Martin is right it isn't free, we pay for it. The funding deficit that is talked about is not actually a deficit at all, that would imply they have identified the amount of funds required and based the "budget" on need. They haven't. They are applying a funding cap on the NHS based on a value judgement. Free at the point of use is quite different to free. How much of the public coffers is being wasted on the current referendum? How much money was spent designing and implementing "universal credit", and for what benefit really? They need to consider their spending priorities before we all conclude we should pay for the NHS, including increasing taxes.
I'll say no more about money because actually I think there's a far more fundamental issue at hand than cost. As a relative newbie to this ongoing condition lark I've been disgusted at the level of care in a number of areas. My current GP is OK aside from a Stazi like quality to their communications but they know little to nothing about the reality of diabetes, but then nor does my consultant, evidenced by his glib interjections of "oh just relax the control between 10am and 12 noon" as if I just press a button and my body will behave. I get that though, I understand why those without diabetes see it in black and white. I was one of those "without" people not too long ago and I had no idea what the reality was like. So we should tell them, no holding back, tell the hell out it, from the rooftops if needed. Not very British I know but empathy only happens if we share. I think Deus is right, there is something very wrong with diabetes treatment, specifically the treatment of type 2 and I'm sorry to say it but I think it comes from a value judgement. In some way type 2 has morphed into something we accept and are used to, something we don't really invest in treating with the respect it deserves. You only have to look at the level of amputations to know this isn't working. Foot checks are all very well and good, but only if they do something with the data. At my foot check this year I had a quite horrendous blister, it was dressed but still weeping quite obviously, I pointed it out so as to avoid some poor unfortunate technician interacting with it. Not a raised eyebrow or a "what's that" or "you should get that looked at", and I got poo pooed when I rang the doctors surgery about it because despite being a blister pro it worried me because it was mighty deep. That's not care, that's tick boxes and a total lack of understanding about the danger. It needs fixing. Train doctors and nurses about the reality, I'd offer my services to train them in the reality of my "new" life and I'm sure there are many of us who would. Then educate everyone about how serious diabetes can be, never mind this not wanting to scare people nonsense, tell the truth. Inform the CCGs that they're not the Stazi and shouldn't pretend to be, they should manage doctors prescribing behaviour by exception not rule. If there are doctors prescribing something too readily identify them, retrain them, talk to them, don't introduce blanket measures. as for endocrinologists I'd say a referral when standard treatments aren't working is a sensible idea. For the majority the core treatments will do the trick, but for who aren't so lucky more expertise is needed. Finally ban the hba1c for anything other than diagnosis and a safety check, it's massively over used as a treatment evaluation and massively flawed. Treatment is as much about ensuring a quality of life as it is about maintaining a HBA1c. When mine was 39 I was practically suicidal, there said it, not very British but completely true. Investigation into why I was just about ready to pack in life was hampered by that hba1c not helped. We need to empower doctors whatever their level to stop, listen and think, not see a number, tick a box and feel totally justified in dismissing the patients concern because their risk of long term complications is fine.
