Hope is the feeling we have that the feeling we have is not permanent.

But what if the feeling we have is permanent? I have a knee condition called Chondromalatia Patallae brought on from over training for a marathon in September last year.  Doesn't sound exciting, doesn't even look exciting. In fact there's bugger all to see except a knee. There are worse things at sea I know but it is frustrating as any kind of activity be it standing, walking, swimming, jumping or sitting, becomes acutely painful. It feels like an internal Imp has been living in my shin and  has decided to jab me every once in a while in an incensed spirit of revenge for perceived mistreatment for which I truly hold no responsibility. He's armed to the fang and very, very bitter. 

(I cribbed most of the last two sentences from my last doctor's case notes by the way. He advocated boiled sheep's head as a tonic). 

Does visibility lie at the heart of generating sympathy? I have to say my experience of the NHS treatment of this deeply painful problem has been woeful. One of the great statistics of the NHS that is used regularly is that approval rates among people who never use it are very low but are extremely high for people who do use it. Well, I know some doctors, I know how hard they work. In the past I have been greatly impressed by the extent of healthcare options available to me on other medical problems I've had. I used to agree with that. I still believe that universal healthcare is just and the mark of a healthy democratic society.

Systemically mismanaged for decades, I greatly applaud the decision by the Coalition government to devolve NHS budgetary decision making to those who know best: the people who treat the sick. Anyone who says the Department of Health knows better is fooling themselves. I briefly worked in the DoH for 6 months and the lights quite literally go out at 5 o'clock. They can't wait to get out of the door. This was my first experience of the Civil Service in action and it was both alarming and depressing (I've blogged elsewhere about the dedication and professionalism of other Civil Service colleagues and departments so I don't feel too stool pigeony in saying that). Overall administration, yes. Localised decision making requiring localised expertise, no. 

So does visibility count? My view is the NHS is great at critical injuries when you are knocking on death's door, and not so good at chronic and long term problems. Others may have a different experience. In my last encounter with the NHS before I left for Polska I did feel let down at the poor service at the London Whitechapel Hospital. Currently undergoing a refit, this Victorian hospital had one X ray machine in operation to service hundreds of patients. After waiting for three and a half hours, surrounded by patients on trolleys in row upon row begging passing staff for pain relief and patients verbally abusing the poor reception staff, I did feel like I had stepped back to the NHS of the 1980s.

I finally got an X ray and a two minute examination by a specialist who told me he didn't know what the problem was and to come back in two months. Case folder closed, eyes switched off and the door shut in my face. Not a great return on an afternoon off from work. I had to then go through a private specialist and private physiotherapy to get anywhere close to a rehabilitative programme, which was expensive I can tell you.

If I had the purse strings I would try, if possible, to allocate more spending on long term debilitating injuries and problems. I really feel we need better modelling on the societal effects of the lack of treatemtn of these conditions. In particular I would start by further extending Cognitive Behavioural Therapy for people with mental health issues. (I will write about CBT and Neuro-Linguistic Programming in depth on other occasions as it is an interest of mine).  

So last Friday I was off to the Carolina Medical Centre on Ul. Pory 78 to get an MRI scan for the next stage of working out exactly what process to use to treat my knee.  The extra cost of private healthcare here seems to have been spent on a battalion of surly receptionists but the surgeon was superb.  During the wait I was entranced by the Polish volleyball team thrashing it out on a nearby plasma screen. If you are ever stuck in a Doctor's waiting room then I can thoroughly recommend women's volleyball. The surgeon was excellent and I get my MRI scan, at a cost well below the equivalent for private healthcare in the UK, this coming Friday. It's on a knee-d to know basis but I'll be sure to shin-e a light on the condition for you as soon as I can, dear reader.

And if they do find that Imp in my shin, I shall remove the little bugger myself with a rusty spoon. Now that’s personal healthcare!