The headlines about the NHS are always the big stories: failing trusts, accidental deaths, dodgy surgeons and so on. But it’s my guess that it’s at the less romantic edges where the system is wobbling most.
Let’s take feet.
Now my own pair are perfectly fine, thank you for asking, but I do know someone who has a problem with one of them. Her GP referred her to a podiatry clinic for further treatment.
The Birmingham community healthcare website proudly boasts “citywide access to podiatry – all in one place”. Let’s forget the irritating lack of a hyphen between “city” and “wide”, and consider the effect. There is one phone line, based at Waterlinks House in Aston, which handles all calls relating to podiatry.
As a result, the number is almost permanently busy. So much so that one might imagine the line is faulty.
After several days of unsuccessful attempts to get through, I offered to visit the local podiatry centre and make an appointment in person. This one cannot do. It’s been centralised you see. I’d call this a limp excuse, if it wasn’t such a bad joke.
This particular clinic rents a room in a local GP practice (and no doubt money changes hands in some bizarre ritual of internal accounting). The clinic is not open every day, and the receptionist at the GP counter visibly winces wherever anyone limps into her surgery. Bad-tempered people with feet moan at her all the time. “And it’s nothing to do with us,” she laments.
When the podiatry clinic is open, they tell you that they cannot make appointments. You have to go through the “citywide” number which is permanently engaged.
The podiatrist discreetly whispered to me that she would love me to complain in public, because, as clinicians, they’re banging their heads against a brick wall.
Head injuries have probably been centralised too. So it turns out that Birmingham’s podiatry service is not “all in one place”; it’s all over the place.
And at some point – as with much of dentistry – the easiest solution will be to hive the whole lot off into the private sector. Or is that more cynical than clinical?
* Dr Chris Upton is staring at his feet at Newman University Birmingham.
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