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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

to expect an out of an hours doctor to coma and see my doctor when...

160 replies

pinkdolly · 10/01/2009 14:12

My dh is serving away with the forces. I dont drive and even if I did, I am ill with bad flu and a chest infection and 27 weeks pg so cant take anything for it (I haven't slept for 3 days!). I have 2 other young children, 1 of which also has flu.

My poor dd1 (6) has blood coming out her ear and is crying in pain despite having calpol and nurophen. She has flu and I think (tho I am not a doctor myself) she may have perforated her ear drum. She hardly slept all night due to the pain.

Now I know it's not life threatening stuff, but come on you'd think they'd come out and see her. Nope, I have to ring around trying to to find someone to drag her out for me while I stay here looking after myself and my other sick dd. Grrr...!

OP posts:
Sidge · 10/01/2009 22:07

There is some logic in making people bring children to Out of Hours though - often if a child has a temperature taking them out of an overheated house into the fresh air can bring the temp down.

You also wouldn't believe the dross that some people expect a house call for - by refusing all but the most serious of cases for home visits means that the doctor's time is utilised much more efficiently. Also at a risk of sounding harsh, the out of hours service isn't there to make life easier for people that can't drive/have no-one to give them a lift/can't afford a taxi - it's there to provide GP health services out of the regular surgery hours. It's called 'Out of Hours GP service', not 'The GP Home Visiting Service'.

naturalbornmum · 10/01/2009 22:09

Well if it is not for people like the OP who is it for? Prehaps she should have called an ambulance?......

MillyR · 10/01/2009 22:16

Pinkdolly, I hope you start to feel better soon and your children feel better too; ear infections are horribly painful.

Kelix · 10/01/2009 22:17

YANBU!

If my DD had blood coming out of her ear I would expect a doctors visit! If I was refused it would be straight to A&E (in an ambulance if needed!!) Blood isnt suppost to come out of childrens ears - I wouldnt settle until I had a medical professional see to her.

Saying that my (limited) experience of GPs is terrible (not syaing they are all crap - just the ones I have seen)

LucyEllensmummy · 10/01/2009 22:25

auntypurple, i am glad that your DN is now getting the medication she needs and is hopefully now on the mind. I agree with you, totally disgusting that you couldn't get a doctor out to a SIX YEAR OLD GIRL! I imagine going out in the cold did her ear the world of good . I hope your sister is feeling better too.

looby, i do agree with you to a certain degree, about getting people in to see the doctor if at all possible. But i really do have some serious issues witn the triage system. I have had occasion to need a doctor/medical advice out of hours. The system where we works goes like this - first of all you get a non medically trained receptionist who asks some specific questions, she then decides what will happen next - you either get a visit, or you come into surgery, or you have to wait for a nurse advisor to call you back. I have in the past waited for over an hour for that call (bearing in mind i was reporting a rash and temperature in a 10m old), then had to wait after that call for a doctor to call me back, about three hours later i arrive at the surgery where it takes me ten minutes to be seen. But to get past the dragons at the portal as it were, you have to be quite insistent and articulate. I am not a doctor and i did not know if my DDs rash was serious. I was 90% certain it wasn't, but I AM NOT A DOCTOR. The nurse could not see through my telephone line to look at my DDs rash - she did her utmost to put me off. When i spoke to the doctor, she asked me if i was worried, and i was honest and said, im not desperately worried no, but im not comfortable to leave it either - Fine, she said - come on over. We were seen straight away, no waiting, out of there in less then ten minutes. So WHY did i have to fight so hard and wait so long? Clearly the fault here is not with the GPs, it is with the system and the fact that i reckon that the receptionists and nurses are pretty much told not to let people come or arrange visits unless they are at deaths door. I used to be a veterinary receptionist and have often had to put people off when they ring - why? Because the vet is late for golf!! I know this isnt quite the same, but i think i would be quite niave to think this doesn't happen in private practice. One of my friends is a doctor and i have to say that she was my reason for making the comment about GPs being generally lazy and resentful about out of hours calls. Her attitude is that everyone is taking the piss by even daring to want ten minutes of her time.

I really think this system is not working, i know that thre has to be an element of triage, else people would just be turning up for minor things that can wait. As to the OP, i agree that had it just been a case that the DD felt too poorly to come then she could be (and was in the end) taken in. But surely her mum's condition and the fact that she had other ill children must be taken into consideration. What if she actually couldnt get anyone to help? She would have either had to shell out for a taxi or relied on public transport.

This was exactly the same when i tried to get a home visit for my mother, i was trying to avoid taking an ambulance, she was potentially having an addisons crisis and needed IV steroids, as it turned out she needed hospitalising, so i probably should have just called an ambulance. But sometimes we can get away with a doctor coming out and injecting. What infuriated me was the receptionists attitude, because it was late in the day (i had only just found my mother in said state) it was like i was taking the piss, "why have you left it until this time to ring" is what i was asked?? . It was like the woman was going to arrange a visit over her dead body (she is lucky that it wasn't over my mothers in the end), and insisted on my mother being taken to the surgery. When i made the phone call my mother was coherent, able to dress herself and get to the car when DP got there an hour later. By the time we got her to the surgery, waited an hour to be seen (despite getting bollocked from the receptionist for keeping the doctor waiting -????) My mother had to collapse and had to go straight to hospital - i can't help but wonder, if i could have secured a home visit, if the injection would have been enough and she could have avoided an overnight stay in hospital that was overstretched in the first place.

I also worry that because people can't get visits or OOH appointments they are just going to A&E when they don't need to.

THe OOH system is certainly not without its flaws, gaping fucking big ones!

Sidge · 10/01/2009 22:25

But Kelix why would you expect a doctor to visit you? What would stop you going to the doctor?

Yes a child with blood coming from their ear needs to see a medic, but doesn't necessarily need a home visit.

SummerNights · 10/01/2009 22:29

My ds needed a doctor at teh weekend when dh was away so I asked for help and they said they could arrange for patient transport within a couple of hours, altho a home visit was impossible. As it turned my mother took us but the offer was there. I am surprised it was not available for you?

LucyEllensmummy · 10/01/2009 22:29

um, my mother didnt have to collapse, she DID collapse and had to go to A&E - my grammar!!!

LucyEllensmummy · 10/01/2009 22:32

Sidge, it was the mothers circumstances that made it extremely difficult to get her child to the doctors.

It never used to be like this - i remember the doctor always coming out to me if i was poorly as a child, to actually have to go to the surgery (which was about 500 yards from my house!) was unheard of.

Sidge · 10/01/2009 22:37

LEM I appreciate that but most people that want house calls want them to make their life easier, which is fair enough but the provision of GP out of hours services aren't based on what makes life easier for the patients or their families, but based on maximising access to the GP.

The home visiting service you remember was from days when a GP only provided home visits to their own patients, and had much smaller lists. Now an average 4 doctor practice will have around 10,000 patients registered with them and will contract out their OOH service as providing 24 hour care to 10,000 patients is nigh on impossible.

naturalbornmum · 10/01/2009 22:40

What stopped the Op taking her child to a doctor was the fact she has the FLU and is also pregnant. How can she be expected to take a child out under these curcumstances - there is no way op could carry a six year old. I feel passionate about this as I have been in similar situations myself.

MillyR · 10/01/2009 22:41

I do think the OOH does not work. A lot of people cannot afford to own a car and if you are ill at night or late in the evening (i.e. out of hours!), there is no public transport. Our out of hours is not at the local surgery; it is not even within our health authority area, as our health authority has combined with a neighbouring authority, so a taxi is £35 there and £35 back. So, while I appreciate it isn't really possible to have home visits, I do think out of hours has to be made more accessible, or people will use A & E instead.

But what are they meant to do? Some people when they say "I cannot afford a taxi' really do mean that they do not have sufficient funds to pay and have no way of borrowing the money.

I agree with LEM about the people who answer the phone; you have to convince them the problem is serious and some people will not have the verbal skills to achieve that. Maybe the problem is not life or death, but leaving a child in pain because you can't get a doctor is certainly not desirable.

naturalbornmum · 10/01/2009 22:42

I don't think that anybody thinks that every patient who asks for a home visit should get one. But in this situation OP should of been visited at home. I for one would call an abulance as a last resort.

27 · 10/01/2009 22:42

MillyR

You said " I do think out of hours has to be made more accessible, or people will use A & E instead."

But you still have to get to A+E, so how would that be easier? Even if you called an ambulance to get there, you would still have to make your own way home.

naturalbornmum · 10/01/2009 22:44

But if you call an ambulance, your Dc will be seen and by the time you are seen etc there may be buses etc running.

I drive but would be wary about driving with a very ill child in the car as you cannot drive and watch them.

MillyR · 10/01/2009 22:46

27, because my local A & E is easier to get to than OOH, although I appreciate that for some people it is impossible to get to either, short of flagging down a stranger in a car.

27 · 10/01/2009 22:47

Or, as is increasingly common nowadays the paramedics may decline to take you to A+E as they are no longer obliged to transport people if they think they dont need it.

naturalbornmum · 10/01/2009 22:49

Blood coming out of a child's ear - hmm yes she did need to be seen.

27 · 10/01/2009 22:51

Yes she did need to be seen, of course she did, who is saying she didnt.

She just didnt need to be seen at home.

MillyR · 10/01/2009 22:51

I don't think people calling ambulances is going to be the answer to these problems! But there does seem to be some sort of solution found. Ultimately, there is not enough money and not enough doctors.

naturalbornmum · 10/01/2009 22:55

"increasingly common nowadays the paramedics may decline to take you to A+E as they are no longer obliged to transport people if they think they dont need it."

Were you implying that this case would justify this? If the OP coukd'nt get DC to docs and they would not come to her - then this should be the next option.

27 · 10/01/2009 22:57

No, I'm just aware that that is generally the case, having heard people talking about it.

naturalbornmum · 10/01/2009 23:00

Apologies 27.

MillyR · 10/01/2009 23:00

It is very, very difficult to get a proper ambulance to turn up (although may vary by area) even when there is a genuine emergency. My cousin lay in the road for 45 mins with an open fracture to his femur; he was 5 mins from the nearest ambulance station. There just are not enough resources.

naturalbornmum · 10/01/2009 23:02

I have only called an ambulance once in the last 3 years and they turned up very quickly, live in a rurual area too.