A Moral Dilemma…….

19 Sep

‘I have a lot of personal experience of the National Health Service and it hasn’t all been good. Anecdotally, it’s a story I’ve heard a lot. So, my dilemma is whether to get involved……’

I have been asked to take part in an outreach program. I spent three days training based largely around Power-Point presentations highlighting the blatantly obvious repeatedly (whoever invented Power-Point should be hung, drawn and quartered). However, it contained the usual health basics: care plans, care pathways, community based treatment, access to other support services, expectations of standards of treatment and its availability. Boring though a lot of it was, it’s the practicalities that cause me to be hesitant……

These projects are meant in good faith but it is in the practical application where the ­­­reality differs from the ideal. The particular group we are discussing are vulnerable, often in unsecure housing, have complex and long term mental health needs, family breakdowns and challenging personalities etc. In my own experience once you have been referred, you’re on your own. Navigating ‘the system’ is hard enough when a person doesn’t have issues. Should you have a chaotic lifestyle appointments may be missed and you may find yourself being discharged and having to go back to the referral stage. The purpose of the project is to engage clients with the process and help them through it……

As an outreach or key worker I would give my complete dedication to my client but from personal experience I know that I will inevitably come across a situation where communication breaks down, usually due to ‘administrative’ errors. Again, from personal experience nobody ever accepts any responsibility or makes very little effort to rectify their mistake. If you are trying to smooth the journey for your client conflict can therefore arise. First, between you and the person responsible for the mistake; second, between you and your client who may already have a tendency to procrastinate and has little faith in the service you offer based on their own past experiences. This could potentially lead to someone dissociating with the service and failing to get a treatable, life threatening disease cured. This could also lead to someone who is symptom free leaving their treatment until it becomes symptomatic, at which point it can be harder to treat and serious irreversible damage can be caused……

At the moment the door is still open but I have expressed my concerns. There are other issues regarding the cost of treatment and a lottery as to which treatment you will be offered. When there exists a treatment with a 95% success rate as opposed to one with a 60-65% success rate which one would you want…?

I’m still contemplating whether I can get involved because at some point I am bound to have a disagreement with a healthcare worker or their administrators. My empathy is telling me I could make a difference; my experience will lead to sleepless nights……

‘What would you do…..? I’d be interested in your thoughts on the subject…..’



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