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33rd Day of Lent: Going without the NHS

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Hospital Invoice

This shocking story has been shared by ‘Ben’ (name has been changed). It sadly shows another failure caused by the inability of the post cuts, post ‘radical redesign’ Adult Mental Health Services of Norfolk & Suffolk NHS Foundation Trust (NSFT) to consistently respond to people in crisis in a timely and appropriate way. However, this story also highlights a National Health Service (NHS) at risk of becoming unfair and unpredictable in terms of who gets what service and shows how gaps and pressures in the NHS pave the way for private medicine and different experiences of mental ill health and treatment for rich and poor:

“Ben is a young man who has recurrent episodes of depression. Unfortunately, six months ago, some stressful live events triggered an episode of illness.

The GP prescribed a high dose of Venlafaxine which for a short period seemed to help. But soon Ben became physically and mentally agitated. He was unable to focus, experienced racing thoughts, was extremely irritable and developed paranoid ideas. Ben hardly slept, did not eat and rapidly lost weight. Ben described his symptoms as different to previous episodes and was distressed by these uncontrollable mood swings. He researched Venlafaxine on the Internet and asked the GP to change his medication as he suspected the Venlafaxine might be contributing to his agitation.  The GP declared that he felt ‘out of his depth’ and was reluctant to change anything without Specialist Advice. He made a referral to NSFT in the hope that Ben would see a Psychiatrist to advice on diagnosis and medication.

Nothing happened for months and Ben’s situation became desperate. After Christmas he reached a complete low and made a suicide attempt. In hospital he was briefly assessed by the Crisis Team but no further follow up was arranged. This experience left Ben really shocked and at a loss about what to do next.

In desperation, Ben contacted a friend who works for NSFT and asked for a recommendation of a private Psychiatrist. He was promptly seen, provided with a comprehensive treatment plan detailing how to stop the Venlafaxine and restarted on a SSRI and Mood Stabiliser combination. The plan also gave advice to the GP about Ben’s diagnosis and future management. Ben is still very low, but he is feeling calmer and more in control since the change of medication.

Ben has no private insurance; his financial situation is very tight. ‘Going private’ is not something he would have ever considered before or that he can really afford to do. The Psychiatrist who saw Ben privately also works full-time for NSFT. There will be more and more people seeking private support because they are unable to access timely help.”

Ben had a right to receive a service within the NHS. He was ill, in crisis and needed treatment. It is difficult to put a price on the suffering, risk and damage that lack of treatment has caused but could Ben make a case for NSFT or his local commissioners to reimburse the £425 he was forced to pay? What happens to those who don’t have friends who work for NSFT or are unable to scrape together enough money to pay for a private consultation?

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