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From gritted teeth to gratitude – why we should appreciate our NHS

28 August 2008

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Tom Brownlie
AMSPAR Chief Executive

The NHS is a wonderful, if sometimes bewildering, thing.

I recently unburdened my woes concerning my dental sufferings to an unsuspecting friend. Last year, during my routine six-monthly check-up, my dentist said it looked like I had a tooth infection – but nothing serious. It was suggested it could be left until my next check-up to see how it went.

On the next visit, my dentist decided to address the situation, as there had been no improvement. If she were to deal with the situation she would have to extract the tooth – at the NHS-subsidised rate. Alternatively, a referral could be made to a dental hospital where the matter could be investigated and the appropriate course of action taken.

Since it is always best to try and save the tooth, we opted for the latter. In October, a letter was dispatched and I was warned that it may take some time.

And some time it was. One Thursday in January, I received a phone call at the office from the hospital in question, asking if I could come for an appointment on Saturday. This was very short notice and, as I was working, I said I could not make it.

I was then informed that someone would call to try and make another appointment. Many weeks passed before this actually happened, and I was given a date in mid-February. I received a letter  confirming the arrangements, which gave the time and name of the hospital. No directions. No department. Just the time.

The waiting game
Being cautious, I set off early, reached the hospital and traced the relevant department, arriving precisely one hour ahead of the appointment. I was told to take a ticket and sit down as the surgery would not open for another hour. I sat in the bleak waiting room and looked at the outdated posters, signs and ads for the Christmas Fayre (yes, I know, this was February), while a child’s handheld console emitted constant beeps.

Confident I had a ticket for my appointed time, I decided the best thing to do was take a stroll and make a few phone calls (a sign said I could not use my mobile in the waiting room). Returning ahead of my scheduled time, I waited for my number to be called. On handing in my letter, I was told that I would have to go to the X-ray department, come back and wait to be called. In the X-ray department, the minimum waiting time was one hour. As I had a meeting in central London at 4.30pm this just wasn’t feasible, so I left.

Over the next few weeks, I tried to make another appointment. The phone was either constantly engaged or wasn’t answered – and this was a department dedicated to handling appointments. Eventually I did get through. After explaining the situation, I was told that I could not get another appointment without going back to the dentist and getting her to write again.

First the worst, second the best
It was only a matter of weeks now to my next six-monthly check-up, so I thought it best to wait and speak to her then. When the time came round, my dentist said she would write to an alternative place. As luck would have it, the “alternative place” was 10 minutes walk from my office – as opposed to the first hospital, which was two train journeys away.

The letter of appointment was markedly different from the first. This letter included a location map, time, details of who I would be seen by, what was involved (well, X-rays!), all the paperwork I would have to fill in – so it could be done in advance – and the suggested amount of time I should allot for the visit.

From this point, everything ran smoothly – or as smoothly as 10 hours of treatment involving the removal of a crown and cleansing of the root canal can run.

Fortunes of jaw
Having detailed the final course of treatment I’d endured that day to my friend, I fell silent when she said how lucky I was. Rubbing my jaw, I reflected. You see, she was Australian.

I considered the number of people I had come into contact with directly since my dentist had sent me to central London. The number of staff totalled 18; in addition to this were the ancillary staff who kept the hospital running, the secretarial staff who produced all the letters to both my dentist and myself, those taking a number of X-rays and staff operating the ultra-modern imaging equipment that was used in the original diagnostics.

As my friend pointed out, she would have had to pay a substantial amount of money for this. Yet we are able to receive it free at the point of use, regardless of our financial standing.
Of course, everything wasn’t perfect – there was a temperamental chair that didn’t want to recline if someone was on it, a delay while someone else was using the portable X-ray, and a water pump that wouldn’t feed the sonic drill. But the staff overcame all these with good humour.

And again, there was the frustrating experience of the original appointment. But the second hospital demonstrated how getting the basic things right can avoid frustration, wasted appointments, clogging up phones and generating
extra bureaucracy.

Now, the question for us all: will the Next Stage Review and the forthcoming NHS Constitution bring hospital one in line with hospital two?