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Dr Hannah Fox: The terror of being denied care

Dr Hannah Fox

I’m used to getting my own way. That makes me sound like a brat, which I’m not. But when I’ve made my mind up about something I can be fairly persistent and persuasive. If you’re in the medical profession you can probably empathise with me – to be an effective advocate for your patients you have to be determined.

This is why, when I was on holiday with my family in the States recently and hit wall after wall trying to get our virally wheezey toddler seen, I was astounded by our struggle.

Being away, I’d waited longer than I normally would have to seek help, and by the third morning I felt she needed some salbutamol. We’d seen a clinic near where we were staying in San Francisco, and thought (naively) that we could pop in and ask for an emergency prescription or appointment. There were no emergency walk-in appointments available and if there had been it was $350 for a consultation. And ‘had we checked with our provider if they covered this clinic?’. So we called our insurance company and they didn’t. Instead they offered us a home visit from a doctor within the next two hours.

It sounded too good to be true. And it was. Five hours later with still no sign of the doctor and the insurance company unsure where they were, we were feeling frayed. I’d already tried and failed to convince an unimpressed pharmacist to sell me an inhaler. Of course they weren’t going to without a US licence to practice. A&E was an option, but our last resort as it was an inappropriate use of it. What we really needed was a GP appointment. In the end we gave up. Our daughter turned a corner thanks to some old-school steam inhalation. I think the latter happened first.

I now see how terrifying it is if you or a loved one is sick and cannot get help

These barriers to a GP appointment, for two determined healthcare professionals who speak the language and have an aptitude for navigating a healthcare system, seemed insurmountable. My view of the US healthcare system sunk to new lows and I thought about all the patients I see in the UK who struggle to access care.

Imagine being in a foreign country, not speaking the language and being turned away for having the incorrect (or no) documentation. I can now see just how terrifying it is if you or a loved one is sick and cannot get help.

Since 23 October 2017, when the government imposed more restrictions and charges for migrants and overseas visitors, this is happening more and more often. Anyone accessing NHS care must now prove they are eligible for free care upfront. Those who cannot pay are refused treatment.

My experience in the US made me feel even more passionately that access to healthcare is of crucial importance. We need to fight for our patients’ right to access healthcare; care that remains free at the point of delivery, care that is based on clinical need and not ability to pay.

Dr Hannah Fox is a GP in Norwich

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