IVF

[kaosmark2]

You can never really understand emotionally what another person experiences, because you're not them.

[Rufus Gwertigan]

having an intellectual understanding of something isn't the same as knowing what it feels like. i had a miscarriage once, and the midwife at the hospital tried to commiserate with me by saying what an anticlimax it must be. And when I went back to the consultant to find out what had gone wrong, rather than just saying there was nothing they could find to explain it, he told me there was nothing special about it.

To them it was a failed pregnancy. To me it was the death of my child. I wasn't disappointed, I was grieving.

You can never really understand emotionally what another person experiences, because you're not them. You can only try to imagine yourself in their shoes, and you could still be way off the mark, because even with those we confide in, we can't link telepathically with people.

Wonder if there'd be less cruelty if we could.

[feral chile]

We had a terrible time at the hands of nurses when my wife had miscarried on a number of occasions. Comments like "you are only young" or "you can try again" seen patronising by the 3rd miscarriage. Even the terminology is shit calling it a "spontaneous abortion". There just seemed to be no idea that we could be grieving. On one occasion the ambulance had told them it was twins from what they had seen and a nurse rather coldly told me I would need to get good to clean it all up. A bloke I did not know was sat next to me and if just sat in shock. He later came and helped as we did not have a supportive family around us.

At the time Ivf was discussed but it really did not seem an option for us given the failure rates (how many times are you willing to go through a miscarriage as well as "moral" grounds). "Luckily" my ex had an ectopic pregnancy and after the tube was removed she carried the others to term so things turned out alright in the end.

Edited June 3, 2012 by feral chile

[Rufus Gwertigan]

I'm pleased to hear things worked out well for you eventually.

I forgot one piece of gross insensitivity - as they were wheeling me down for a scrape after telling me they'd test the foetus, I begged them not to cut my baby up - leave it in one piece I said. And the nurse replied if it was still in one piece I wouldn't have miscarried.

There seemed to be not even an intellectual understanding of the protective instinct. And they put you in the same recovery ward as people who have had terminations, which is practical and cost effective I suppose but pretty tactless.

I think my consultant's attitude influenced everyone else - I have a very strong antipathy towards him, from several bad experiences of his callous indifference to his patients - I've even walked out of his office to avoid hitting him on one occasion. And when the maternity unit was threatened with closure, woe betide any campaigners to keep it open who had the misfortune to canvass me for support.

[Rufus Gwertigan]

I very much doubt they will be taking up delivery suites with people wanting abortion unless they really had to. Also you really don't have a clue what is going on in the room next to you.

[feral chile]

Maybe we are lucky in Warrington. Each lady has its own delivery "suite". You can't hear much coming from the rest of the ward besides the odd labour screams.

Edited June 9, 2012 by feral chile

[abdoujaparov]

Well here in Wales, while I was miscarrying, they gave me an internal with the whole group of doctors around my bed. Unfortunately, there wasn't enough room for them all, and one of them kept pulling the curtain open. Which wasn't very pleasant for me. I should imagine it was even worse for the other patients eating their food around a table in full view of my bed.

[feral chile]

I think its fair to say within something as big as the NHS you are always going to find the good, the bad and the ugly... That was certainly unacceptable...

Did you tell that group of doctors you wanted more privacy... Did your husband/partner speak up ? I know I wouldn't of stood for such a carry on with my wife. Part of the problem in the NHS and just us Brits in general. We do tend to complain after the event instead of at the time.

Edited June 11, 2012 by feral chile

[abdoujaparov]

What do you suggest as an alternative?

[abdoujaparov]

I wouldn't disagree with any of that but the trick is always doing it in a way so we don't make worse the post code lottery we already have.

Ultimately you would need far more money to have every service more local than we currently have. The reality is I don't think you could do it with every treatment but more treatments at your local GP health centres are becoming far more normal which is cool. My local "health centre" (formerly known as my GPs surgery) now offers lots of treatments you used to have to go to the hospital for.

[abdoujaparov]

not that different to the education system....

it's all about the numbers, on a short term basis, usually looking as far ahead as the next election... which is no time at all

[eFestivals]

I think the NHS needs to be broken up, decentralised and made more patient-focused.

things have gone far more in that direction over the last 15-ish years, and it's led to a greater unhappiness about the NHS, due to the "postcode lottery" of whether a person can get treatment in their local area or not.

The simple fact is this: a national health service should offer the same 'national' service, of treatment being available for all the same things for all people.

The "bureaucratic madness" you speak of comes in a large part from a greater amount of localisation, and that won't be decreased by more localisation.

There will always be an amount of conflict within any health service - public or private - between the business needs and the patient's needs. The amount of impact into patients of the business side of things is most lessened by making the business side of things as remote as possible from the delivery of service to the patient - which means re-centralising more of the bureaucracy and not the other way around.

But firstly we need a national conversation about what the NHS is meant to deliver. It's stupid to believe that the NHS can treat old and young on an equal basis (as is being proposed by this stupid govt this very day) whilst being afforded, and my guess is that govt are proposing it happens to undermine the viability of the NHS to help bring forwards its demise.

Edited June 12, 2012 by eFestivals

[abdoujaparov]

I think that is both true and false. There is obviously savings to be made by doing this more and doing it better but we obviously couldn't have an MRI scanner in every local health centre either. Its all about balance and I think you would need a staggering amount of short term spend to make it all happen. That is just the way the government etc tick.

[abdoujaparov]

things have gone far more in that direction over the last 15-ish years, and it's led to a greater unhappiness about the NHS, due to the "postcode lottery" of whether a person can get treatment in their local area or not.

The simple fact is this: a national health service should offer the same 'national' service, of treatment being available for all the same things for all people.

The "bureaucratic madness" you speak of comes in a large part from a greater amount of localisation, and that won't be decreased by more localisation.

There will always be an amount of conflict within any health service - public or private - between the business needs and the patient's needs. The amount of impact into patients of the business side of things is most lessened by making the business side of things as remote as possible from the delivery of service to the patient - which means re-centralising more of the bureaucracy and not the other way around.

But firstly we need a national conversation about what the NHS is meant to deliver. It's stupid to believe that the NHS can treat old and young on an equal basis (as is being proposed by this stupid govt this very day) whilst being afforded, and my guess is that govt are proposing it happens to undermine the viability of the NHS to help bring forwards its demise.

[abdoujaparov]

So what do you do about situations where areas raising and paying more tax than other areas? True decentralisation sees that area keeping the money for itself.

Then you have issues where another area has more issues than another area and runs out of money quicker.

It seems decentralisation creates massive winners and losers to me.

[abdoujaparov]

I can remember sitting A&E with my mum for around 7 hours back in the 80s... the targets means I have never spent more than a couple of hours in A&E before being seen. Targets are not all bad.

[eFestivals]

Whatever the causes of the NHS bureaucracy (which I didnt refer to as "madness"), the point is that it distorts behaviours. Bureaucracies develop their own dynamics and inevitably become self-serving, whether they are as a result of a particular approach to localiation or through central control.

Yep - so by having more bureaucracies to be 'local', we get many versions of distorted behaviour, none of which will be any better than any other, but all of which will add to confusion and chaos with the service that is delivered - and the facts of the last 15 or so years get to prove this beyond all doubt.

Like it or not, any service has to have a bureaucracy behind it.

*One* bureaucracy - a central one - has one behaviour, which those both within and outside of the NHS will come to understand, and the combined pressure of many outlets will come to shape into something workable.

Which is funnily enough what existed before politicians started fucking about with it to satisfy the ever-moving goalposts of selfish people who wish to believe they deserve a personal service at the expense of services to others.

[eFestivals]

Without a doubt, the NHS has improved immeasurably in the last 15 years

it has, but is back on a HUGE slide again. I wonder why?

[Rufus Gwertigan]

This is sadly typical of an institution which is too big, too depersonalised and too driven by its own bureaucratic imperatives to see patients as people. All my recent experience of the NHS has been marred by this tendency - a failure by clinicians to treat people as people

[kaosmark2]

Delocalisation is not only bad on an equality sense, but on a treatment sense. Some recent(ish) personal examples:

I go to university in Bristol, my parents live in Oxford. I broke my hand in Oxford 18 months ago when visiting for Christmas. I had a preliminary scan and treatment in Oxford, which I needed, and then the results and details (which I couldn't obtain on the day) transferred to a hospital in Bristol. Because it is a decentralised bureaucracy (albeit a very poorly run one), the paperwork was the same, the form structure was the same, and the doctors and nurses and admin staff in Bristol instantly knew the format of paper, and could get the information off it quickly. They used the same program for my scans, so could get them off the CD quickly. A lot of things about my treatment were mismanaged horribly, but more delocalisation (such as a way to transfer said data properly via a computer network) would have solved some of them.

In contrast, before going to university I spent a few years working for a private Forensics company who did work for a variety of police forces across the country. No 2 forces use the same type of system, so they can't exchange data easily, they get very quickly confused when they have to work with other police forces (cases as common and simple as a stolen car recovered in a different place), it was an administrative nightmare. OK, that's partially exacerbated by how phenomenally stupid the police are, but a unified system would have solved a huge number of problems.