GP, who ironically insisted on those occasions that "I looked too healthy". I have since changed GPs to another one in the same practice.

OP posts:
fluffyjumper · 21/08/2019 21:17

Sorry should the nurse of just done the smear without informing you of the changes that are happening? It's all part of the procedure to discuss these issues and it opens up conversations that could lead to actually helping you.

Patients like you are part of the reason we are leaving our jobs. I had a patient get really angry with me for not being able to get her blood. She shouted at me, 'its just a case of sticking the needle in'. We are not the public's servants, we are an emergency service, a vital service to treat you. We are all over stretched and whilst you only see us working nice monday to friday hours we are often finishing late to help our patients, often missing school plays, family celebrations.

I have nursed for 15 years and out of a cohort of 50 nurses there are only about 15 nursing in the NHS. I'm leaving in a couple of months as I'm tired of patients expecting so much from me I'm not a maid.

QualCheckBot · 21/08/2019 21:23

fluffyjumper Sorry should the nurse of just done the smear without informing you of the changes that are happening? It's all part of the procedure to discuss these issues and it opens up conversations that could lead to actually helping you.

Yes, of course she should have done! Why on earth would anyone want to be told their cervix has shrunk (not convinced it has) or that they are suffering from dryness (I'm definitely not) while getting a cervical smear?

I didn't shout at anyone while having this done, so stop projecting. I did say "well I don't have any problems having intercourse". Another nurse actually took over and did the smear almost instantly. I know we are all human, but fgs I'm 47, I'm not geriatric!

Best of luck in your next career.

OP posts:
Mummoomoocow · 21/08/2019 21:36

This seems much more a case of you having issues with growing older.

minibroncs · 21/08/2019 21:59

OP, go private if it's that bad. I can't stand NHS bashers

No, if the NHS isn't up to standard then we work on improving it, we don't tell people to accept poor and inadequate care.

I can't stand ignorant people.

PickAChew · 21/08/2019 22:00

If you get these three prescriptions every month, then you're being daft not spending £104 per year on a pre-payment certificate.