Health advice: Take control of your health

Cost-cutting in the NHS seems to be inevitable in these harsh economic times – who hasn’t heard of people getting short shrift from overworked doctors, being denied access to certain drugs or even being misdiagnosed? But patients have responsibilities as well as rights, so make sure you do your homework before even setting foot in the waiting room.

Maximise your appointment time ‘The recession has undoubtedly hit general practice,’ says Dr Graham Archard of the Royal College of General Practitioners. A GP’s workload is heavier than ever, but he maintains appointment times have not been cut. ‘A doctor is paid to do a job, whether that takes a minute or an hour.’ However, Katherine Murphy, chief executive of the Patients Association, paints a different picture: ‘On our helpline, we’re receiving complaints about communication. There is sometimes very little eye contact with the GP, who is inputting information into a computer.’

So how do you get the most out of your appointment time? Katherine recommends you take someone with you to make sure you ask all the right questions and absorb what the doctor tells you. The average GP appointment lasts seven minutes, according to Netdoctor, so book a double appointment if you have more than one issue to discuss. ‘Write down your symptoms beforehand, so the doctor can get to the nub of the problem quickly, and you get more of his or her expertise,’ advises Dr Archard.

Trust your instincts

Getting the best treatment from your GP or consultant is about being self-aware. ‘Don’t just assume that doctors know best,’ says Jacqui Graves, a specialist nurse and programme manager for Macmillan. ‘You’re the expert on you, and only you know what’s normal for you. And don’t be frightened to keep asking questions.’ Dr Archard agrees that patients should trust their instincts, but recommends caution when researching symptoms online. ‘It takes ten years of hard study to become a GP. If a doctor says you have a condition, look it up, but don’t try to self-diagnose. Trying to assess yourself online is a disaster!’

The future of breast care

One in eight women will develop breast cancer at some point. The NHS Breast Screening Programme offers free screening every three years if you’re between 50 and 70, but what about younger women? ‘Digital mammography, which uses clearer digital imaging rather than traditional x-ray fi lm and chemical processing, is much more effective at looking at their denser breast tissue,’ says Dr Rachel Greig of Breakthrough Breast Cancer. However, the government has failed to meet its 2007 targets to implement this across the UK – an issue that Breakthrough is campaigning for. ‘We want all women to have access to the best possible standards.’ Seventy per cent of cases of breast cancer are detected by women themselves. Check your breasts regularly and reduce your risk by maintaining a healthy weight, exercising and reducing your alcohol consumption. Visit www.breakthroughbreastcancer.org for self-examination videos.

Fight for a better NHS

Whatever your health gripe, it’s important that you speak up – after all, it’s your NHS. Helping to raise funds or signing petitions – such as for Macmillan’s 24/7 community nursing campaign, which supports cancer patients in choosing where they die, or their free car-parking pledge for cancer patients – can all help change policy (visit www.macmillan.org.uk or call 0808 808 0000). And with the Health and Social Care Bill soon to become law, there are radical changes afoot – not least the abolition of PCTs in favour of GP groups and the use of private healthcare within the NHS – all of which could affect the way services are delivered. So keep an eye on what’s going on in your area and, if you have objections, make your voice heard.

Beat the postcode lottery

Whether it’s psychotherapy or podiatry, all sorts of services are now subject to a postcode lottery. ‘Primary Care Trusts (PCTs) are cutting back on things such as pain relief and social care, too,’ says Katherine. ‘Some patients have been known to move in order to beat the postcode lottery, but this seems extreme,’ says Prima’s Dr Sarah Brewer. ‘If you have a valid medical condition that needs treatment which isn’t available in your area, but you know it is available in another, create a fuss. Seek advice from self-help charities and publicise the problem by contacting your local PCT, newspaper, MP, radio or TV station. You may be able to change local policy if you keep raising the issue.’ To find out about services you might be entitled to, call the Patients Association helpline on 0845 608 4455, or visit www.patients-association.com.

Smear tests: the five-year glitch

Cervical cancer is one of the most common cancers among women (second only to breast cancer), but is largely preventable thanks to nationwide testing which catches pre-cancerous cells that are easily treated. However, although it’s recommended that women aged 25 to 64 have a smear test every three years, because GPs are only paid for their workload by the government every five years, there is no financial incentive for them to offer tests more often than this. In fact, some health authorities use a five-year rule as a means of cost control. If you’ve had an abnormal smear in the past five years, you should have a smear test annually. If your GP can’t help you, visit your Well Woman or Family Planning Clinic.

Yes, you can seek a second opinion

It may not be enshrined in law, but if you feel your health concerns are not being taken seriously, or that your diagnosis is wrong, you are entitled to ask to see another GP or, if things don’t get better, a consultant. ‘It’s a foolhardy doctor who says no, because everybody makes mistakes,’ says Dr Archard. You can also ask to have a specific worry, such as cancer, investigated to rule it out. ‘If a patient presents to a GP three times with the same set of symptoms, they should be referred, regardless of whether or not the GP thinks it could be cancer,’ says Jacqui. Making complaints is much harder, though. All GP surgeries have a complaints procedure (ask at reception) or you can write to your PCT (find details at www.nhs.uk). And if your complaint is about a hospital? ‘Write to the chief executive of the trust, copying in the Patients Association,’ says Katherine. ‘If you don’t get a satisfactory response, we will help you communicate with them.’ You can register with another practice without giving an explanation. But informing your current surgery may speed up the time it takes for your medical notes to be transferred to your new GP.