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A walk-in waste of money

How do you spend £700 on a simple case of whiplash? Use a walk-in centre, says Phil

How do you spend £700 on a simple case of whiplash? Use a walk-in centre, says Phil

I don't know how many times I've written about walk-in centres, but it's a lot. Like a dog to vomit, I am continually drawn back to them. Every time I think I've written the last word on these ridiculous wasteful money pits for our taxes, I hear yet another preposterous shocker of a tale. You're going to enjoy this one. It's a belter.

Last Friday, my patient was waiting at a roundabout in his works van when, in his words, ‘a Volvo went right up my arse'. On Saturday he woke up with a sore neck, which got worse and he didn't get much sleep on Saturday night.

On Sunday he could barely turn his head, so he went to the walk-in centre for some painkillers. He'd have been better off going to the chemist.

The nurse, after taking his blood pressure and asking about his ethnic background and all those odd things they do, examined his neck. Apparently, she visibly blanched as she felt her way down. ‘Does it hurt there?' she asked. ‘As a matter of fact it does,' said my patient.

She made him lie on the floor and told him not to move his head. She called in her colleague and they yattered together in the corner. She wouldn't tell my patient what was wrong. Then they called an ambulance. The ambulance crew and the nurses yattered together for a bit, while my patient lay rigid like a self-conscious draught-excluder, then they all tied him to a backboard and immobilised his head.

This took some time. My patient asked them things like: ‘What the hell are you doing?' and they told him things like: ‘Don't worry, soon have you sorted out. Don't move your head!'

They shipped him off to A&E, while my patient protested weakly that he was alright and asked if he could just have some painkillers. In A&E, a doctor took the collar off and examined him again. It sounds like the doctor wasn't as professional as he might have been, because he muttered: ‘The silly bugger. Everybody has a lump in their spine there.'

You'll all be ahead of me here. The nurse hadn't palpated a fracture or dislocation, she'd palpated the spinous process of C7, which is prominent in just about every member of the human race. If she'd reached round and felt the back of her own neck, she'd have felt the same thing.

I don't know exactly what an episode like this would have cost. I've asked around, and estimates of the cost of a walk-in centre consultation, an hour of an ambulance crew's time, and a casualty consult vary from £400 to £700. In contrast, a packet of diclofenac costs about £1. Quite an impressive performance from an outfit that is supposed to save money and reduce secondary care referrals.

The A&E doctor didn't bother with an X-ray and told my patient he could go home. They wouldn't give him a lift back so he had to get a taxi back to the walk-in centre to pick up his car.

When I saw him on Monday, he was angry, more than anything else. ‘They wouldn't listen to me. They treated me like a piece of meat. I knew what I had, I've had a whiplash before.'

I gave him a pound's worth of diclofenac, and shared his anger. Maybe you will too.

Dr Phil Peverley is a GP in Sunderland


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