Where is our dream health service: Somewhere over the rainbow?

Halloween may be on the horizon but there is not much more frightening, it seems, than the state of the health service here in the region. Last week, in opening NICON, Northern Ireland’s annual health & social care conference, Jonathan Patton, the Chair of NICON, borrowed Dorothy’s line, “We are not in Kansas anymore” to demonstrate that we are indeed in a strange and scary place.

Waiting lists of course were a feature of discussions and I thought, I too, would borrow Dorothy’s journey, as a story aid, to highlight a typical patient’s journey from referral to appointment. Here I am, Dorothy, and I start to develop symptoms that whip me up in a storm that lands me in my GP practice, let’s call it Oz. When I get there, I encounter the most unlikely of things, a GP, let’s call them Glinda the Good Witch. Glinda, not being able to help me, writes me a referral to see a Consultant, the Wizard of Oz. Now this sounds straightforward, but unfortunately, accessing the Wizard isn’t going to be easy or imminent, and indeed, I must sit on a waiting list, you got it, the Yellow Brick Road.

While on the waiting list/ yellow brick road, I will encounter much strangeness and I don’t mean lions and tigers and bears, oh my! I will encounter first a scarecrow seeking a brain – the system, unable to think outside its narrow referral pathways. I will encounter the Tin Man seeking a heart – the system suffering from compassion fatigue after years of being overworked and underappreciated at the coal face. I will then encounter the cowardly lion- the system not brave enough to stand up and say people matter more than technology and data.

I will then hit a poppy field and go to sleep on the road / waiting list for years, and after I wake, I will get a text message asking if I still want to stay on the yellow brick road. I do, of course, want to continue to Oz. Alas, when I get to the Wizard / Consultant I am diagnosed with my symptoms, they are now a permanent part of me and indeed I might as well click my heels 3 times and head on home to self-manage my condition.

Now I know what you might be thinking, surely in all that time there would be someone I could call to help me cope with this long and harrowing journey on the waiting list / yellow brick road. Well you would be wrong. The Chair of RCGPNI Council, Dr Ursula Mason today at NICON quipped; “we may be the front door of the NHS” (in this region that’s HSCNI) but we are “not the call centre for the NHS”. So, Glinda won’t be helping you in the meantime! But don’t be disheartened dear reader, there is a plan to design a ‘waiting well’ process that will accompany you along the yellow brick road should you land in Oz, this is I believe somewhere over the rainbow at present.

Sarah Kirkwood

Sarah Kirkwood is from Belfast and works as a medical secretary.