I'm writing this in the middle of nowhere, stuck on a train that is 3 hours later than the one I was hoping to catch, because I had to stay in for a plumber who failed to turn up because I wasn't at home when they rang to check if I was at home. As I'd arranged for the plumber to call between 3 and 5 pm, I naturally thought that getting home by 2.30 pm would be enough. They'd phoned at 12.30 pm, and again at 1.30 pm, to say they were rearranging the appointment for another day. After I'd listened to the answerphone messages, I rang them to say I was at last in, as I'd said I'd be. ‘That's OK’, said the chap on the other end, ‘our plumber will be with you between 3 and 5’.
He wasn't, though. When I phoned at ten past 5, a recorded message told me that the office was closed, and would I phone again during their opening hours, which were 8.30 am to 5.30 pm.
So here I am on a late train, which is getting later, and I seem unlikely to get to my hotel much before 10 pm. There will be no-one in when the plumber calls later this week. Theirs is the second company to fail to send a plumber. The first lot cancelled an appointment, apologetically fixed another one, to which they failed to turn up. When I phoned them they found the job number and couldn't understand where their chap was.
These are all private companies. I know things go wrong. Nothing is perfect. But, private or public, things will continue, every now and then, to go wrong. Every fault in the public sector is assumed to be because of useless public sector workers who are stalling Our Great Leader's reforms. Hospitals or schools, private money and ambition will set things to rights. Except — lo and behold! — Hewitt has had another vision. Forget the hospitals; tell them all to get out into the community with their clinics and treatments.
I don't think Hewitt is wrong in thinking that patients with chronic diseases in the community tend to be ignored, and that the NHS concentrates too much on acute and sexy illnesses treated in hospital. But why didn't the Labour government think so 9 years ago? And how long will it be before all is turned on its head yet again?
- © British Journal of General Practice, 2006.
