Getting good or even acceptable service from the NHS is a bit of a lottery. Since becoming a permanent customer of the NHS earlier this year I’ve been astounded by just how bad some healthcare workers can and how badly managed NHS services are. I’ve also been extremely pleasantly surprised about how good some of them can be as well. The problem is that I’m finding that whether or not I get a good practitioner or a crap one is a bit of a lottery.

I have a truly excellent and knowledgable personal diabetes nurse who has helped me get my blood sugar down from one of the highest she’d seen to something approaching normal. The treatment I got for a foot infection acquired by way of wearing steel reinforced boots during many hours walking around Tel Aviv and Jerusalem was professional and caring. However other aspects of the NHS such as phlebotomy and dietician services have been less than stunning.

With the dietician I was disgusted at the lack of depth of dietary knowledge that she had. There was little in what she said that could not be found in a competently written book or from a credible US website such as that of the Mayo Clinic on the subject of diabetic diet. It was a waste of time and a waste of money on the expensive parking charge at the hospital. Pertinent information about my lifestyle and which is known to my GP surgery such as the fact that I follow a Kosher diet that is mostly vegetarian (due to the cost and availability where I am of Kosher meat) seemed to have not been passed onto the dietitian. She certainly seemed a little confused when I brought the subject up.

But it is the phlebotomy services that have let me down the most. Since January of this year I have seen five different phlebotomists or nurses acting as phlebotomists and only one of them has been what I could call good. My medical records clearly state that due to an unfortunate incident decades ago where I fainted after a blood draw, I have a fear of needles that requires the blood taker to realise that my veins retreat at the sight of a needle and to allow me calming time. It might not sound much to some people but it is a problem for me. The first one had so few customer service skills that she reminded me of the sort of person who would have been appointed to serve customers in a bread shop in the old Soviet Union, a place with so little business competition that things like customer service skills were not needed. She refused to listen to me nor make more than one attempt to get blood. The next phlebotomist was absolutely fine and chatted away to distract me and got the blood out with no problem at all.

Last week and the week before I had to see a different phlebotomist who had an unbelievably shit attitude. There was no decent greeting just ‘sit down there’. When I explained I’d rather lie down she reluctantly let me do so but terminated the appointment when I told her of the fainting problem. She then made another appointment for me the following week. I accepted this in the hope that I’d win on the NHS lottery and not get this individual next time. Unfortunately I lost this lottery and this individual was there again. Again I had the cold attitude that marked this person out as probably better suited to a part of the medical profession where talking to patients is considered as unnecessary, such as mortuary work. Also again was the apparent failure to properly read medical records and the nurse made a half hearted attempt to get blood out, failed to do so and then blamed the failure on the fact that I drink coffee.

I’ve now come to the conclusion that I will no longer play the NHS lottery when it comes to blood draws and my quarterly HB1AC glucose tests and instead pay the £200 per year it would cost me to do the tests at home and get a private lab to analyse them. Yes it’s expensive and yes I will have to forgo something else in order to pay for it, but I’m fed up with turning up at the surgery and wondering will I get someone decent who is competent and who I have confidence in or will I get someone who should really be confined to sticking needles in cloth rather than people.

As regards the foot infection this ended up considerably worse than it should have been. This was because there was a one week delay in being prescribed antibiotics that occurred because the receptionist refused to make me a GP or a prescribing nurse appointment unless I used the surgery’s app, an app that has been woefully bad for others who I have known who have used it. I tried to treat the foot infection myself by putting antiseptic cream on it but to no avail. I eventually had to hobble down to the surgery. I presented myself, after a week of increasing bipedal decrepitude, at the exterior window which is the only way of speaking to the receptionist due to building work only to be told no you can’t make an appointment or amend an appointment in person as the computer is on the other side of the room. I then had to phone the surgery standing outside the building and tell the receptionist the same bloody info I’d given her through the window five minutes earlier. After a week’s delay since the infection started I quickly saw a nurse who said ‘oh look a foot infection here’s some antibiotics’. I was then given an emergency podiatry appointment at the local hospital where the staff were excellent.

My experience has shown me the horrendous inconsistency of NHS treatment and organisation. Yes some of my moans may seem to some to be minor especially when set against the deaths or disablement of mothers and babies in NHS maternity units, 63% of which are considered by the Care Quality Commission to be ‘unsafe’, but I’m not the only one who is being short-changed on basic medicine. There must be millions like me who have to play the NHS lottery and wonder whether they will get a healthcare worker who is someone competent, caring and who the patient can have confidence in, or someone who might not be best suited for any part of the medical profession. Stuff like blood tests and dietary advice provision are not rocket engineering, the NHS should be able to provide a very good standard of these basics, but they don’t. If they can’t get the basics correct then it’s certainly not a service that is the ‘envy of the world’.