This site is intended for health professionals only

Letter of the week: I have seen the future, and therein lies chaos

And it shall come to pass in the last days of the NHS that the chicken shall run around headless. The knowledgeable shall not know, the giver of help shall feel utterly helpless and the wise shall be found to be lacking in comprehension.

Nobody will know. The GP will not know what to advise.

The care of a young man will pass from one consultant psychiatrist to another. The young man will not see his new psychiatrist. Things being what they are, appointments will be cancelled, but these will count as ‘missed’ appointments. This young man will quickly reach the point where the administration will discharge him from follow-up on account of repeated ‘missed’ appointments.

His GP will look at the medications. Such medications necessitate specialist psychiatric supervision. So the GP will make a new referral. However, the process will continue until one day the young man will attend his GP with his latest appointment letter – he is going to see his new consultant for the first time that very afternoon. The young man will seem very pleased; and likewise his GP.

But their pleasure will be short-lived. The young man will attend in good time, only to be told that the appointment has been cancelled. Later that day, a junior psychiatrist will write to the GP to say that his patient has missed yet another appointment and, therefore, has been discharged from all follow-up.

Faced with a system designed not to deliver care, the GP will despair.

Shortly afterwards, the GP will receive a discharge letter for a different patient who has recently died in hospital. The GP will not think a discharge letter is appropriate. He will shrug his shoulders – perhaps he is out of touch? Then he will read that certain of the medications – not all of them, mind you – are to be continued after discharge.

Bracing himself, he will read on. Section seven will inform him that his patient has died; in section nine he will again read that his patient has died; but in section eight he will learn that he is expected to do blood tests in two weeks’ time. He will ask himself if the right index finger does not know what the left index finger has just typed. Or is somebody trying to tell him that he’s not of this world? Poor man: it will be beyond his understanding.

Forgive me, reader. These portents of things to come have already happened in 2012.


Name and address supplied