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A & E: How Far Away?


Gardian
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[quote user="sweet 17"]

Betty, aren't they now talking about doing away with walk-in centres as they are deemed not to be cost effective?

I am not sure of my facts here but I thought I caught in passing, that is in passing between the dog and the husband playing on the floor, a bit of an interview with somebody or other about this?

Would be interesting if you could comment as I thought that these walk-in centres were an excellent alternative if you were sort of between boil on the bum and gasping your last?

[/quote]

 New role of the Emergency Care Practitioner Paramedic  will be to take on these sorts of patient who dial 999 and treat them so they don,t have to go to A&E .  Graduate entry paramedics will be trained to deal with a lot more than the old  "Ambulance Man " with a first aid kit that many of us were used to coming into contact with  when we injured ourselves in our younger days ..... A good thing too !

I see a lot of people sitting in A&E waiting to be seen who really are not an emergency and by the look of many and listening to them they may not have got round to registering themselves with a doctor .... Some bring the whole family so there can be half a dozen people demanding immediate care for one of them... A& E staff in the UK need the patience of Job just to deal with all the stuff that is associated with their task in patching people up . 

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I think the point you're making Frederick is that the population needs educating.

I have a niece who is a paramedic; one of the first things that happened to her when she started training was to be issued with strengthened boots and taught how to use them in her own defence.

Hoddy
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I see a lot of people sitting in A&E waiting to be seen who really

are not an emergency and by the look of many and listening to them they

may not have got round to registering themselves with a doctor .... Some

bring the whole family so there can be half a dozen people demanding

immediate care for one of them... A& E staff in the UK need the

patience of Job just to deal with all the stuff that is associated with

their task in patching people up

Not just in the UK Frederick. This is more and more the case in France especially in towns like mine with a large impoverished population since you have to pay the GP even if it is reimbursed later whereas you are seen free in Urgences

The large family syndrome can feel rather threatening and is common with what is called here the 'Gens de Voyage'

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[quote user="sweet 17"]

Betty, aren't they now talking about doing away with walk-in centres as they are deemed not to be cost effective?

I am not sure of my facts here but I thought I caught in passing, that is in passing between the dog and the husband playing on the floor, a bit of an interview with somebody or other about this?

Would be interesting if you could comment as I thought that these walk-in centres were an excellent alternative if you were sort of between boil on the bum and gasping your last?

[/quote]

I don't honestly know, Sweets. Ours (and son#1's, from what he tells us) still operates, and is open 8-8 Mon-Fri and 9-5 at weekends.

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[quote user="sid"]

Plus, we got a daily visit from the nurse to administer anti-DVT injections for the next 5 weeks.  

[/quote]

This is why healthcare costs are so high in France.  This is a very easy injection to do yourself and has the tiniest of needles..  Kinda like our neighbour being paid to take her 12 year old kid to school....

Mrs R51

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I disagree about this being the reason " why healthcare costs are so high in France."

The cost of this is not all that high as a home visit by the nurse is very low(2.50€ http://www.ameli.fr/professionnels-de-sante/infirmiers/votre-convention/les-tarifs-conventionnels_herault.php)

The reasons for the costs being high are to be found more in the structure which pays Doctors by the 'acte' and so pushes consummation; in the fact that private cliniques have access to public funds which they treat as a cash cow; and in the high profits made by the French Pharmaceuticalameli actes infirmiers companies.

In short letting private greed have  free access to public funds without adequate control.

The poor patient who needs a nurse's visit is a very small cog in this.

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Sorry Norman - totally disagree.  I have a severe thrombophilia so have to have these injections twice daily and they are a piece of cake.  The cost of €2.50 has to be 'notional' as the time and petrol costs of a visit to someone who may live in a rural location is significantly more.  Needing prophylactic injections following an injury is not 'a poor patient who needs a nurse visit' - it's someone who can't be arsed to do it themselves and who drags a nurse out into the sticks wasting a good hour of her time.  If you were in the UK they'd tell you to pull yourself together and get on with it.

Mrs R51

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[quote user="richard51"][quote user="sid"]

Plus, we got a daily visit from the nurse to administer anti-DVT injections for the next 5 weeks.  

[/quote]

This is why healthcare costs are so high in France.  This is a very easy injection to do yourself and has the tiniest of needles..  Kinda like our neighbour being paid to take her 12 year old kid to school....

Mrs R51

[/quote]

I couldn't agree more. People are hoodwinked in France into believing that the quantity of attention/medication they receive somehow relates to quality.

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No Norman, I have friends and family with real and severe illness at the moment and they are cared for very very well on the NHS. Maybe there are regions where the care isn't so good, but here in this part of the NE of England, I have no complaints.

But that is only one side of it as I have complaints too. And that is that there are some very very stupid over paid people in charge of certain aspects of the NHS and I wouldn't trust these managers to tie my laces (maybe they cannot tie their own), never mind run anything at all.

I unfortunately found my self with an infection several months ago and on a weekend. Due to medication I take, I have to have a blood test done immediately if this happens. I have three walk in centres near here, none of which can take bloods on a weekend. So I called 111 and all they could offer was A&E AND they offered to send an ambulance for me. On so many levels this is ridiculous and as I said, those in charge who should have the slightest modicum of common sense, but apparently that is not a qualification and is ignored.

So A&E full, you betchya it is. With people who do not want to be there, should not be there, especially on a weekend. As the consultant said, 'WHY are you here?' and I explained that there was no where else for me to go.

In fairness, I have no idea what would have happened in France on a Sunday afternoon. I do not know whether the labs have a 'garde' on an evening or at the weekend. But my problem was that there were walk in centres that should have been able to help me and they did not. That they are closing them is no surprise, that they should shut down 111 seems essential to me, as they were as much use as a chocolate fireguard.

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[quote user="Russethouse"]A clear and certain sign that if you can stand on your own two feet, you should.

Shame it isn't extended to other things....;-)[/quote]

We are talking about sick people in need of medical attention.

Your attitude is part and parcel of the growing idea that the weak and needy are to blame  for costs(compare the ide of 'benefit scroungers' ) when the real problem is to be found in the businesses that make a profit from the treatment and medicines that are prescribed.

Nobody asks to be ill, and it is not the patient's fault if at that point in their life they need help.

I deplore the uncaring attitude in some posts which strangely enough come from people who live in privileged parts of the UK with easy access to London Hospitals,  and enough money to possess second homes.

As to idun's point:

Surely when the GP is closed you go to la Maison Médicale de Garde?
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Bit of a facile argument, there, Norman. Not like you at all. What constitutes a privileged part of the UK, in your opinion? And when we (those of us who live in the UK) have a National Health service, what on earth has having the means to afford a second home got to do with anything? I think you have somehow confused a number of ideas there. Here in the UK, as far as the NHS is concerned, need is based on need. No more, no less. In France, you get a nurse to pop round and minister to you whether you need it or not, and very often they come to administer stuff you don't need with the frequency or in the quantity that's provided. I know of people who've had daily visits over a period of 3 weeks or so, pre-op, by a nurse to administer anticoagulants. How is that a justifiable expense, need or use of resources? I've never heard of it in the UK, and nor do I read regular reports of people dying as a result of this omission.

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I agree. A friend here in the UK had a DVT recently and needed regular anti-coagulant injections. It was expected that he go into the surgery for the nurse there to do them, as he was quite capable of driving. It would have been a nonsense for a nurse to make a trip out to him.
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[quote user="NormanH"]Surely when the GP is closed you go to la Maison Médicale de Garde?[/quote]

We don't have such a thing and our nearest A&E is a good 1/2 hour away. So I think we call either our own Doctor, and the call will be rooted to someone on duty somewhere, or else we call 15. Failing that we drive to the Hospital - as our GP suggested to my husband when I was ill - as it is quicker.

Sue

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NH,  I needed a blood test, on a Sunday afternoon, and as far as I am aware there were no Maison Medicale de Garde and still aren't in my area, only les urgences.

I have never lived in the south of England, so have no idea how patients are treat there. All I know is that anyone who has anything serious has been seen immediately and problems which are not life threatening, like mine, have entailed no longer a wait than I had in France, so that's fine with me.

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[quote user="NormanH"][quote user="Russethouse"]A clear and certain sign that if you can stand on your own two feet, you should.

Shame it isn't extended to other things....;-)[/quote]

We are talking about sick people in need of medical attention.

Your attitude is part and parcel of the growing idea that the weak and needy are to blame  for costs(compare the ide of 'benefit scroungers' ) when the real problem is to be found in the businesses that make a profit from the treatment and medicines that are prescribed.

Nobody asks to be ill, and it is not the patient's fault if at that point in their life they need help.

I depluore the uncaring attitude in some posts which strangely enough come from people who live in privileged parts of the UK with easy access to London Hospitals,  and enough money to possess second homes.

As to idun's point:

Surely when the GP is closed you go to la Maison Médicale de Garde?[/quote]

There's a big difference to being 'sick' and having a condition, or needing a short term course of treatment when you are actually pretty well..

Of course people who are ill should have visits but there are plenty of people who could and should manage perfectly well themselves if given adequate instruction.

My attitude is that while you are able you should do what you can for your self, that frees up resources for those that really need them, as we all may in the future.....I don't suppose that suits you though...
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[quote user="KathyF"]I agree. A friend here in the UK had a DVT recently and needed regular anti-coagulant injections. It was expected that he go into the surgery for the nurse there to do them, as he was quite capable of driving. It would have been a nonsense for a nurse to make a trip out to him.[/quote]

1) "He was quite capable of driving". Good for him. What about those who aren't, or who haven't got a car? 

I can't drive and can hardly walk (especially just after I came out of Hospital) I suppose I should have just " pulled  myself together and got on with it."

2) Where would one drive to in any case? None of the Doctors in my town have a Nurse attached to their practice.

Nurses are independent workers without a surgery to go to. The only time I have seen one is at my home.

I  really can't understand the vitriol expressed in this thread against people who are sick.

The money being spent by whichever system UK or French doesn't line our pockets...

Can no-one see that the 'villains' (or at any rate the ones who make the money out of the system and so take the resources) are those who milk the state for what they can get: transport providers; clinics that give as many inessential but profitable  examinations; pharmaceutical companies who make exorbitant profits; consultants who do the minimum at each consultation thus obliging you to go back three times so they get three fees; GPs who refuse to give renewable prescriptions so that they get their fee each month.

This is what I mean by private greed having access to public money.

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[quote user="Russethouse"][quote user="NormanH"][quote user="Russethouse"]A clear and certain sign that if you can stand on your own two feet, you should.

Shame it isn't extended to other things....;-)[/quote]

We are talking about sick people in need of medical attention.

Your attitude is part and parcel of the growing idea that the weak and needy are to blame  for costs(compare the ide of 'benefit scroungers' ) when the real problem is to be found in the businesses that make a profit from the treatment and medicines that are prescribed.

Nobody asks to be ill, and it is not the patient's fault if at that point in their life they need help.

I depluore the uncaring attitude in some posts which strangely enough come from people who live in privileged parts of the UK with easy access to London Hospitals,  and enough money to possess second homes.

As to idun's point:

Surely when the GP is closed you go to la Maison Médicale de Garde?[/quote]

There's a big difference to being 'sick' and having a condition, or needing a short term course of treatment when you are actually pretty well..

Of course people who are ill should have visits but there are plenty of people who could and should manage perfectly well themselves if given adequate instruction.

My attitude is that while you are able you should do what you can for your self, that frees up resources for those that really need them, as we all may in the future.....I don't suppose that suits you though...[/quote]

perhaps those of us who enjoy good health should show some compassion for those who have the misfortune to be ill. It is all too easy to treat people as malingerers who should just "pull themselves together".

 

I must admit to being surprised to seeing contributions from people who generally show compassion being somewhat harsh in their contributions to this thread 

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I see no vitriol here. Why take this so personally? Nobody is addressing any of their comments at you or your situation, Norman. Why not attack the arguments if you disagree rather than try to have a snide pop at the people you disagree with? I had you down as being better than that.

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Am I allowed to pour some oil on troubled waters here?

Norman is, I think, feeling vulnerable as he lives alone and is not very mobile, as he himself has said here many times.  So, perhaps, we make some allowance for him?  Sorry, Norman, if you don't like what I am saying but...heyho...

OTOH, Norman, there is nobody being "vitriolic" or whatever less inflammatory word might be more appropriate, here.  You know very well that Betty, RH and KathyF are not nasty, unfeeling people.

When my OH was ill, I wasn't too worried about whether money or resources were being "wasted" on him, I wanted them to pull out all the stops AND THEY DID!  Thank goodness!

Then, only yesterday, I collected our anti-grippe vaccines from the pharmacie and I injected both him and myself as it was something I felt perfectly competent to do and I told them I didn't need the portion of our ordonnances that prescribed a nurse to do the jabs.

So, I think everybody is more or less agreed that you use the services as required but that, if at all possible, you do what you can for yourself so as not to use scarce resources.

Is that OK, everyone?

Anyway, I'm off to bed so I won't be here to read whatever it is that you want to contradict me about![:D][:P]

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someone who can't be arsed to do it themselves and who drags a nurse out

into the sticks wasting a good hour of her time
.  If you were in the UK

they'd tell you to pull yourself together and get on with it.

All sound pretty judgemental to me, as do

I agree that there is waste in the French system (I have posted about it before).

I am  sad to see that waste blamed on the patients alone when I believe that it is the structure that is at fault.

It is also true that some people in France  misuse the  system, but that is a matter of Public Health education.

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I agree Sweets, I think Norman has the wrong end of the stick...the system in the UK is different, there are nurses attached to most GP surgeries....I regularly see quite disabled but otherwise well people out shopping in our local supermarket, if they can do that I'm pretty sure t hey can get to the doctors surgeries for jabs etc..that leaves the community or district nurse free to call on those who really are not mobile for whatever reason.

I really can't see anything wrong with that.
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NH, I have NOT seen anyone told to go away at the GP's or at the hospital. If someone needs their care at home, where I live they get it. The receptionist will always ask if the patient can get in etc, and why not, but then IF a house visit is necessary, then it is given.

I am seeing a lot of extra care for a family member at the moment and no one suggested other than the 'proper' care be given where ever it is needed.

All I can do is cast my mind back to my nightmare of a stay in french hospital. How rude and negligent all the nurses were to the very old lady in the next bed, it was disgraceful. They refused to basically help her with very basic needs, which she had help with in her own home.

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