Saturday 25 November 2017

Rude health... Parking notices

Sending disabled people to garda stations was bad enough, says Maurice Gueret, but now smokers need GP permits

Disabled parking bays: great for patients
Disabled parking bays: great for patients

Disabled parking bays are great for patients whose walking is permanently and severely restricted. To avail of spaces, you have to apply for an EU Parking Card from the Department of Transport. The scheme is run for them by the Disabled Drivers Association in Ballindine, Co Mayo. It costs a very reasonable €35 for a two-year permit, but I wonder if they have considered making the whole procedure a bit easier on people who already have difficulty getting about. To get your permit, you need photographs taken at the chemist, a form filled out by the family doctor, and confirmation of your identity at the local garda station.

Access to many of these places is difficult at the best of times. Indeed, you take your life in your hands trying to park in or near many police stations. In these days of online connectivity and joined-up government, should we really be expecting disabled people to jump through this many hoops to obtain what is their right?

GP's waiting room

Margaret is not impressed with a new notice on the door of her GP's waiting room. "Only one condition may be dealt with per consultation. Patients are advised not to ask questions or raise other issues as the doctor has many other patients to see." She didn't take a selfie of it, but I'll take her word it exists. While I may have some understanding of the sentiment behind it, I couldn't condone it. In my years of practice, I only once came across a patient with a shopping list of complaints. He had written them all down in numerical format and when he had about 12 collected, he graced my door. He checked the fee per consultation first and then produced his list. I did a deal with him and offered to cure half of his complaints that day, and half the following week. But he never returned and I convinced myself that my exceptional treatment must have cured the lot in just the one visit.

GP app

I have heard of doctors who keep a selection of notices in the bottom drawer that are put up when the need arises. If a notorious fee defaulter is seen in the vicinity, the sign about settling all bills on the day goes on the door. And if a particularly rude, malodorous or aggressive person drives up, the appropriate sign can be whipped out in a flash. But Margaret is quite right to get angry about such a sign. With a pharmacy bill of €144 every month, she tries to keep doctor visits to a minimum anyhow. She wonders if a mobile phone app might fill the ever-widening gap she sees between doctor and patient. No more long walks in the rain from the nearest parking a kilometre away. No wheezing her way up two flights of stairs to sit in a crowded, germ-filled, narrow corridor for three-quarters of an hour. No more talking to the back of the doctor's head while he focuses on the computer for the entire two minutes. Her GP app would be like an online supermarket. Instead of storing favourite groceries, her app would store allergies, current tablets and chronic conditions. The user would have all the time in the world to survey menus and click symptoms. Once payment is authorised, the app will email a prescription to a pharmacy or display one of the following codes:

A&E means bring a blanket, pillow and enough water for three days.

SAD means see a doctor.

PFR means paracetamol, fluids and rest.

And YAAH means you are a hypochondriac.

Margaret wonders if some technically skilled teenager might bring a working prototype to the Young Scientist Exhibition. You know, she may be on to something!

Smoking exemption

GPs can be a bit sensitive about notices themselves. A rather odd one was spotted on a hospital unit this summer, stating that "This is a non-smoking hospital. If you wish to continue to smoke, you will need to get a letter from the GP to exempt you". It was signed by the head nurse of the ward and family doctors reacted furiously when they heard about it. It conjured up an image of wheezy patients leaving the hospital ward in pyjamas and slippers. Grabbing a fag on their way to the GP. Picking up a letter to permit them to smoke. A nonsense too far, even for the HSE. Days before this, they had to apologise for advertisements they ran, urging parents of under-6s with grazes to obtain free emergency treatment at the GP.

National Lottery grants

The recent National Lottery grants from the Department of Health included €30,000 to a lobby group who wish to ban smoking on all university campuses. I wish them as much luck as the group who want to ban drinking on the campus of the Dail and Seanad. Another group were awarded €30,000 from Dr Leo's National Lottery kitty to tell school children about cancer. Now, cancer charities can do a lot of good work in their field, but I'd have concerns that kids have enough worry beads under their pillows these days without introducing cancer to the school curriculum. I'm not convinced that primary-school children need to hear from spokespeople for each and every human illness. Sure, some children do get cancer. And in the course of their illness they teach us adults a thing or two about how to cope in such serious situations. But we need to have a discussion about both the timing and content of health education. Secondary-school biology could certainly do with a revamp or being branched out into a new examinable subject on human and animal healthcare. But I'd think long and hard before allowing individual disease-promotion to be taken piecemeal into our schools.

Dr Maurice Gueret is editor of the 'Irish Medical Directory'

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