Sceptically Fit

05/12/2011

Half-Arsed Health System

Filed under: Personal — Tags: , , , , — Sceptically Me @ 18:42

I finally got around to getting my cholesterol results from a test I had back in June. I needed to see a doctor for an unrelated reason recently and while there was told they came back fine except for the fact that  have a low enough count of red blood cells to be borderline anaemic

Now that I knew what the letters I’d been ignoring were, I bothered to make an appointment with the nurse for a follow up test. She gave me a printout of the original test results and explained that my serum cholesterol is below what’s considered good in the UK, and my HDL cholesterol is higher than the good range for the UK, to such an extent that they can’t give me a ratio. So, yay for me and my saturated fat consumption.

Now here’s where the story of my half-arsed approach ends, and the NHS’s begins.  There was no LDL cholesterol count – not just no differentiation between good and bad LDL, no LDL at all.  Why not?

Maybe it’s not cost effective. It’s not cost effective is the reason given for why they don’t test for HIV, (or hepatitis or syphilis which is usually in the same test) in the UK. Despite all the advertising from health groups; despite the awareness campaigns based on how you can’t tell by looking at someone and you can’t know yourself until you’re tested; despite the advertising saying the earlier you start treatment the better; if you want to be sure without being a gay man or an African immigrant you need to argue for it. The nurse explained that they normally only test if you have symptoms like a sore throat that won’t go away. If you are pregnant you’ll be offered a test – the nurse didn’t really get my point that knowing before pregnancy might be a better public health policy.

I am a huge supporter of the NHS despite my personal experience of it. Free public healthcare is the cornerstone of a modern society. We may not be able to do away with the massive inequality of wealth but at least we can make sure people can be healthy regardless of their ability to pay for it.  I also realise that there’s a limited budget (though I think it’s obvious that’s due to government mishandling like prioritising banks…) but prevention is cheaper. And I realise doctors only have a limited time – so I’m not offended that my doctor doesn’t remember me from visit to visit, that he doesn’t know any of the details of my history and that he doesn’t have time to read anything in my file before he sees me. In general, I’m ok with that. I don’t need to pretend someone is taking vital interest in me – not for me the attention-giving quackery of homoeopathy – but when of your patients decides they want to find out about their health why can’t you at least run a decent test? A cholesterol test is not like asking for a full body mri. A basic std screen is not like asking to be genetically screened.

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