Hospitals outside London are
failing people living with HIV with awkward appointment systems and HIV-unfriendly
waiting rooms. Time for a change, says Allan Morris
I
make no apology for the shameless plagiarism of Dickens’ great
work for the headline to my story, as it perfectly sums up my experiences
of trying to access clinic services during the last five years: five years
under the New Labour ‘Project’ and its effect on our cherished
National Health Service.
When I lived in the city called London, I took for granted that I could make
an appointment at the St Mary’s clinic in Paddington. I took it for
granted that, with a simple phone call, I could change that appointment if
something came up. The clinic acknowledged that I had a life outside of HIV
and their working practices made it possible for me to plan my visits around
other priorities.They worked hard on keeping down waiting times, protecting
my confidentiality with separate waiting and consultation areas. They had
a separate reception, attentive, well-trained staff, even a couple of beds
for those unfortunate enough to be feeling ill on a particular visit. And,
best of all, a walk-in clinic when I needed to see a doctor urgently. Why am
I stating what probably seems ‘normal’ to all you big-city dwellers
who have always had the benefit of such a service? Well, let me now tell you
about the other city...
A year and a half ago I moved out of the smoky capital to a small town in
north Hertfordshire called Letchworth Garden City. It’s in a beautiful
area and I wouldn’t swap the view from my living room window for a cure
for HIV… well, maybe, but you get my point. The nearest GUM clinic is
at the Lister Hospital in Stevenage. While the clinic itself is separate from
the rest of the hospital, HIV and non-HIV patients are not kept apart: we
have to share the same waiting and reception area. Most of the time there
is only one doctor in attendance and his patient list is growing at a rate
he simply can’t keep up with. This applies to people with HIV and people
with other STIs. Thanks to this government’s unwillingness and inability
to properly address the explosion of STIs in this country, this clinic and
its brilliant staff are under the most extreme pressure and they are definitely
not coping.
It has got to the stage that the appointments telephone service is only available
between the hours of 10 and 12, five days a week. If you don’t ring
during this time, you don’t get an appointment, and you can’t
change one either. It’s impossible to get a human voice on the line
to discuss your problems and, assuming you can get the time off work, you
can’t go there in person either, because they don’t have a walk-in
service.
They don’t have access to a pharmacy, so you have to “order” your meds several days in advance and then make another visit to pick them
up. To illustrate this, I was suffering such severe side effects recently
that I wanted to discuss the possibility of coming off my treatment for a
while, or changing it. I could not access the service at all, and ended up
making the decision myself, to the complete horror of my consultant, when
I finally managed to get to see him. That was a drama in itself, involving
the local charity, Hertsaid, and the primary care trust. It took me several
weeks, many emails and phone-calls just to get an appointment and tell the
doctor what happened.
I’m sure the service works reasonably well with those not working, but
more and more of us are doing rather well on treatment and have gone back
to work. Do I have to be punished for having a full-time job and making my
contribution to society and the exchequer? Surely I should be rewarded for
that?
No point in whingeing unless you can make some constructive criticism, so
here’s my suggestion. Keep the same number of opening hours, but shift
them to suit the very patients who need to access the service. I see no logical
reason why a clinic can’t open its doors from 10.30 to 19.00 instead
of the times I’m at work. My job takes me to Milton Keynes every day
and it’s all but impossible for me to get enough time off during the
day to get to the clinic and back. My employer is not aware of my status,
so explaining that kind of behaviour would be very difficult. Come on the
NHS! The face of HIV is changing and it’s time you moved along with
it.
