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Welcome to the NHS a la Gordon Brown.

Still as left wing are you now when it's personal?

Political comments aside, I hope you've fully recovered so you can regale us all with your wit and wry comments.

Nick,

Sorry to hear of your problems; perhaps it's down to expectations.

In a similar situation at Easter this year (at an East Coast resort), I was surprised to be able to get an NHS GP to issue a prescription after just a fifteen minute wait.

I'd disagree on one point though: I'd never expect a pharmacist to issue presecrition drugs without a prescription. Even back in the 1970s that was a no-no.

You make a valid point Nick (including your own bad admin in not having the inhaler).

Sadly though, gone are the days of services (be the medical, teaching, police etc) being there to support the community. It is now often a case of the community supporting the service.

However would all this change under a Tory Govt and Andrew Lansley being the SoS for Health. I suspect not to be honest as it there are no obvious vote winning stats to produce.

Nick, I sympathise with you and yes, albeit that you should carry a spare one. Our doctor's instructions are that if we are outside our area we should call OUR out of hours doctors service who in turn will arrange for a prescription to be collected from the nearest available service which might also be a hospital. May I wish you all the best Nick and keep fit.

The problem has always been with this government that while they're good at identifying and communicating problems, they have failed to deliver the necessary solutions.

This has resulted in endless reviews, findings, failed reforms and the cycle continues. Twenty four hours to save the NHS and we're still at it ten years later. Gordon Brown has to be held accountable for that. Another review does not wipe out the last ten years.

p.s. Its not your fault. Not ideal but I think a quick trip to the local A+E was in order for a couple of puffs and a prescription.

"I don't think I've turned into a misty-eyed nostalgic when I suggest that that in the past someone might have said, 'we've got an inhaler you can use (or I'll pop this prescription in front of the doctor) but next time do remember to bring a spare'"

The bit of information your leaving out is the number of people who got sick/died when they were given the wrong stuff in the days before they had more checks.

I think your experience says more about the receptionist not knowing what the walk-in centre could and couldn't do and the expectation gap with the chemist; rather than a whole root and branch problem with society today.

Hi Nick,

Sorry to hear of your problems. A Pharmacist is allowed to make an emergency supply, or sale, of a Prescription Only Medicine - such as your inhaler even without a prescription - provided they can be satsified you're who you say you are and that you have a genuine requirement for the drug and they can are clear about the appropriate dose for you. Obviously this is more likely to happen if you use the same Pharmacy on a regular basis so the staff know you. You would have had to pay the full price rather than the standard £6.85, but the Pharmacist should have been able to sort something out for you especially if it was a "reliever" inhaler e.g. Salbutamol - rather than a "preventer" such as Beclomethasone. Assuming you had the empty complete with a label and proof of ID it should have been relatively straightforward.

For reference see Page 14, Medicines, Ethics & Practice, 31, July 2007, Royal Pharmaceutical Society.

Cheers

Phil

Sadly this is not limited to just health. I am in the process of TRYING to register for Self Assessment. To me as a non-accountant type this seems like a straight forward request.

I started off with the number on the SA website who told me they didn't do it ring this number... rang the number... guess what they don't do it either ring this number... so on and so forth.

After about 8-10 different numbers I was given a number that I had ALREADY called. I tried again to be told the same. And given the same number as they gave the time before.

By this point I could take no more, and the polite lady took up my cause for me... but EVEN she couldn't manage it and apparently became bewildered when one of the people she was talking to gave her offices number!

I still do not have a tax return and I am obviously concerned that I will be 'chased' as a tax dodger.

It is causing me unnecessary grief - how hard can it be?

I don't believe that under this Labour government and with GB's constant tinkering as Chancellor things have gotten any easier. Going back to health care it is difficult to get an appointment as someone who works full-time and cannot afford to take time off.

It's a sorry state of affairs.

Nick,

I have to agree with David Lester's sentiments above regarding your comment about the pharmacist. They can't dispense prescription-only medicine without a valid prescription, simple as that.

I realise that it helps to add another layer to your tale of NHS buck-passing, but in future can you lay off the innocent parties please?

Apart from that, keep up the good work, and I hope the asthma trouble eases off soon!

20 years ago I was away from home when my inhaler ran out. I was able to get a replacement at the chemist under a "pharmacist's prescription".

Maybe he could do this because I'd got the inhaler, and he only needed to replace it?

Nick

This is YOUR medication. YOU need to take responsibility for making sure YOU have a sufficient supply.

I used to be a practice manager and the biggest cause of grief were patients demanding their regular medication NOW ('if I die its all your fault')when with a little forthought they could have asked for their repeat prescription in good time and saved a lot of un-necessary agro.

If my mum could work out when her tablets would run out and put a note in her diary of when to reorder them than anyone can

Martin wrote:
20 years ago I was away from home when my inhaler ran out. I was able to get a replacement at the chemist under a "pharmacist's prescription".

Maybe he could do this because I'd got the inhaler, and he only needed to replace it?

A Pharmacist couldnt prescribe an inhaler for you soley on the basis of you standing there with an empty one in your hand. It might not belong to you, what will you do with it etc etc. Thats the point of a prescription as its authorised by your doctor

Next time Nick stop faffing about and go down to your local A&E department - they could have given you an actual inhaler within minutes! God knows people present there for lesser problems, and yours actually sounds genuine.

We live in a small town in rural central Portugal, where the local chemist will either provide the medicine you require from the pharmacy immediately or will always have it by 3pm. Things like inhalers and a large range of other medicines are available without prescription as you are treated like an adult. If a prescription is required the pharmacist will provide the medicine and ask you to follow up with the prescription. The medical care here, we have a health clinic, emergency cover for minor incidents and laboratory testing facilities is infinitely better than anything we had in UK. Our Council area serves just 7500 people.

What it boils down to is that you were evidently ill and nobody did a thing about it because your situation didn't fit the required forms.
As my husband (retired vet) points out, you'd have been MUCH better off had you been a dog - but the vet would have expected payment.
If a vet refuses to treat an animal that is ill, he is liable to be struck off.
I have a couple of chronic complaints so I am careful to take a prescription with me when I travel abroad. It never occurred to me that I'd need it in this country. Why couldn't the pharmacist/ doctor / walk-in centre ring your local practice which could have faxed through a prescription?
What would have happened if you'd run out of heart tablets, had the same lack of treatment, a heart attack and died?
Would your family still have been told reprovingly that you should have been more careful?

And I wonder what all that complete waste of time cost you, your employers and the taxpayer funding the NHS, let alone the risk to your health? Of course the Child support agency was the same, the tax credits system is probably even worse, the farmers rebate system is now running about a year late and two weeks ago the OECD reported no discernible improvements to education whilst doubling the budget over the last ten years.

It seems the only thing this government reliably delivers are the tax bills.

And do take care of yourself Nick, this government certainly won't help you.

When my girlfriend was taken ill on a day out, I called NHS Direct to find out where the nearest walk in centre was and had to go through a lengthy form filling exercise - including giving my address - which took about 15 minutes. It also took considerable persistence to communicate the fact that I was not actually at home, therefore being told where the nearest walk in centre to my house was not particularly helpful!

I have found the NHS walk in centres very helpful, but when there is not one locally I have no clear idea who to contact in a non-emergency situation.

For what it's worth, I had a much better experience trying to get an inhaler for my similarly forgetful partner.

I rang up, explained, they told me of an out of hours surgery, which simply gave me one. No fuss, no hassle.

I /hope/ it would have been dfferent for methadone :-)

I'm surprised that you are surprised!
How many of this Government's statements actually deliver the objective trumpeted in the sound bite??

A few weeks ago my granddaughter fell ill while visiting us. She was able to see a doctor at my local NHS practice immediately (well, she did have to wait for 20 minutes), and the doctor arranged for a prescription to be available at the local Boots by his computer link.

This clearly proves that the NHS as a whole is wonderful.

According to Wikipaedia you are a former chair of the Young Cons, Nick; and sometimes it shows.

Further to the announcement that the Government want GP's to open in the evening and/ or weekend and that inpatients are going to be screened for MRSA.

These additional resources will require additional funding. Could you get the Government to confirm where this extra funding will come from otherwise their figures 'don't add up'.

This is actually more serious than you may the Government takes into account future growth in the economy when estimating revenue / expenditure. As the most recent growth forecasts are substantially lower than those in April there would seem to be a £5,000,000,000 deficit in the Government Accounting - will this be covered by extra borrowing or what? If they won't saythen yet again the figures 'don't add up'.

Nick - I need regular medication ( a simple allergy drug) that is available only on prescription.
I am on repeat prescription - and have to go to collect this every 28 days. Every month I write on prescription - please let me have 2 months supply.
Every month I get 28 days supply.

I do not have to see the doctor(only once a year).

So in Spain recently I purchased 4 months - across the pharmacist counter - without prescription, and without question - each month costing half an NHS prescription!,

Now I am saving the NHS time, and saving myself money!

Mr Robinson,

Talking of health, Mr McCavity's blowing hot and cold over whether to call an election can't be doing your and your colleagues' health any good at all. Being subjected to those constant changes of temperature must have brought out your recent cold.

What is it doing to the nation's health? Grabber Gordon ought to carry a health warning!

Are you going mention that when you're next on telly ?

Nick

Last year I had an asthma attack and have a steroid (prednisolone) for such occasions. Like you I found myself on my way to Shropshire on a Friday evening, without the drug (a rarity, and if I had died no one would have been to blame apart from me!). My mother spoke to her GP who prescribed it to me, gave the prescription to my Mother who collected it and I was much better that evening.

If the GP had not prescribed it I would have ended up in A&E locally.

A much stronger drug issued almost certainly illegally but for all the right reasons.

My Mother was pretty cross with me, my wife was even crosser and I was not impressed with myself either. But I thanked the NHS and the Doctor who was practical, reasonable and understanding.

Anon (Age 34)

Precisely my experience, Nick. The NHS, in the words of John Reid about the Home Office, "prioritises process over outcomes". A sad reflection on life in the litigious society.

Nick - I sympathise. I had exactly the same scenario when I had an asthma attack in the night and found myself without medication. I tried everything to avoid troubling Doctors with a comparitively minor ailment, but in the end NHS Direct insisted on calling an ambulance to take me to the local A&E so I could be given an inhaler by a doctor there. The ambulance crew even asked me to sit in a wheelchair to make the whole timewasting exercise look less silly than it was. As I kept wheezing my apologies for wasting their time, and saying all I needed was an out-of hours GP, they told me not to worry. "We've taken to calling them NHS Divert" said one.

Can't you get someone in on work experience to remember all these things for you?

Hope you're back to well again.

I suppose that you would rather there were no controls on prescriptions Nick.

Firstly the form filling questions ensure they know who they are talking to and, as a medical service, are legally covered for any advice given. They could ignore these and get sued...

Where there is no immediate danger, NHS Direct is a signposting service designed to point people to the appropriate service. Unless I’m mistaken that is what they did in your case, and you decided to ignore this and try to circumvent a system with safeguards designed for both patient and clinician.

Finally if you please to consider how many people, especially those who knew they would be travelling like for example a Â鶹¹ÙÍøÊ×Ò³Èë¿Ú journalist, forget their medication and because of this waste the time and efforts of those who serve us so well. The time they wasted giving you advice you did not follow could have been spent providing a service to those who wish to listen.

NHS Direct help to save lives, you have done them a great disservice by whinging about your refusal to follow their advice.

I heard Darzi peddling the "NHS is the envy of the world" line on the Today programme this morning. John Humphries for once gave this ludicrous claim peddled out by politicians short shrift. It's not, and has not been, for many long years. It is monolithic, bureaucracy-heavy behemoth.

I too suffer from asthma, controlled by tablets, not inhaler. I live in Brussels (no I don't work for the EU), and travel a lot for work, When my tablets were lost with my luggage, it was very simple - and minimal cost - to get said tablets in pharmacies in both Spain and Switzerland to keep me going.

In Belgium, the healthcare system is immeasurably better. Normally i can see my GP within 24 hours, I had access to an MRI scan for a knee injury in 10 days, and for most things i can make my own appointment with a specialist if required - thus not clogging up my GP's time for an obvious referral.

The NHS has become a sacred cow - no one is allowed to change it - yet teh world it was set up to serve has long disappeared.

Separate health finance from health provision, as they do in most of Europe, and you might just see some changes

This is symptomatic of the way things are run under Labour. All discretion has been taken away from staff. We are left with form fillers who abide rigidly by the rules regardless of the exigencies of the situation.

I have been a victim of this mentality in another department and have been left seriously out of pocket because my case didn't fit in with their rule book and discretion is not allowed. Then again if they break their own rules try getting them to acknowledge it or do anything about it. Ignored letters, even having my MP take up my case will not move them. It's frustrating, infuriating and totally unnecessary if they would just trust staff to do their jobs.

The NHS is still run for the benefit of its staff and their bureaucrats. All this nonsense about "caring" - they do a job like anyone else, indeed, so inefficiently that a private company working like that would soon be out of business. The best proof of that is our so-called caring professional GP surgeries, who think it is office hours only! Time to cut this sugary nonsese and run the service for the benefit of its customers - not that any politician would have the courage to say or do this, so we are stuck with the 25th worst service in the 29-member EU.

Who do you want as the next Labour Party leader then ?

Chris C (11) - I think you're being unnecessarily harsh on Nick. To be fair to him he does acknowledge in his posting that he should have had a spare, etc. Guess what? he's human just like the rest of us, and from time to time we all make mistakes or forget something important. That's the reason our society has decided a universal, free at point of delivery, healthcare system is important; to help we poor mortals out when we make such (and much worse) errors of judgement.

I have to say that my experiences of the NHS recently have been very similar to Nick's. Each person I have spoken too has been polite, professional and clearly wants to do a good job, they're just hamstrung by the system the operate within. My wife was recently very ill with a gastric virus. My local out of hours GP service rang back after about an hour, confirmed that I was doing all the right things to ease her symptoms and keep her fluid levels up, but resolutely refused to come out and even see her, let alone administer an anti-emetic. I came within half an hour of driving her to my "local" A&E - read: twenty-five minutes by car if you're lucky and don't even think of trying to get there in under and hour and a half by public transport. NHS Direct were as much use as the proverbial chocolate teapot.

What the NHS needs is some clean sheets of paper on which the health care professionals can mark out the most efficient and best way to deal with their patients. And for the politicians to keep out of their way. I don't want a choice; I want my local point of healthcare, be it my GP, out of hours service or hospital to be clean, efficient and effective.

It is correct that a pharmacist is able to supply your inhaler in an emergency situation.

In this case since the doctors surgery is open and a prescription can be obtained by registering as a temporary resident,I feel the pharmacist acted correctly.

The NHS prescription tax for a Ventolin inhaler is £6.85.The cost to you of an emergency supply which is based on cost of the medicine and outside of NHS arrangements would be considerably less.
The pharmacist is probably used to people trying to circumvent the existing legislation and supply controls in order to save themselves time and money in organising their repeat prescription.

I am sure the pharmacist would have used his professional discretion and made an emergency supply if it was the weekend when the GPs were closed and your wheeze sounded convincing enough.

Here in Shropshire we regularly deal with numerous requests over the weekend in our out-of-hours service - Shropdoc, for forgotten prescriptions. This, among all the genuinely ill patients who call in. Obviously we check that the request is reasonable and then fax a prescription to the most convient chemist. Forget NHS Direct - call your local out-of-hours service

Nick,

Just to repeat because a couple of posters here are giving misleading information. A Pharmacist CAN make an emergency supply/sale of a Prescription Only Medicine - WITHOUT - a Doctors Prescription - provided certain stringent criteria are met to ensure the system is not abused or the patient put at risk. In the case of an inhaler it SHOULD have been easy enough for the Pharmcy you visited to have done this. I have been a qualified Pharmacist since 1983 and have had these issues crop up over the last 24 years, indeed I have myself made an emergency supply of an inhaler to a visitor on holiday when the Doctor was not contactable. The issue is NOTHING to do with which party is in power - it is about people not taking adequate responsibility for their own health (ahem!!) You could have repeated this story every year for the last 25 years and it would have rung true - leave the politics out of it Nick - and make sure you always keep a spare inhaler handy!

I've had much the same experience with an emergency shortage of insulin...

Accidentally smashing my entire supply of ampules of the stuff, I found myself at a local hospital at the diabetes centre, (literally) begging for an emergency supply to last the weekend. I was sent to A&E, who promptly told me that as it wasn't an actual emergency (at least not until I started to actually die from a lack of insulin) to go try the diabetes center I'd just come from! I then tried to use a nearby walk-in center, only to be told that as there was an A&E nearby, I'd have to go there instead...

Eventually (several hours later) I made it home to my local GP who happily signed an emergency prescription and even managed to wrangle up some spare insulin there-and-then.

A weekend away ruined because insulin isn't, apparently, a life-saving drug.

And as for comments from the likes of Chris C (above); if everyone was as 'carefull' as you suggest, you'd be turning away people with broken bones for not being 'carefull' enough not to climb tall objects or cross the street infront of lunatic drivers... its attitudes like yours that define todays NHS.

Hi Nick
I ran short of my inhaler too...Luckily i was on holiday in Portugal. Popped into the pharmacy and was sold one for LESS THAN THE PRICE OF A UK PRESCRIPTION.

Oh for crying out loud, this doesn't have anything to do with any particular leadership, left or right, or anything else; and you people claiming otherwise are part of this very problem! Ken Hall almost nailed it when he complained of a lack of common sense - but the fact is that as this society grows more and more litigious, as the mass media whip up more and more of a frenzy about every little mistake made by anyone with any responsibility - it is entirely predictable that people who, at the end of the day, are not paid to take the risk or responsibility of using personal discretion, will place themselves behind whatever set of rules will shield them from that responsibility most effectively. It doesn't matter who has to make that decision, so long as it isn't them.

Such people are known as jobsworths, and anyone who thinks they've only arrived in the last decade has clearly not read any Douglas Adams recently. (Beware of the leopard.) If anything has changed, it's that the jobsworths run things now - but considering the ever-escalating demand for health provision, budgets that are rising nowhere near as quickly, and the spiralling risk of legal action against health providers for exercising discretion, is it any wonder they've taken over the NHS?

What terrifies me is that society at large appears to be in the grip of a kind of learned helplessness that gives rise to exactly this kind of manifestation - nobody is prepared to take any responsibility for anything, and when someone is brave enough to break that trend the mob tears them to pieces for it. Consider Jeremy Vine's recent admission of impotence in the face of unacceptable violence. A carriageful of people can easily overpower any group of thugs - but one person alone may well end up being killed by them, and the reluctance of anyone to go first means that nobody does anything! Those of us who couldn't care less what anyone else thinks of us will look after ourselves as best we can; those of us who wish to be seen to be "good people" will hide behind whatever pointless procedures, whatever ridiculous rules we can seize upon. Thatcher claimed "there is no such thing as society" - well, if you and I won't even make eye contact, let alone get each other's backs or lend each other a hand when we need to - above all, to recognise that the rules humans make are subordinate to the needs of the person in front of us, and not vice versa - there really is no such thing as society! There's just a maze of regulations for us poor rats to run around, and when we drop dead other rats will scamper over our bodies.

Shh! Don't mention PFI! I mentioned it once but I think I got away with it!

Hi

Your experience is so typical of the NHS - driven by dogma and prodedure and so difficult to use. I fear that the latest round of soundbites by the prime minister will do nothing to change it. The only way to make it customer focused ( like it should be ) is to allocate the money to the patient - then it will finally be responsive

Nick,

any pharmacist should be able to issue an emergency prescription for a 5 day supply or one off inhaler, but may charge a prescription charge when you may not normally pay one, so I am surprized they were not more helpful.

actually tested this out myself at the weekend at an ASDA pharmacy.

Also, at most Gp surgeries, and certainly ours, you could register as a temporary resident to get a presciption issued, where you may get a gentle rebuke for not remembering/having a spare inhaler!

Steve
(GP)

Ok well make no bones about it first, the Conservatives in large want to see a private health care system and we turn into America just as Hilary comes in and wants to turn them into Sweden!

The other argument is that we already have a private healthcare system. If you can pay you jump to the top of the list! This shouldnt be true, but it clearly is. As more people pay to get a scan or an x-ray or what ever all they do is push NHS(paid already with tax) patients further to the bottom. I assume that officially this should not happen as surely there is time for NHS work and time for private work. By all means believe this but it aint true.

Private means extra revenue which the hospitals clearly need and want. So I ask one?

An answer: Pay for all the private capacity in teh uK to serve the NHS and in effect get rid of private all together. Choice is not always a posetive thing in terms of customer care. It's a bit like giving people the freedom to kill, not very wise.

Now we've sorted that pne, we can go in to schools, housing......

Its stupid things like the mess you went through that makes the NHS inefficient, a joke as far as 'patient centered care", and something - as a kidney transplant patient - experience all the time. ANd guess what; its the most basic of nonsense like this that drives us all mad. And yet when you say anything that doesnt conform to their 'systems' the receptionists glare at you; and get on the phone to the police for 'being agressive'!

It is an inconvienience, and danger to the patient / 'customer', and its costs the NHS more money than it needs.

When will the NHS wake up, and think through scenarios such as yours instead of looking at it from the top?

I wrote my politics degree dissertation on healthcare systems in France and the UK. I've experinced both in equal mesures. No where is perfect; but the French arent so pig-headed about sending you in circles for a basic thing like an inhaler.

Just think - you could have had an attack and ended up in A&E, and cost far more.

Well... just don't forget your inhaler when you go to the USA. I spent three hours in ER, most of it alone in a room while the clock ticked and the bill went up, was eventually issued with an inhaler and sent a bill for $200! Ridiculous! Kate

Well... just don't forget your inhaler when you go to the USA. I spent three hours in ER, most of it alone in a room while the clock ticked and the bill went up, was eventually issued with an inhaler and sent a bill for $200! Ridiculous! Kate

I can't believe you did that.

Wealthy people such as yourself should just walk into a private clinic, pay £50. Your time is far more valuable than the cost of waiting for the NHS.

NHS queues are only for the poor.

Nick, your story reminds me of a similar thing that happened to my girlfriend. we were in bristol for the weekend and she had forgotten her inhaler. she was ok for a while but it was getting quite late and she started to feel worse and worse. so we went to a&e getting there about 12. we hadn't been drinking. she was at this point very close to having an attack herself. she asked for an inhaler and was told she would have to wait four hours. i asked what if she had an asthma attack (by now a serious concern) in the waiting room? The doctors replied: "We will resuscitate her". I unsurprisingly flipped my lid. "Why can't you walk down the corridor get her an inhaler right now and ensure that this doesn't happen." Targets and requirements was the response. frankly the world has gone mad. i also think doctors have become pathetic. why they don't show a bit of backbone in these clearly medically important situations is beyond me. if anybody else waiting in the department had complained i am sure they would have understood if it had been explained to them. we sat for four hours in a&e until she was seen. luckily there was no asthma attack. ironically she is a doctor herself!

It seems that the government is now blamed for every failure, inefficiency or personal problem. Politicians are rarely the direct cause and it is time that the professionals start to take responsibility for letting this mess develop. They seem to just stand back and wait for things to go wrong and then pretend they had better ideas all along. How often do we hear about the 'nanny state', immediately followed by demands that the government 'do something about it'.

It was good to see that Nick accepted some personal responsibility for his oversight. If only health officials would stop politicizing the NHS and ensure that they provide the joined up processes that they are paid for, life would be easier for everyone.

re-reading this thread, it seems that a lot of trouble would have been saved if you had contacted the emergency OOH GP service (Not A and E) as advised right at the onset- you would have seen a GP, which is appropriate for deteriorating asthma in the middle of the night, and had treatment including (but not neccesarily limited to) a new inhaler. All the comments bemoaning how terrible the service now is seem to have missed this point. There WAS a GP available OOH.

The reasons pharamcists cant simply hand out prescriptions is not a petty rulem, it is to prevent the real risk of harm from incorrect treatment. In asthma a particular risk would be merely giving an inhaler to someone who needed more than just that.

Finally - it sounds like you need a review of your asthma prevention treatment if you are getting so wheezy in the night - I'd book in with your GP

I am also asthmatic and have on more than one occasion found myself without an inhaler. Each time I have simply popped into the local NHS drop-in centre and they have found one for me - no form filling or lengthy waits required! My general experience of the NHS had been 90% positive, but nobody wants to hear about that...

As an NHS school nurse specialising in asthma I must castigate you severely, Mr Robinson. If your asthma is so severe that you need a replacement SO urgently, why do you only have the one? Every asthmatic I deal with has several. They also tend to run out without much warning so they are prepared for that. Come on, Mr Robinson! You have berated the "blame all" culture many times. This was YOUR inefficiency and the NHS is NOT to blame. Do you REALLY want it to be so easy to get medicines that ANYONE can walk into any pharmacy or GP surgery and get what they demand? Cost is one consideration (50% of meds are wasted) but what about nefarious use of such meds? I recommend that my patients ask their GP for a prescription for at least 3 inhalers; keep one on your person, one somewhere convenient like your briefcase or car and the other at home. Diabetics don't "find themselves without their insulin". If this medication is THAT important to you, you would be more conscientious. Make an appointment with the asthma nurse at your surgery forthwith!

Hi Nick

I think your incident is part of a much wider problem within the NHS that has become so full of policy and procedure to protect the practitioners, that it no longer matters if the needs of the patients are met.

In the past 5 months, whilst nursing our 68 year old diabetic father, my family have been exposed to the very best and worst of the NHS ‘system’. It has taken all our wit and wisdom to wade through the sea of bureaucratic depts, most of whom didn’t want to take responsibility to help or liaise with other practitioners, which ultimately led to his right leg being amputated last week.

If or when you finally get past the automated telephone answering machines, the autocratic, gate keeping, policy and procedure making administrators, you will actually find the cream of the NHS. A dedicated team of professional, well trained, experienced and, most of all, kind staff who struggle to provide the best possible care with ever decreasing resources.

It seems to me that as long as we all tick the right boxes in the quality control questionnaires to fulfil the justification for the processes, the NHS will only be a success on paper not practice.

P.S. Happy Birthday!

I had a similar problem last year. I ended up having to go to the emergency department at the hospital to get treatment and a prescription.
I do not know why we cannot just buy the inhalers over the counter. When I go abroad I dont take any as I can easily get them there no problem and for the fantastic price of 3 euros. Just shows how much the NHS a la Gordon Brown and every predecessor is ripping us off and not just for medication!!!! Why bother paying NICS if we have to pay on top of that.

Nick,

As a fellow asthmatic I sympathise - and, like you and thousands of others no doubt in similar situations I've just assumed that the battle is too much and wheezed my way through the day.

But your experience of the NHS is absolutely right. Good people working in the NHS, with every intention to assist, can't because the system exists to manage patients, not treat them. It is a system that regards your visit as an 'episode', not an opportunity to treat you and make you better. A symptom of that is the obsession with compiling statistics on processes and the processing of patients (length of patient stay in hospital, waiting times etc.) which, while an element of the experience of medical care, is not a measurement of care itself.

It's as if on taking your car to a garage for an MOT you were promised that it would be seen within 24 hours, that a document would be produced within 36, and that the car would be given a free car wash....but at no point is there a promise that your car's problems will be comprehensively identified and fixed.

You will remember that Mr Blair was, at the last election, flummoxed by a member of public telling him of the absurd 'notify us in advance if your going to be ill or turn up on the day if it's an emergency' system GPs are now using to meet their targets. That's a consequence of the fond belief that the NHS is 'managed for care delivery' and not just managed for the sake of form (and forms!)

Real healthcare would start being patient centred by looking at how to achieve outcomes for the patient, not outcomes for the government. So, of course, we are stuck with the NHS we have.

Welcome to my world! i am a severe asthmatic and am extremely careful about ensuring I have the relevant inhalers at all times. The doctors though object to me having a spare (even though without it I would end up in hospital) although I have wangled one by deception.
On the odd occassion where I have run out, the only way I can get a new one is to go to an A&E department and wait. My doctor requires 48 hours to fill a prescription, and is never open when I am not working. They have now restricted the hours that I can phone for a prescription also. Its getting more and more difficult - answer? Never get ill!!

I found myself in exactly the same (stupid)situation last week but had a lot more joy.

A very helpful colleague made a phone call to a local pharmacy who said they could do an emergency prescription for me.

I arrived, had to sign a book, pay a fiver and then I could breathe normally again.

I thought the service was fab! Maybe it depends on the area?

This reminds me of the situation i was in having asthma at primary school. not being thought as grown up enough to take my inhaler when i needed it. It had to stay in the school nurses office, meaning during a breaktime of running around and then needing my inhaler i would have to wonder the school looking for the nurse who would then determine if i need my inhaler or not by which time i would be very sort of breath and wheesy. my mum on hearing about this gave me a spare one and told me not to tell the teachers!

Philip, writing at 'number 7' is the only correspondent here giving the correct picture on this situation. He is spot on - it's nothing to do with politics or policy, in these circumstances any community pharmacy is legally able to supply Nick with a salbutamol MDI (metered dose inhaler,at Nick's own cost. I'm also pretty sure that a huge majority of my colleagues in community pharmacy, aware of their ethical obligation, would have helped Nick. He really was unlucky in his choice of pharmacy - most pharmacies in 'holiday hotspots' receive and tackle similar requests every week, if not almost every day - I certainly do. A GP's 'temporary resident' prescription is a better solution (and quite possibly less expensive) and may be requird for certain classes of medicine. We really are here to help and I'm sure I speak for the majority of Pharmacists when I say "Sorry Nick. that shouldn't have happened to you."
Idris

Dear Nick,

I am sorry to hear of your difficulties in getting a new inhaler.

With your busy life , you couldn't possibly request a repeat prescription before your inhaler ran out.

No doubt you need your sleep so attending your local out of hours provider to pick up a prescription, for the next day, is out of the question.

When you are ready to see a GP, they " claim " to be busy eg seeing patients, so cant see you until 3 pm !! Why arent they available at a time you want, after all you are just one of the thousands of patients on their list.

As for your experience with NHS direct, it doesnt sound very patient centred when you know exactly what you want and they ask you lots of questions , probably to exclude other medical problems.

Write to GB and ask him to invite you to his next citizen's jury on the NHS and make sure political correspondents are never treated in this way again !!

Poor you. Had a worse experience when in the UK 2 years ago on a rushed visit due to family illness.

My ventolin inhaler developed a fault, having forgotten my nebuliser..had the nebules!! It was nigh on impossible to obtain neither a replacement inhaler or hire a nebuliser. Six/eight surgeries were not prepared to issue me a prescription or were too busy to issue an appointment that day to obtain that said script.. Furthermore, no chemist was prepared to examine my letter from the asthma specialist outlining the chronic asthma.
In Australia one can freely purchase Ventolin inhalers over the counter and hire nebulisers.
After 2 debilitating days of trying all alternatives was told to attend the nearest A&E.
This then entailed 4 days hospitalisation for oxygen and stabilisation and a massive increase of the daily steroids.
Whilst I am English, this was an unnecessary charge on NHS and could not be reclaimed from my travel insurance. All could of been avoided by one inhaler or nebuliser.

I am afraid I have little sympathy for you or for your other correspondents who decry the NHS on the basis of your experience. You screwed up by forgetting your inhaler, so why should you expect a publicly-funded service to leap into action to rectify your mistake? In extremis, the NHS is flexible, responsive and outrageously wonderful (and I refer here not only to my acute appendicitis last week, but also to the care given to my mother, who died of cancer earlier this year); for routine health problems, patients are expected to accommodate themselves to the system. I cannot see why this should provide cause for complaint.

I hope you have now managed to obtain an inhaler - and that you will never again forget to pack a spare when you go away!

Poor you. Had a worse experience when in the UK 2 years ago on a rushed visit due to family illness.

My ventolin inhaler developed a fault, having forgotten my nebuliser..had the nebules!! It was nigh on impossible to obtain neither a replacement inhaler or hire a nebuliser. Six/eight surgeries were not prepared to issue me a prescription or were too busy to issue an appointment that day to obtain that said script.. Furthermore, no chemist was prepared to examine my letter from the asthma specialist outlining the chronic asthma.
In Australia one can freely purchase Ventolin inhalers over the counter and hire nebulisers.
After 2 debilitating days of trying all alternatives was told to attend the nearest A&E.
This then entailed 4 days hospitalisation for oxygen and stabilisation and a massive increase of the daily steroids.
Whilst I am English, this was an unnecessary charge on NHS and could not be reclaimed from my travel insurance. All could of been avoided by one inhaler or nebuliser.

My wife is an asthmatic and had the same problem. We went to the local chemist in the seaside town we were visiting and the chemist issued an inhaler, which we paid for. Perhaps Devon chemists have a more enlightened approach.

I am sorry to hear about your troubles and hope you are better now.

The following is not meant as an excuse for what happened to you, but simply an attempt to show you how it looks from the other side.

I am singlehanded GP in the rural north of Scotland. In the summer months my practice is swamped by tourists who have run out of/lost/forgotten this or that of their often long lists of repeat medication.

By far the most of these requests are perfectly genuine, but some are not. And even the most genuine requests are often based on misunderstandings (one-off prescriptions by own GP thought to be repeats) or need some explaining - after all it is my name on the prescription, so if you get things wrong, I am in trouble.

My receptionists are therefore under strict orders to get people in via an appointment, prescriptions are not issued over the counter.

If it is urgent (i.e. you are sick right now) I will see you right away, if it is simply to fill up stock, it will be later in the day. Sometimes quite a bit later. Other people have a right to be seen too.

The potential for abuse of a Salbutamol inhalers is obviously zilch, but my receptionists are not in a position to know that and unless you tell them you are ill (or are visibly ill) they would tell you you need to be seen by myself in the next available appointment - whether this is in 5 min or later this afternoon, whatever is available.

Once I see you and you tell me/show me whatever you require, then I will make up my mind whether it is safe enough to issue without knowing much about you (showing me your empty inhaler would probably be sufficient) or whether it is necessary to try and speak with your own practice.

Again - to stress this - if you are ill, this is different, but if you simply want some fill-up, you might have to wait further while I will try and speak to your own GP to confirm the medication.

Some might find my approach overcautious and tedious, but many people are on a cocktail of drugs, modern drugs are often very powerful and can do just as much damage as good. Prescribing wrongly in a hurry simply in order to be nice and helpful can end in a catastrophe. I'd rather not and I guess you not either.

I am afraid I have little sympathy for you or for your other correspondents who decry the NHS on the basis of your experience. You screwed up by forgetting your inhaler, so why should you expect a publicly-funded service to leap into action to rectify your mistake? In extremis, the NHS is flexible, responsive and outrageously wonderful (and I refer here not only to my acute appendicitis last week, but also to the care given to my mother, who died of cancer earlier this year); for routine health problems, patients are expected to accommodate themselves to the system. I cannot see why this should provide cause for complaint.

I hope you have now managed to obtain an inhaler - and that you will never again forget to pack a spare when you go away!

I can definately say, having experienced the NHS many times that there is a lack of putting the patient first in many places.

I've dealt with the local practice manager who cannot get me a prescription that day when I've run out of medicine in error. I know it's my responsibility to make sure I run out, but sometimes it happens and I don't need to be treated like an imbicile, but switftly and efficiently helped.

I've also dealt with NHS ward nurses who have been lovely and nice people, but where my 88 year old granmother, who they were caring for, lost 1 stone in weight in 6 weeks under their direct care.

My local NHS practice shuts on a Wednesday afternoon. I cannot order prescriptions, or even phone them to make appointments then ???

The NHS needs to consider itself as a service industry and put it's clients at the foremost of everything it does.

Roy.

After nearly four years of not feeling well, and becoming very thin indeed, my sister in America was able to get to the doctor thanks to the generosity of a sibling. It was found that she had trichinosis, an amoebic parasite and oseoporosis. She worked in theatre on short term contracts and was unable to afford health insurance.
I came to Britain in 1961 and married an Englishman, and became British. That would not have happened here, guys. Our Health Service has its problems, but it is UTTERLY wonderful compared to the USA, where 50 MILLION people do not have health insurance, and hence have very little medical care.

I lost my inhaler on a trip to Leeds recently and became quite wheezy over the course of the morning. I went into a city centre pharmacy and asked what they could do to help. They ended up ringing my GP surgery and after a talk with the receptionist (who confirmed that I have an inhaler on repeat prescription) and the doctor they issued me one there and then.
I had assumed that this was general practice but obviously not - mind you, I guess that inhalers are not open to the kind of 'abuse' that other drugs could be.

Hey Nick,
I completely sympathise but next time get yourself down to A+E i've been in exactly the same situation myself, and it is a nightmare...yeah ok we should all carry a spare but if you are scatty and a bit disorganised like me it can just slip you by. The only draw back of heading down the the A+E is that they may try and admit you until you are well enough to leave, which takes about 10 minutes and a cup of tea for me usually, but they like to observe you for a couple of hours and you have to sign a form to try an leave.
Failing A+E which I have only ever used once as a last resort, try and get friendly with your local chemist, they'll still do the 'I'll just get the doctor to sign this for you' thing, they get stoppy about it but if you are persistent it works. They'll huff for a minute about your lack of organisation but at least you won't run out of puff in the long run.

Maybe the procedures are in place, and rigidly followed, not out of government red tape or a lack of care towards Nick in this case, or patients in general. Maybe, it's because if you went in to a chemist demanding a prescription medication that you couldn't provide a prescription for, and the pharmacist, not being a doctor, provided the wrong medication, you'd be straight back in there with a lawyer and a claim for damages. Or, you'd be dead. Either way a bad outcome for the NHS. However, I do think out of hours access to GPs is dreadful and needs to be addressed.

I was in a similar situation to Nick's last week. I am a Type 1 diabetic and realised early in the morning that my injection pen that I give myself my insulin with was missing (probably fell out of my bag the night before). To those who say that it was Nick's fault for losing his inhaler: it happens, just like losing your keys or wallet. No matter how careful you are, as I am with my injection pen, if you have a chronic illness, chances are you'll misplace your medication at some point because of how often you use it.This was the only time I've ever lost my injection pen. Anyway, unsure of where to get a pen from so early in the morning (and having recently moved flat, unsure of where my local hospital was) I rang NHS direct, who told me I needed the out-of-hours number, and when I called that, it bounced back to NHS direct. Having explained exactly what my problem was, they asked me all the questions about whether I was having a heart attack, though it was urgent I got some insulin into me! They then asked if I wanted to be put on hold to speak to a nurse, not really appreciating that time was of the essence. My A+E was 25mins away by bus, and then I saw a nurse to get some insulin another 25mins or so later. OK, apart from the NHS direct kerfuffle, not too bad. But I still needed a pen. So I see a doctor for a prescription, put it in at the pharmacy, am told I have to wait 45mins, and I do... only to be told they don't have any and I'll have to go to the diabetic centre upstairs. I explain to the receptionists my situation, who fret for 20mins about me not being registered there before finally seeing a doctor who hands me 2 pens. So it took over 2 hours from start to finish to get not even medication but rather something which allows me to medicate myself! It'd be useless to someone who didn't have the relevant stuff. I can appreciate what Nick's saying - though I got what I needed in the end,it wasn't made easy for me - and there was no real sense of urgency shown.

I have severe asthma, and I have always been told by my doctor that if I were ever to be wheezy and my inhaler had run out, I should go to any pharmacy and they will be able to provide me with an emergency one (at full cost) and a small rebuke. I have tested this, and the pharmacists have always called my GP's surgery to check that I am asthmatic, and then given me an inhaler. I think that if you had persisted a little, the pharmacist probably would have given you an inhaler.

NHS direct, on the other hand, does not recognise medical emergencies as such and will always ask you to waste precious time (and breath)with useless questions. Once they have their survey answers, they will always always advise you to contact an "out-of-hours doctor". Very useful. Especially seeing as there aren't any out-of-hours doctors in many towns, and therefore to go and see one would take up even more previous time and breath that a severe asthmatic just wouldn't have.

I agree Nick. I've had exactly that experience. And in the past I've been able to get a pharmacist to give me a puff of Ventolin. So now I have half a dozen.

If you do try and get a spare inhaler, don't be surprised if you run up against the "No more than 30 days' supply at once " rule, thereby preventing anyone from building up a stock quickly.

By the way, have you noticed that the inhalers have been reduced in size to make sure that they only last for 30 days. Another winner for the taxpayer I don't think!

I had a similar experience with an inhaler in the lake district 5-6 years ago with exactly the opposite result. The pharmacist was able to provide me with an emergency supply which they are able to do with almost any drug. I have also been provided with 36 hours supply of antibiotics enough to last until an appointment with a doctor. In this case the minimum quantity is one inhaler thus the emergency supply has to equal the whole prescription, I think you should have tried another pharmacy!

Nick,
If you had appeared to be in sufficient trouble you would have got help, one way or another.
You cannot expect people to run around, in such circumstances, after those who don't take sufficient care in looking after themselves.
This is an example of unrealistic expectations and the nonsense the NHS personnel have to tolerate as calmly as possible in between dealing with the really ill.