Medical ranting

[triskellian]

About four years ago, I had a series of asthma attacks which ended with a few days in hospital, and a lot of meetings with doctors to discuss different medicines.

Since then, my asthma's been stable, so although I've seen doctors for other things in the meantime, no one's looked at my asthma. The surgery I go to has been getting increasingly insistent that I have to see the asthma nurse for a checkup, so I finally gave in and went yesterday.

And it made me angry...
I demonstrated that I know how to use my inhaler properly. I explained that my asthma was giving me no trouble at the moment. Against my wishes, I was weighed and measured (I have a deliberate policy of not knowing how much I weigh as part of my "trying to be sane about my body image" plan. Yes, I could have not looked. And, no, I haven't got either taller or shorter since my last checkup four years ago).

Apparently I am supposed to do this every year. Show up, be weighed and measured, breathe in from one tube (inhaler) and out into another (peak flow meter), and answer a bunch of dumb questions. I've had asthma my whole life, and it seems I can't be trusted to just get on with it on my own. If it changes, I'm perfectly capable of making an appointment with the doctor to talk about it then.

Next, I discover that the rules about prescriptions have changed and I'm now only allowed to have a prescription for one month's worth of medicine at a time (ie one inhaler, when I'm used to getting three). This means it costs me three times as much (the prescription fee is per medicine, not per item), and it means that every single month I have to go through the rigmarole of getting more medicine. I'm horribly disorganised about getting my medicine anyway; I don't fancy having a running-out-need-to-get-more crisis every month.

All of this is particularly galling in light of two facts. The first is that some chronic diseases entitle their sufferers to free prescriptions, but chronic asthma, despite its potentially life-threatening nature, isn't one of them.

And the second fact is that the big thing in asthma treatment is for sufferers to learn to manage their condition themselves so that it doesn't affect their lives. Which I was getting on with quite nicely until I started being forced to jump through bureaucratic hoops. Monthly prescriptions (and associated fees) and yearly checkups have much more of an impact on my life than my asthma itself does :-(

Comments

[bibliogirl.livejournal.com]

You might want to look at the prescription "season tickets"; I don't know how they would work out in regard to one prescription a month, but my dad used to have one before he turned 65, I think.

[triskellian]

Yep, I need to investigate those - it'll probably mean it costs me double rather than triple :-(

[bibliogirl.livejournal.com]

I thank my lucky stars that the only medicine I take regularly is (a) free to its users, (b) comes in six-month sets (usually), and (c), since I started going to one of the local clinics rather than my GP, is handed out at the clinic rather than me having to remember to go to a chemist...

[uitlander]

I was going to suggest the same. I've just renewed mine - worked out just over £90 for the year. Having said that, of course it covers you for everything in the year, not just inhalers.

The surgery are probably following NHS guidelines to monitor asthma sufferes. Yeah, its a pain as it seems to be all nicely under control, but some sort of regular health check could also catch other problems early - which is no bad thing. Weight thing is annoying, but sadly there are health issues associated with weight. I tend to ignore my weight now, but I've managed to lose a lot. Occassionally venturing near the scales helps remind me to curb my enthusiasm for 'nice things' every so often - but that is a personal choice. Of course, the manner in which 'helpful advice' is issued by any medical staff is key here, so if they are actually being pleasant and vaguely supportive I'd grit my teeth and try and see it as a positive, annoying as it may be.

[lanfykins.livejournal.com]

People who have to pay for more than 5 prescription items in 4 months, or 14 items in 12 months, could save money by buying a PPC. From 1 April 2004, the charge for a single prescription item is £6.40, whereas a 4-month PPC will cost you £33.40 and a 12-month PPC £91.80

So in triskellian's case it might or might not help, but it still doesn't deal with the problem of having to get hold of a new prescription every month. I used to end up regularly managing to put myself in anti-depressant withdrawal with the correct application of just a little incompetence.

Have you pointed out all of these issues to your doctor? In so many words?

[triskellian]

Have you pointed out all of these issues to your doctor? In so many words?
No, 'cause it was the nurse I saw yesterday. My plan is, indeed, to explain all of this to an actual doctor, and see if I can get classed as some sort of exemption to the month-at-a-time rule. I'm tempted to try secretrebel's suggestion that I claim bureaucratic hoops exacerbate my asthma ;-)

[lanfykins.livejournal.com]

I believe kharin managed to thwart a similar rule using sarcasm alone*, so it's possible.

I believe the phrase was, 'So when are you going to install the revolving door in the surgery?'

[ex-kharin447.livejournal.com]

That did work for a while. Unfortunately, the events triskellian has just described have also happened to me. The phrase 'So I'm expected to asphyxiate myself to save you money?' failed to do the trick.

[lanfykins.livejournal.com]

Hmm.

Fortunately my doctor doesn't seem to have clocked the fact that I'm asthmatic and haven't had a new prescription in over a year, or I'd undoubtedly be called in too...

[ex-kharin447.livejournal.com]

"but it still doesn't deal with the problem of having to get hold of a new prescription every month."

You might want to look at electronic prescriptions schemes - I get my inhalers mailed to me from these people: http://www.pharmacy2u.co.uk.

Not all doctors are using this but there is a surgey in Summertown that is signed up.

[triskellian]

Thanks for the link - I'll investigate.

[elethiomel.livejournal.com]

I was going to suggest the same. My Mum has one and IIRC it's about £40 (although it may have gone up) and covers you for a year, so it'd work out about half-price, give or take.

I agree with you about the fact the asthmatics should be exempt from prescription charges. Interestingly I believe that thyroid condition sufferers do get free medication although I believe those conditions are rarely, if ever, fatal.

[triskellian]

Yep, thyroid conditions are my favourite comparison. Much more debilitating than asthma, but they ain't gonna kill you.

[onebyone.livejournal.com]

I find it difficult to conceive of any ethical argument which doesn't result in either almost everyone or almost no-one getting free prescriptions.

So I conclude that the purpose of charging some people but not others is almost entirely to do with budget management. Given this, there's probably not much mileage to be got from considering particular examples of it being flagrantly unfair.

[triskellian]

You're right, of course. Doesn't stop it making me angry, though.

[bateleur.livejournal.com]

I dunno, because if you seem angry about the lack of fairness, that might result in "discretion" being used where this is permissible.

[uitlander]

As with amny others, I find it insane that asthmatics do not get free prescriptions. Its a life-long medical condition, and presenting any barriers to people who need ventolin and the like to breathe is insane. One instance where I don;t mind paying a bit more tax & NI to cover this sort of thing. I don't want asmatics 'rationed' on number of inhalers - I want them to have plenty lying around so if they lose/misplace them there's no problem. One of my friends regulalry leaves one over at my place as he knows he's forgetful - 'caching behaviour' in archaeological parlance, and something I thoroughly approve of.