Wednesday 14 November 2012

How to make a fuss

At an antenatal appointment this week I was ushered into a room before my main appointment so my urine and blood pressure could be tested. The room, a side room off the waiting room, would be private if only they'd shut the door. And, of course, if they hadn't tried to do my tests in the same room at the same time as they were testing someone else. I made a fuss of course, I am good at that. "It's not our normal practice" they told me. "Then why are you doing it now?" I asked. So they waited, not, I think, because they thought I was being reasonable, but because I was making a fuss. Or as I think of it, making a fuss. The reason? As I explained to them, it's no good for patient confidentiality, mine or the other patient's, if they discover something wrong with one of our tests.

But I have a particular interest in/chip on my shoulder about this issue that stems back to the early weeks of my daughter's life. In the area in which we live, due to high density housing, a large number of immigrants and poverty, all newborns are offered a BCG injection to protect against turberculosis. I was in two minds whether to have this for my daughter, largely because of the associated swelling and scarring and not wanting my beautiful newborn's perfect skin to be sullied in this way, but a belief in herd immunity won out and we duly went to our appointment.

If you are not the kind of person who believes that environment affects behaviour you have probably never been to this particular health centre in Tottenham, North London, where the TB jabs in our area are offered, I used to be a patient at the GP practice there but found it so demoralising I left very quickly. Once I rang over fifty times before getting through to a receptionist. Upon telling the GP I finally saw about this he agreed,saying he'd had the same problem one day when trying to call in sick. Unlike my current GP where you get what you want by being nice to the receptionists, there I found you only got acknowledged by being as arsey as possible.

Anyway the appointment started badly when everyone there for this injection was asked to fill out a form about their baby including whether they are HIV positive. I understand of course that medical professionals need to know the answer to this, but the forms were being collated on the counter where any other patient walking by could see them. This would not only impinge on my daughter's confidentiality if the answer were yes, but on my own too. On principle I objected.

We were then escorted into a room with another parent and baby. "Are you intending to do both of these children in this room one after the other?" I asked. They said yes. What did I do? That's right, I made a fuss. It wasn't going to happen, I explained, for two reasons. First, I did not want my child, or the other child, to get upset by the post injection screams of the child who went first. But also because it was possible that I, or the other mother, might have medical questions or issues to ask that should be kept confidential. Not just HIV which was clearly on the agenda as a question, but anything else too. "You'll have to wait here in the corridor then," they told me. Which I did. But I was fuming. What they were trying to do as a time saving measure ignored some of the basic tenets of healthcare that we expect our modern health service to offer.

It reminded me, in those early days, that I was not only my own health advocate, but my daughter's, and that just because she was a baby did not mean she didn't also have the right to respect, dignity and privacy as a patient. What's more, that there are times when she will only get that by making a fuss, something I am proving very adept at teaching her.

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