No, I DON'T Want a Smear

I don't have smears, or any other screening test, for many reasons, including those outlined by Margaret McCartney in her excellent article here and further explained in her blog here. I have a very different view about health to that of most people, I don't lecture others about them, and because I work in health I am careful to toe the party line if I am asked about things like this by patients.

But when the NHS is in the mess it is in, does it REALLY need to keep sending me invitations to have a smear? Especially when I have sent a well-reasoned and considered letter to my GP explaining why I will never have a smear unless I have worrying symptoms, and absolving them of any responsibility for a bad outcome of that decision? In the 8 years since that letter, I have continued to receive four invitations a year.

Every year I also have to go for a health check because I have asthma. I am a physotherapist. I am quite capable of doing my own peak flow measurement if I thought it was of any use. I know how to diaphragmatically breathe, how to take my inhalers, and I can even do Buteyko techniques if I ever had the motivation to. As it happens, I was (shamefully) using my inhaler incorrectly. Was it found on my health check? AS IF! It was the pharmacist who found out on an impromptu check when the pharmacy was quiet. THAT didn't cost the NHS anything, or waste anyone's time.

I have to have my thyroxine level tested yearly. WHY? I asked the GP, 'is my thyroid going to regrow and start working?' Of course, the answer was 'no'. So why do I have to have the tests? Because it is 'best practice' when you are taking thyroxine. Erm, no, it's a pointless waste of my time, the time of whoever has to take the blood, whoever has to process it, and the money involved.

All small amounts. But add them up, across an entire population, and that's a hell of a lot of money wasted. All because GPs get incentives for screening and health checks. What a pile of bollocks.

All it would take is an easy way for people to opt out of tests. Not for them to forget to go, but for them to actively opt out. Then GPs wouldn't lose their bonus, and money wouldn't be wasted.

Actually, I think there is an argument to be made for taking all of the 'cheaper' screening out of the NHS, but that is another blog post. But I am an adult (age-wise at least!), I know my own mind, and I am perfectly capable of deciding I don't want these checks. Whatever happened to 'listening to the patient' and 'the professional/patient partnership'? It doesn't exist when it comes to screening tests and checks. WHY?

On the same day that I was having my stupid yearly health check (which I attend because otherwise the GP practice manager says they will refuse to give me prescriptions), someone put on Facebook how they couldn't get an appointment for their sick child AT THAT PRACTICE.

If the NHS had spare capacity, fair enough. It doesn't. If no-one has the guts to take the decisions necessary to ration healthcare, at least let people opt out of 'preventative healthcare' if we want to!