Dr Crippen, aka The NHS Blog Doctor, has written a very thoughtful response to my recent post on Jade Goody’s cervical cancer. Dr Crippen practices in the UK, and corrects my misperceptions of how low-income folks get care in his country.No Margaret. You are confusing the UK with the USA. God knows, the NHS is creaking, and we have problems enough, but we do not have “public clinics” for the impoverished poor. In the USA, the impoverished poor, aka the unemployed working class, predominantly black and Latino, may need “public clinics”. In the UK everyone is entitled to a “primary physician” as of right, independent of status and means. Yes, yes, before someone, or no one, or “angry from Tonbridge” writes in, a few people slip through the net, and a few people have incompetent GPs, and there is a difficulty with the homeless who are of no fixed abode, and so on and so forth but by and large most people have a GP. God knows, I do not hold back on criticising the failings of the NHS, but I become amazingly protective when people try to suggest that we have problems akin to those experienced by the medically uninsured in the USA.
I encourage you to head on over and read his post, which includes a description of the cervical cancer screening program in the UK.
Dr Crippen also thinks I went too far in hoping that someone
personally called, warned, cajoled and hollered at [Jade] countless times, until finally, as a last ditch effort, they sent her a certified letter.
You know what? He’s right. I doubt I would have called “countless times”. I was being a bit hyperbolic, probably because I was feeling particularly saddened and frustrated by the fact that a preventable death was about to occur in a young mother of two children.
But I like to think that I would have called Jade at least once if she failed to respond to her letter. Probably twice if I know myself well. And I suspect from reading Dr Crippen’s post that he would have done the same.
So don’t worry, Dr Crippen – you and I are in full agreement that the medical profession does not need anyone breathing down our backs to force patients to accept medical care that they have been duly informed that they need. I was in no way trying to insinuate that the medical profession bore any legal responsibility in Jade’s tragedy. They sent her a letter, she ignored it. Her bad.
That said, the question that remains is simply this – Did anyone call Jade when she failed to follow up on that last abnormal pap smear?
Which is not to imply that they were required to do so, or that the government should mandate it. I’m just speaking as one human being to another. It seems like it would have been the right thing to do.
And I hope someone did it.
That was really all I meant to say.
is the spelling mistake deliberate?
Crippo –
? What mistake – nothing deliberate.
I’m guessing the first poster noticed that you spelled the pseudonym “Crippin” rather than “Crippen.”
I like the way you handled your response 🙂
Bardiac-
Aha! Thanks – I didn’t see it. It’s been corrected.
Of course, we won’t discuss how he butchered the spelling of my last name in his post…
BTW, went for my first bike ride of the season last Saturday…Hooray!
Yay! Congrats on the bike ride!
I went yesterday, too, and it was wonderful, even though I was slow and laggy.
I agree with TBTAM as a patient and as someone who works for doctors I would like a call more then a letter or both (if one didn’t work). Sometimes there can be an old address or error with the maill as well as sometimes something can go wrong with an answeriing machine or voice mail as well as have a wrong or old phone number, and not always mean importand medical info. is being ignored. Doing one after another seems better then down the line an ER physician having to tell her or send her back to say you have late stage advanced cancer that has spread too far to successfully treat or cure.
Jade Goody used both private and NHS medicine. At the early stage you’re discussing, though, she probably used the NHS only. Either way, she would have had a GP (primary care physician) who had the records. I imagine if she went to see that GP, or any GP at the practice (for, it seems necessary to say, a totally free consultation) they would have raised the matter. It is I think simply not true that she had one letter and only one.
then down the line an ER physician having to tell her or send her back to say you have late stage advanced cancer
that is not, as I undertand the story, what happened. Nor is it typical of procedure here in the UK.
Unfortunately, those that truly know what happened won’t be discussing it on the blogs.
Great response Dr.P
“Of course, we won’t discuss how he butchered the spelling of my last name in his post…”
Thank goodness we don’t have to pronounce your name 🙂
I’m a UK GP
It is very likely that Jade had an NHS (free) GP. It is very likely he/she would have behaved like me in such a case.
namely:
We probably took the smear (ie a member of the practice – so we would feel a real sense of ownership/responsibility.)
On the practice receiving notification of such a serious abnormality such as a potentially cancerous smear I would have tried to contact the patient directly.
ie by phone. If several attempts failed I would have sent a letter and phoned again and sent at least another letter (possibly recorded the second time). I might even have gone round to the patients registered address and knocked on the door (though this might be taking it a bit far if I hardly knew her).
I think most UK GPs would behave in a broadly similar manner.
We wouldn’t have charged for this service (we can’t but it wouldn’t have entered the equation for most of us – though we undoubtably might have felt irritated she was playing so hard to get!)
At the end of the day we all have the right to put out heads in the sand. Sadly in this case this was a bigger mistake than usual for Jade.