The patients have their say

PHARMACIES: Health service reform must centre on the patient, writes Kieran Fagan

PHARMACIES: Health service reform must centre on the patient, writes Kieran Fagan

Patient rage takes many forms, not all of them rational. Personally I hate pharmacies. Chemists shops, poitigeiri, apothecaries' halls. A plague on all their houses. I hate queuing while someone in a white coat talks pseudo medicine in a Most Serious Voice to some halfwit hypochondriac, who may or may not have a cold in the nose.

I hate having to tell lies to buy a few light dose aspirin for heaven's sake. "Oh yes, the doctor knows." "And who is your doctor?" "Shipman, no I don't think we know him." Thin smile.

And then get overcharged by Mr Smarmy Pharmy who unblushingly quotes the prescription charge for an over-the-counter drug.

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I know I shouldn't feel like this. Some of the most attractive shops in any given area are usually pharmacies. The goods are nicely displayed, and here in Ireland we still have plenty of independent traders. The dreadful sameness which affects retailing - be it Top Shop, Tesco or Boots the Chemist - is avoided. My nearest town has lots of handsome pharmacy premises

The make-up counters look good. The perfumes ditto. The exquisitely boxed sets sold as Christmas presents may be cruelly expensive, but they sparkle. Even the men's toiletries which seem to have taken quite a lurch in a girlie direction impress. I positively enjoy the camera counter, though much of that business has gone to specialist shops.

But when I approach, in hushed tones, the White Coats, that's when my trouble starts. I approach the Rewrap Brigade with an attitude problem... Rewrap is what they do, it might have been dispensing once, but the only grinding this lot do does not involve mortar and pestle.

Now, this is unfair, I know that. Unfair to the many skilled pleasant people who work in chemists' shops up and down the land. But it's my phobia, my personal take on the patient rage which hits many normal people at the initial point of contact with the health service.

Recently I picked up some kind of bug when visiting a provincial town. Bug equals pills from doctor equals solution is the sort of primitive approach I adopt to medicine. So I went along to an impressive group surgery. Impressive premises, impressive list of doctors and services offered. It was a mini-medical centre and the impressive receptionist took my details and said that Dr X would see me shortly.

So I took a seat and read the day's Irish Times, impressively provided, and waited. Traffic was brisk. People came in, spoke to the receptionist and were called in reasonably short order by one or other doctor. Then an agitated heavy-set young woman rushed up to the reception desk.

There was a longish muffled conversation,but it was clear she wanted to see a doctor straightaway. The receptionist shook her head. The young woman turned away and rushed out of the building. Through the glass door I could see her standing outside, tears streaming down her face.

That was when I broke the rule. In non-confrontational tones I spoke to the receptionist. "Excuse me, you cannot see her from here, but that young woman who just left is standing outside - she is weeping and clearly is very upset." "There's nothing I can do about that," was the frosty reply.

"I had better then," I said, and I went outside. But she was gone, sweeping away in a taxi.

I waited 90 minutes, while other patients came and went. That put manners on me.

Now I'm pretty sure that the caring and competent doctors, sitting in their rooms, seeing their patients in order, don't want people in distress turned away. But are they being cocooned from a reality they choose not to know about? Is the receptionist so afraid of the doctors that she cannot say to someone in distress: "Look sit down there, I'll get a doctor for you", and call one, one of the four present that day.

Equally I'm pretty sure that the people who own and work in pharmacies don't set out to make people feel small, or patronised, or disempowered. But when you and I talk to each other, those of us who are on the receiving end of our medical service, we tell similar stories. Much worse than mine, of being left on trolleys, of being pushed around hospitals and clinics from queues for this to queues for that, to queues for the other.

Of being treated as if our time has no value, and the only valuable time is that of the Gods who work in the health service. Of being dehumanised, processed, not treated as people in distress at many of the common initial points of contact with medical services.

And when the Minister for Health, Mr Martin, is asked, he tells us that he is reforming the system.

Minister, if fixing the system was the problem, you or someone else would have it fixed long ago. What has happened here is the human being in need, the patient, the person who turns up at the myriad "gateways" to the health service, has been forgotten.

No Minister, this is not about the system. It's about commonsense and humanity. All the king's horses and all the Minister's health reports won't put the Humpty Dumpty health service together again until the focus is placed on the needs of the patient - not the system. Until you understand this, we patients will continue to be impatient.