Health, time and its abuse
How well do you use your time?
How well does the NHS or any health provider use YOUR time?
How does your time get wasted by the inefficiency of organisations?
You've suffered on waiting lists, in waiting for hours at A&E, waiting
for hours for a pre-arranged medical appointment, waited for health
results, been kept waiting at call centres of utility companies.
It is criminal the amount of our time that is wasted.
And yet we put
up with it!
You've heard the excuses. you've doubtless also made some,
even to yourself.
I must go
I’ll come back later
I'll check with my colleague (and the line goes dead)
In a minute
I’d love to help but…
I’m rather busy just now so …
I’d love to be healthy but …
I’d love to do my spiritual practices every day but …
I’d love to pray but …
You can end any of those slatter entences any way you like. But I bet most will end with, “I don’t have time.” Or “Cannot be bothered.”
We always blame time, make excuses for the lack of it, our misuse of it. Over weeks and months, we notice our health fail and yet we say “I’ll get around to doing something about it, in time.” We abuse the time we are given. Are you guilty of being a time thief?
I had a dear friend who, when she would complain about her ailments, would simply respond with, “Ach, can’t be bothered,” when one offered her possible solutions and choices. She is now dead. Because she left it too late to take personal responsibility. And I miss her so. But we cannot do people's journey for them, only with them.
“All men run after time” -so wrote the French Abbe, a Catholic priest, theologian and writer, Michel Quoist (1918 –1997) in the mid twentieth century. But as we run in this so-called busy world, so much of the stress we put upon ourselves lies not in all that is going on outside ourselves, in the world out there, but in what we think “in here” – in our minds – on the priorities, or lack of priorities we give to things and events in our lives. There's always something more inportant than what is really important.
We all have the same amount of time each day – whether we count in minutes or hours or none of that man-made measure. How we choose or opt to use that time is down to us - fair and square. It is to each our responsibility. Yes, someone or something may come along and knock your day for six – but you choose how to respond, and therefore how to spend your time.
The Welsh poet W H Davies once wrote a poem, Leisure, which, for me, reminds us just how we take time for granted.
What is this life if, full of care,
We have no time to stand and stare.
No time to stand beneath the boughs
And stare as long as sheep or cows.
No time to see, when woods we pass,
Where squirrels hide their nuts in grass.
No time to see, in broad daylight,
Streams full of stars, like skies at night.
No time to turn at Beauty's glance,
And watch her feet, how they can dance.
No time to wait till her mouth can
Enrich that smile her eyes began.
A poor life this if, full of care,
We have no time to stand and stare.
Time and Self-Responsibility
Do you take time just to stand and stare and take in the awesomeness of life?
The Abbe points out that at every stage of life we will always find some excuse for running away from the deeper things that matter… from Truth, Beauty, Life. And this applies to so many facets of our lives - from the student who would rather party than study, the many organisations that abuse our time through their automatically controlled answering “services” and who deliberately fail to respond to customers, to doctors and nurses, run by an appointments system that would have them rush the consultation without truly ,listening, and to people at the end stages of life who, regretting what they didn’t do in life, suddenly find, “It is too late, I have no more time!”
Time is no one else’s responsibility but ours – our failure to carpe deum, to seize the day, and make the most of every moment of now and with a spiritual bent, instead of forcing our will on time, passing each moment of now back to God, however we understand the notion of a higher power, to direct our time, our every moment, with meaning and purpose.
This is not to ask for more time because we are so busy, a common failing, but to live in grace that we are guided to make the best of each moment of time by making wise choices.
Perhaps to pray, without it being religious – “I give thanks for the time that I have. I have time, all the time in the world. Guide me to use this moment of time wisely, in all that lies ahead.”
Time and health
When it comes to health, my health, and the use of time, I have a big issue. There, I’ve laid my time cards on the table. I have an issue – or rather, issues, and they are these.
Whilst I am saying that we as individuals need to take greater responsibility for how we use our time, I am mindful that factors impinge on our time. How we respond is down to us. And sometime we have few options.
Take the NHS as an example – it wastes time and resources hugely, public money is wasted grossly, in particular, the time (and money) of patients and service users seems seldom considered. Governments think the antidote to NHS problems is more money! It isn't.
Here are some examples:-
I took eight months of toing and froing at the Forth Valley Royal Hospital in Scotland to get an appointment for hand surgery. On the day of the procedure, I turned up at 8am as requested. A nurse kept saying the consultant was running late, but no reason given. I was eventually seen by the consultant at 10.20 – who simply told me my procedure was being cancelled! It took another eight months before the procedure was undertaken.
Is that an effective use of time? It is certainly not efficient nor conducive to good health and well-being.
I was admitted to hospital, not related to any other story here, as an emergency, and there languished for 14 days, witnessing many abuses of time where it seems the patient and THEIR time just do not matter. Nursing staff would appear, do a small something, then say they would be back “shortly” to do something else. “Shortly” often meant hours later with the patient in pain and anxiously waiting. In some cases, “later” meant they would appear at all times of NIGHT to do routine checks which they said would be done earlier in the evening. Impossible for the patient to rest. To heal. Not a good use of patient time. Not healing whatsoever.
And with the noise of staff heckling, laiughing, and talking along the corridor, it was impossible to reast and sometimes sleep. Not a good use of time.
On another occasion, I had a nasal operation at 8am, completed by 9.30am – yet was left in a “waiting bay” until 6.30pm until they could find a ward to take me overnight. This despite having had to wait eleven months for the operation and the fact that they knew when I was admitted that day that I had to be placed in a ward after the operation! Forth Valley NHS – avoid.
On my day of discharge, I was advised at 8.20am that I could go home within a couple of hours BUT it took until 4.50pm, with me sitting, taking up a private ward, doing nothing, waiting for a discharge note and some pain killers. Gross abuse of patient time and NHS resources.
I could go on with Forth Valley Royal and indeed NHS Forth Valley – especially their CEO and her cohorts – who pay lip service to patients and complaints, have false meetings, promising things will change when a year later they don’t, just wasting patient time, and all the time influencing a bad impression of the organisation.
My local hospital is a half hour away up the motorway. In 2016 I was frequently called in just to have bloods taken – a process that took two minutes – but took two hours of my time to travel, wait, and be seen, then return. Yet, it takes me two minutes to pop down to my local medical practice where they can take bloods - yet frequently NHS Forth Valley say the bloods must be taken at the hospital. Why? It is the same blood, the same test, and the record of results goes on MY file. It is bureaucracy and insistence on THEIR system gone mad.
They could take a leaf out of approaches in Canterbury, Christchurch, New Zealand.
In New Zealand, the District Health Board for Canterbury, the south island’s largest and most populous region, was engaged back in 2007 to review how it delivered patient services, and with a specific focus on whether they wisely used, or instead abused, patient time.
In 2007, its main hospital in Christchurch regularly entered ‘gridlock’ – with patients backing up in its emergency department and facing long waits as the hospital. It ran out of beds – now that rarely happens.
They can now demonstrate low rates for acute medical admissions compared to other health boards in New Zealand. Its average length of stay is low. Its acute readmission rate is low.
These three gauges point to a system that now has good-quality general practice that is keeping patients who do not need to be in hospital out of it; is treating them swiftly once there; and discharging them promptly and safely to good community support.
Reduced strain on Canterbury hospital and greater efficiency within it has prompted fewer cancelled admissions. Waiting times for elective surgery are down. General practitioners (GPs) have been provided with direct access to a range of diagnostic tests. That has shortened the wait for them, in some cases dramatically. As a result growing numbers of patients arrive for outpatient appointments already ‘worked up’ – with their need to see a specialist established.
A range of conditions that once were treated purely or mainly in hospital are now provided promptly in general practice.
The Canterbury health system can claim it has saved patients more than a million days of waiting for treatment in just four clinical areas in recent years.
The goals adopted for the Canterbury health service plan were that:
services should enable people to take more responsibility for their own health and well-being
as far as possible people should stay well in their own homes and communities
when people need complex care it should be timely and appropriate.
To achieve these goals a new way of working, a new set of principles so to speak, was essential. The key requirements were:
those in the health system – from primary to community to hospital to social care, and whether working as public employees, independent practitioners, or private and not-for-profit contractors – had to recognise
that there was ‘one system, one budget’ in Canterbury
Canterbury had to get the best possible outcomes within the resources available, rather than individual organisations and practitioners simply arguing for more money
that the goal was to deliver ‘the right care, right place, right time by the right person’ – and that a key measure of success was to reduce the time patients spent waiting.
The above is in total contrast to the way NHS Forth Valley is run in which
There, there is NO encouragement to enable people to take more responsibility for their own health and well-being. Doctor knows best. Doctors and consultants don’t listen. They bulk prescribe statins despite all the evidence to the contrary to do so. They claim that exercise and eating less is the way to diet and that eating your carbs is the way to go. It isn’t. They are averse to new ideas, to complimentary medicines, to vitamin and mineral supplementation and even to the NHS Funded Centre for Integrated Care in Glasgow. Doctors are simply living fifty years behind the times.
In 20 years of being diagnosed as diabetic, I have had no training programmes to help in my management or curing of diabetes, and all consultations revolve around whether glucose counts are too high. When I make progress, as I have done, I am never asked what I do to achieve that. When I choose to tell staff, they are usually condemnatory of anything that is complimentary or “new!” or achieved through nutrition. It is NEVER about health and living and well-being – only about doom and gloom and being terminal.
There has been no discussion ever about how to stay well in one’s own home and community
As for when people need complex care it should be timely and appropriate, this is a concept that seems alien to Forth Valley. I had to fight with a GP for over 12 months to get my breathing issues taken seriously, with another GP any reporting of issues to do with diabetes, phlebitis, cellulitis, etc were just ignored. Another GP ignored serious signs of vomiting and diarrhoea for four appointments over four weeks and then I had to be rushed, as an emergency, to hospital with sepsis.
I could go on with examples. Our system simply is failing us and it is down to an archaic system restricting time a professional can have with a patient, professional staff - their arrogance and ineffectiveness and inefficiency.
Scottish Government, with whom I have met, and NHS Forth Valley CEO and Chair, whom I also have met, are simply not open to a new way of working, a new set of principles so to speak. They simply create a brick wall for the patient. It's like it is all too much work to shift the paradigm.
Whilst Canterbury and New Zealand said that those in the health system – from primary to community to hospital to social care, and whether working as public employees, independent practitioners, or private and not-for-profit contractors – had to recognise the need for change, in NHS Forth Valley, no one recognises the need for change.
And the Scottish and UK Governments have only one solution – to plough more money into a broken system, like trying to give the kiss of life to a dying corpse.
There needs to be a review of the present paradigm, are they offering the right treatments, is there an effective use of patient time, are they really focussed on ploughing their present furrow or getting the best possible outcomes within the resources available, rather than individual organisations, departments, and practitioners simply arguing for more money.
When it comes to the use of a patient’s time, and I have had much experience of NHS Borders, Lothian, and Forth Valley, (as well as more efficient health services in New Zealand, Germany, and Spain) and their goal may be to deliver ‘the right care, in the right place, at the right time by the right person” but there is no evidence, from all with whom I have spoken who have experienced our dying NHS, that any of this really happens nor that there is ever a key measure of success being to reduce the time patients spend waiting or overall, to enhance the patient time-usage experience.
Languishing at home with an increasingly debilitating condition eg mental health issues whilst waiting months for an appointment is not conducive to good health.
Havcing to make appointmnts, turn up, wait, to get a prescription in the UK seems ridiculous given that in Spain, a European Union country, one can go to the pharmacist and most medicines are available over the counter. Why are doctors given such power?
NHS Scotland needs to revise its way of working, the paradigm of health it uses eg switching from the biomedical model to a more integrative model, and use patient time more efficiently and effectively. The current medical model is an expensive machine in need of replacement.
Speak up when your time is being abused by the NHS or whoever. If organisations are causing you stress, take time to give feedback.