NHS Rant

When you start exploring Psychology, one of the things that becomes apparent quite quickly is the belief that there must be a reason for everything, and if that reason is not known, then the most likely, or the reason that seems to make the most sense, is accepted as the reason.  There's no tolerance for uncertainty and the unknown; you will rarely see a finite "It is not known why" instead there is always a clause "however studies have associated..." which in my view is a dangerous mentality.

Personally, I would rather hear the correct answer to a question or an outright statement that the correct answer is not known, than to have an answer presented that openly admits it's not correct.  I must add the condition here that this is something I feel in terms of academic study, not in terms of ideology and philosophy.  Explorative thought processes need to incorporate hypotheses and postulates to advance.   I take issue with assumptions made especially in a medical context where a definite response will be pursued based on that response.  When you are researching you pursue indefinite responses in order to find definite results.  In the context of treatment however I think it's dangerous to pursue definite action based on indefinite responses. 

To give an example, in terms of physical health, a person who has some symptoms of Cancer but has not been diagnosed Cancer, would not be treated for Cancer.  Chemotherapy would not be given to someone who might not actually have Cancer.  Yet when you leave physical health and venture into mental health there seems to be an attitude of "catch-all" conditions, where if you can't define the exact condition someone is suffering from you simply treat them for depression instead.  There is a disturbing willingness in Mental Health in the UK to assume that either stress, depression, or some physical condition is the cause of any mental problem that cannot be diagnosed precisely.

If you embrace causality, then you believe that every cause has an effect, or that every effect, has a cause, depending on which direction you are looking.  That has extended into many fields including healthcare where it has been somewhat modified to say that for every symptom there is a condition, or for every condition there are symptoms.  The interesting thing here is that when you read the former it is agreeable, that namely, for every symptom there is a condition, but, when you read the latter, something doesn't sit right and becomes immediately apparent to you - for every condition there are symptoms - your immediate thought, or mine at least, is "Well, some conditions don't have symptoms..." - this is where you begin to see the flaw in using this reasoning - healthcare just is not that simple.

Yet despite this, the notion that multiple symptoms must all correlate to a single condition, is something that seems too prevalent in the Healthcare Industry.  I should stress here I am speaking from experience of healthcare in the UK, but I would imagine this extends beyond the UK as I know a few other countries have a similar problem.  I don't like the laziness of healthcare professionals to jump to conclusions that the root of all your problems is a condition that you probably don't even have.  I don't like the fact GPs in the UK ask 3 things - do you smoke, drink, or do drugs - and if the answer to any is yes, they immediately try to link any symptoms you have to complications associated with those three.  I don't smoke, I don't do drugs, and I rarely drink, when you pass beyond those 3 questions most GPs end up in a state of confusion - that or they don't believe you and insist that you must and that those are the cause.  I dread to think what a visit to the doctor is like for people that do answer yes to any of those questions.  While these 3 tend to be the "go-to" reasons for GPs, the same mentality exists with Mental Health, there as I said above, stress, depression, or physical conditions are used as their 3 "go-to" reasons as well.

When did Healthcare become "googlised" - where the most popular result must be the one you need?  When did healthcare abandon the process of diagnosing people properly?  There have been several times I have visited a GP and had no offer of any further tests or diagnostics to try and find out what might be wrong.  GPs have effectively become a barrier to treatment rather than a gateway.  Mental Healthcare in this country is already woefully inadequate, general healthcare it seems is not far off the same fate.

I've had very positive experiences of the NHS in the past, some of which I have written about on this blog.  My overall opinion of it has been in steady decline for years now.  I know many people are going to immediately retort that the NHS needs more money.  It doesn't.  I've worked for the NHS.  The problems with the NHS are down to systemic failures, an idiotic Trust based structure that duplicates and triplicates work and propagates a postcode lottery, obfuscated policies and procedures that create goose-chase accountability where it's nigh on impossible to find out who is responsible for key services, and the widespread waste and mismanagement of resources.  I have seen millions spent on unnecessary purchases, computer systems that cost billions which the majority of staff hate and many don't even know how to use because they are so badly designed and are often counter-intuitive; all this whilst primary care suffers, acute facilities close, and other services are outsourced to community organisations and third party private companies.