31 October 2009

Granny Smith

There was a time when if you were a passenger on a train you were referred to as a passenger. Now, of course, you are a customer. Managers think this change is important. As a passenger Dr Grumble finds it irritating. It gives him the impression that the railway now just wants to profit from him and not look after him as he tries to get from A to B.

There are those in the hospital, not usually doctors, who insist on calling their patients clients. The implication is that there is something demeaning about being a patient. Dr Grumble is a patient like everyone else. He doesn't feel demeaned by being a patient. Dr Grumble happily refers to his GP as his doctor and Dr Grumble sees himself as one of his patients. He is certainly not a customer nor does he want to be.

In a heavily veiled sort of way this is all about money. Passengers are people who go from A to B. Customers are people from whom you extract money. The managers want the staff to focus on where the money comes from rather than getting people from A to B. Big Business is interested in the corporate customer. BA is interested in Dr Grumble the business traveller but not Dr Grumble the cheapskate tripper.

You can see the same changing focus in healthcare. The people who are sick are the poor and the elderly. They make needy patients but are not ideal customers. Yet NHS provision is moving more towards the needs of the city slicker and the worried well. These people are customers rather than patients. They are vocal. They have power. Their money speaks. Polyclinics for healthy patients with money are attractive for Big Business. They will be easy to privatise. And privatised they should be because the taxpayer should not be paying to meet the needs of the wealthy worried well. It's the impoverished chronic sick that need the NHS and the taxpayer's support.

Contrary to what the vocal worried well believe, the concerns of GPs about the change to Martini healthcare were nothing to do with restrictive practices. Their concern was for Granny Smith. It was to do with their realisation that in today's NHS Granny Smith doesn't seem to matter any more.


BenefitScroungingScum said...

I was musing upon the same subject last week. http://benefitscroungingscum.blogspot.com/2009/10/where-have-all-gps-gone.html

Seems to me that the shift to 'customer' is ultimately short sighted as it makes the doctor's job so much more difficult/time consuming and therefore expensive..or perhaps that's the ultimate plan...the only 'free' health care will be the only 'easy' healthcare

Dr Grumble said...

I have just read your post, BenefitScroungingScum. It's amazing how similar your sentiments as a patient with a chronic condition are to mine as a doctor. It fortifies me because sometimes I really do begin to wonder whether I have it right. There are evil forces out there trying to tell doctors they have it all wrong.

Keep shouting about how you see things because we are in a world now where patients may be listened to but doctors are not. The Granny Smiths of this world are not the blogging types and Big Business just wants to give voice to the well-off worried well rather than the chronic sick who they just see as a drain on resources. They must have noticed your name!

BenefitScroungingScum said...

Big business loves me Dr G ;) Google wetherspoons complaints or head office and end up on my blog...similar for BT and even Ryan air. I think you'll rather like the recent search that ended up on my blog from a royal bank of scotland address...they'd googled wetherspoons and christmas lunch, got to be seen to be cheap whilst boosting those bonuses!

You do have it right, in fact you, the Jobbing Dr, Dr Crippen etc should be leading up the new dept for health and welfare..one which might actually stand a chance of making equitable reforms if we included a few of us sick people as ministers. Whilst that may not happen, I think we could make a difference if the professional medic bloggers and the patient bloggers banded together to pool our knowledge/resources.

Keep up the fight, otherwise one day we'll all end up as Granny Smiths and who will care for us then?
Bendy Girl

Sam said...

As for SIR Liam ... well ... he's 'excused'... he always is! ;-D