英国全科医生诊所员工面临虐待和“需求海啸”
2021-05-31 jiangye111 6980
正文翻译
Staff at UK GP surgeries facing abuse and ‘tsunami of demand’
- emergency summit reveals deep crisis with serious impact on mental heath of doctors, dentists and staff

英国全科医生诊所员工面临虐待和“需求海啸”
——紧急峰会揭示了严重影响了医生、牙医和工作人员心理健康的深刻危机


(Primary care in England is ‘in meltdown’, says the chief executive of the Salford Primary Care Together partnership.)

(索尔福德初级保健合作组织的首席执行官说,英格兰的初级保健体系正在“崩溃”。)
新闻:

NHS staff at GP surgeries are facing unprecedented abuse and aggression from patients, while stressed doctors are increasingly suffering from mental illness, because of an appointments system “in meltdown”, family doctors’ leaders have revealed.

家庭医生的领导们透露,全科医生诊所的英国国家医疗体系(NHS)工作人员正面临着来自病人的前所未有的虐待和攻击,而由于预约制度“崩溃”,压力很大的医生正遭受越来越多的精神疾病。

The scale of the deep crisis in GP surgeries was revealed in an emergency summit of more than 60 NHS doctors, dentists and administrative staff in Salford, which the Guardian attended, triggered by a recent rise in verbal abuse.

英国《卫报》参加了在索尔福德举行的由60多名NHS医生、牙医和行政人员组成的紧急峰会,会议揭示了由最近不断增多的言语虐待引起的全科医生手术严重危机的规模。

“Patients are short-tempered and not happy waiting for anything … They want letters. The latest one was a request to speak to a GP because he needs a letter to confirm anxieties that cause him a problem in long queues – because he wants to take his son to [Southport amusement park] Pleasureland and does not want to queue.” Jan Crowshaw, GP manager

“病人的脾气很坏,等待什么都不开心……他们想要证明信。最近的一次是他想找全科医生谈谈,因为他想要带儿子去(南安普顿的游乐园)游乐场,不想排队,所以他需要写封信来证实自己的焦虑。”——简·克劳肖,全科医生主任

It comes after a recent poll by the body representing GP surgery staff across the UK found that 75% of them face abuse every day, including assaults, threats, racism and sexism.

此前,代表英国全科医生的机构最近进行的一项调查发现,75%的全科医生每天都面临虐待,包括袭击、威胁、种族主义和性别歧视。

Jan Crowshaw, a GP practice administrator in Salford for 27 years, said: “In all my time I have worked for the NHS, we have never ever encountered the level of vitriol that has been levelled at us in the past few weeks. We have all noticed not only huge increases in patient demand, but also massive increases in complaints.

简·克劳肖在索尔福德当了27年的全科医生,他说:“在我为NHS工作的所有时间里,我们从未遇到过像过去几周这样的尖言刻薄。我们都注意到,不仅病人需求大幅增加,而且投诉也大幅增加了。

“Perhaps most distressing of all is a real surge in the number of patients who feel it is appropriate to shout at, swear at and insult not just our non-clinical staff but clinical staff as well. We have one member of staff reduced to tears every single day.”

“也许最令人痛心的是,越来越多的患者认为,不仅对非临床工作人员,而且对临床工作人员,都有必要大喊、咒骂和侮辱。我们每天都有一名员工被骂哭。”

NHS figures released this month show that GP practices in England delivered almost 5m more appointments in March 2021 than the month before, and nearly 3m more than in March 2019.

NHS本月发布的数据显示,2021年3月,英国全科医生诊所的预约数量比前一个月多了近500万,比2019年3月多了近300万。

“We are aware of one instance of a dentist committing suicide during the pandemic because of financial losses and job losses and I’m sure there are many more suffering with depression and stress-related illnesses.” Hamza Anwar, dentist

“我们注意到有一个牙医在大流行期间因为经济损失和失业而自杀的案例,我相信还有更多的人患有抑郁症和压力相关的疾病。”——哈姆萨·瓦尔,牙医

But surgeries are still struggling to meet the increasing demand for appointments and GPs have faced fierce media criticism for carrying out phone consultations because of Covid restrictions. NHS England has now told all GPs that they must offer face-to-face consultations.

但外科手术仍难以满足日益增长的预约需求,由于新冠肺炎限制,全科医生进行电话咨询的做法受到了媒体的猛烈批评。NHS现在告诉所有的全科医生,他们必须提供面对面的咨询。

The Institute of General Practice Management (IGPM), which represents staff across the UK, carried out the poll. It has launched a campaign video on YouTube calling for a zero tolerance approach called “If I die, it will be your fault” – after one of the most common abusive statements directed at staff.

代表全英员工的全科医疗管理协会开展了这项调查。该组织在YouTube上发布了一段宣传视频,呼吁采取零容忍的方式,名为“如果我死了,那就是你的错”——这是针对员工最常见的辱骂之一。

Kay Keane, a practice manager in Stockport, told GP Online: “A man attended our practice with six knives because he didn’t get the treatment he wanted. He smashed up the waiting room and threatened staff members. It was terrifying and unacceptable.”

斯托克波特的一名诊所经理凯·基恩告诉GP Online网:“一名男子带着6把刀来我们诊所,因为他没有得到他想要的治疗。他砸碎了等候室,并威胁工作人员。这种行为是可怕和不可接受的。”

“Digital medicine is seen as lazy and actually it’s harder. Fifty per cent of a face-to-face consultation is [watching the patient] walk across the room. You are trying to see that down the telephone line. And it’s really, really hard. And I don’t think people understand that.” Lance Gardner, chief executive of Salford Primary Care Together

“数字医学被认为是懒惰的,实际上更难。面对面的咨询有50%是(看着病人)在房间里走两步。现在你试图通过电话线看到这一点。这真的非常非常难。我认为人们并不理解这一点。”——兰斯·加德纳,索尔福德初级保健中心的首席执行官

Lance Gardner, the chief executive of Salford Primary Care Together, who organised last week’s Zoom call of worried NHS staff from local practices, said surgery staff are having serious mental health problems as a result of the intense pressures on them.

索尔福德初级保健中心的首席执行官兰斯·加德纳表示,外科医生承受着巨大的压力,正面临着严重的心理健康问题。上周,他组织了Zoom电话会议,让当地诊所忧心忡忡的NHS工作人员参加。

“Primary care is in meltdown. It has never been like this. I am terrified that I am going to get a phone call that somebody in primary care has taken their own life. GPs are having to seek medical advice and counselling. People are mentally falling over. They have been hit by a tsunami of demand,” Gardner said.

“初级保健正在崩溃。从来没有这样过。我很害怕我会接到一个电话说某个初级护理的医务人员自杀了。全科医生必须寻求医疗建议和咨询。人们在精神上崩溃了。他们受到了需求海啸的冲击,”加德纳说。
原创翻译:龙腾网 http://www.ltaaa.cn 转载请注明出处


The Salford summit also heard how patients’ attitudes towards GPs were not the same as they were in the past.

索尔福德峰会还听说,患者对全科医生的态度与过去不一样了。

“We were already busy to start with. It’s not like we started off with a great deal of capacity to fill … Patients are on long waiting lists and conditions slowly get worse as time goes on and we have to manage that. They keep contacting the practice to find what is happening [with their treatment or operations]. That causes a significant amount of absorption of time.” Dr Nick Browne, GP

“我们一开始就很忙。这并不是说我们一开始就有很大的能力去填补…病人在长长的等待名单上,随着时间的推移,病情慢慢恶化,我们必须处理好这一点。他们不断与诊所联系,以了解(他们的治疗或手术)发生了什么。这会导致大量的时间消耗。”——尼克·布朗医生,全科医生

“The patient perception of us has changed,” Dr Nick Browne, a Salford GP, said. “Somebody mentioned to me that they feel as though patients are coming to us with much more minor problems at a much earlier stage. Their expectations of our response is much greater.”

“病人对我们的看法已经改变了,”索尔福德全科医生尼克·布朗说。“有人对我说,他们感觉好像病人来找我们时,只是觉得自己有一些早期阶段的小问题。他们对我们的反应期望更高。”

The British Medical Association, the UK’s largest doctors’ unx, wrote last week to the health secretary, Matt Hancock, to request an urgent meeting about the GP crisis. The fear in many surgeries is that patients needing urgent care will be missed because appointments are snapped up so quickly.

英国最大的医生工会英国医学协会上周致信卫生大臣马特·汉考克,要求就全科医生危机召开紧急会议。在许多手术中,人们担心的是需要紧急护理的病人会被错过,因为预约时间很快就被抢订一空了。

“A patient turned up at the surgery and threatened staff with a hammer because he couldn’t get an appointment that suited him.” NHS staff member, in the Institute of General Practice Management campaign video

“一个病人出现在手术现场,拿锤子威胁工作人员,因为他无法得到合适的预约。”——NHS工作人员,在全科医学管理研究所宣传视频中说道

The BMA’s GP committee chair, Dr Richard Vautrey, said it was very concerning to hear of the rising levels of abuse and aggression being experienced. “There can never be an excuse for this kind of behaviour,” he said. “Unfortunately, GPs and practice staff are very often at the receiving end of this frustration, when really it has originated as a result of many issues outside the control of the practice, such as lack of resourcing, chronic understaffing and years of underinvestment by the government.”

英国医学协会全科医生委员会主席理查德·沃特里博士表示,听到越来越多的虐待和侵犯行为,我们感到非常担忧。“这种行为永远没有借口,”他说。“不幸的是,全科医生和执业人员往往是这种挫折的受害者,而实际上,这是由许多超出执业控制范围的问题造成的,比如缺乏资源、长期人手不足和政府多年投资不足。”
原创翻译:龙腾网 http://www.ltaaa.cn 转载请注明出处


Prof Martin Marshall, chair of the Royal College of General Practitioners council, said the supply of doctors was not enough to meet demand: “This was already the case before the pandemic, and we are now at crisis point. We are hearing from our receptionists and practice staff that they are bearing the brunt of this frustration, and even anger, and this is having a serious impact on their wellbeing and morale.”

英国皇家全科医生学院理事会主席马丁·马歇尔教授表示,医生的供应不足以满足需求:“大流行之前就已经出现了这种情况,我们现在正处于危机点。我们从前台和实习人员那里得知,他们遭受了挫折、甚至愤怒的冲击,这对他们的福祉和士气造成了严重影响。”
原创翻译:龙腾网 http://www.ltaaa.cn 转载请注明出处


“The job of being a GP is largely undoable at present and these pressures are keenly felt by our teams,” he added.

他补充说:“目前,全科医生的工作基本上是做不了的,我们的团队深切感受到了这些压力。”

Crowshaw said staff were “drowning under the workload”. “We don’t want to miss the cancer or suicidals. [But] our access has become first come, first served, with those that shout the loudest at the head of the queue.”

克劳肖说,员工们“被工作量压垮了。我们不想错过癌症或自杀的人。(但)我们的准入已经变成了先到先得,以及那些排在队伍前面的喊得最大声的人。”

“The mental health and wellbeing of [pharmacy] staff is at an all-time low and staff are also facing abuse from the public.” Luvjit Kandula, director of pharmacy transformation, Greater Manchester

“(药房)员工的心理健康和福祉处于历史最低水平,员工还面临着来自公众的虐待。”——鲁吉特·坎杜拉,大曼彻斯特区药房转型部主任

Some fear the situation will get worse as patients on long waiting lists for operations turn to their GP for extra care. Increasingly surgeries are just shutting down and “handing in their keys” because they cannot cope.

一些人担心情况会变得更糟,因为等待手术的病人会转向他们的全科医生寻求额外的照顾。越来越多的外科手术因为他们应付不来而关闭并“交出钥匙”。

“I was talking to our lawyer and she said six GPs in the last week in April rang her law firm to hand their keys in,” Gardner said. “They hadn’t had six GPs s hand their keys in the previous six years, never mind in five days.”

加德纳说:“我和我们的律师谈过,她说4月份的最后一周有6个全科医生打电话给她的律师事务所要求‘交出钥匙’。在过去的六年里,他们加起来都没有遇到过六个医生‘交钥匙’,更不用说短短五天之内了。”

评论翻译
BenAird
My nearest GP practice only accepts new registrations on Wednesdays between 12 noon and 1 pm. They only accept 25 new registrations per week. You have to go to the surgery with the form already filled in - no they don't have blank forms, you have to print it yourself.
The surgery tells people not to queue up and wait, but by 11am there's almost always a queue of at least 20 people, and it only gets longer. The excess folk in the queue hope that those in front of them have mistakes on their forms, for which they'll be sent away to try again next week. Unfortunately, even if you're, say, 10th in the queue, there's no guarantee of success, because people often bring 3, 4, or 5 forms with them, to register their entire family. If you're unlucky and don't manage to get registered, don't panic! The helpful receptionists will direct you to other local practices, who only accept a smaller number of new patients one day a week.

离我最近的全科医生诊所只在周三中午12点到下午1点接受新预约登记。他们每周只接受25个新预约。你必须带着已经填好的表格去手术室,不,他们没有空白的表格,你必须自己打印出来。
手术告诉人们不要排队等待,但到了上午11点,几乎总是会有至少20人的队伍,而且队伍只会越来越长。排队的多余的人希望他们前面的人表格上有错误,因为这样他们就会被送去下周再试一次。不幸的是,即使你排在第10位,也不能保证成功,因为人们通常会带着3、4或5张表格来预约整个家庭。如果你运气不佳,没有预约上,不要惊慌!热心的接待员会指引你去其他地方的诊所,他们每周只接待少量的新病人。

fedora007
Do you live in the Soviet unx, circa 1960? That bloody sounds like it. My god.

你是生活在60年代前后的苏联吗?听起来很像。我的天哪。

mrminutehand
I used to complain about my town's GP office having a 3 to 6 week wait for appointments, but after hearing other people's stories I believe we are practically spoiled - since we can at least book online appointments and sometimes catch cancelled appointments.
Speaking of public services going downhill, I actually live abroad and 10 years ago I renewed my passport. Easy form, postage application, fee in local currency and my passport was posted to me within 3 weeks.
I just finished renewing my passport again in the same country. Only in-person applications at the centre halfway across the country, “We recommend you stay another business day in case of interview" and they're only open from 9am to 11am Mondays, Wednesdays and Fridays, so another business day means a 3 day stay.
The logistics were well over three times as expensive as the passport itself, which was already £140. 4 hours each way by train, hotel, then another train and hotel journey to pick up the passport.
Including lost income from days off, renewing a passport cost me about £800. Because funding has been cut so severely that all passport services in this country were shut down, replaced by agents who forward applications to the UK, of which there are only four in the country.
Edit: to make it worse, they never changed any policies due to Covid. Still in-person only. A friend finished his application before Covid, then was told to travel to the capital city to pick up his passport... while both the capital city and his own city were in lockdown.

我过去常常抱怨镇上的全科医生要等3到6周才能预约,但在听了其他人的故事后,我认为我们实际上已经是受宠若惊了——因为我们至少可以在线预约,有时还能捡漏取消的预约。
说到正在走下坡路的公共服务,我实际上住在国外,10年前我更新了护照。简易表格,邮资申请,当地货币的费用,以及我的护照在3个星期内寄给我。
我刚刚在同一个国家更新了护照。只有在离这里半个国家之距的中心亲自申请,“为了面试,我们建议您再待一个工作日”,他们只在周一、周三和周五的上午9点到上午11点开放,所以另一个工作日意味着额外3天的逗留。
后勤费用是护照本身的三倍多,护照本身的费用已经达到140英镑。再加上4小时的火车,酒店住宿,然后另一列火车和酒店旅程去领取护照。
包括请假带来的收入损失在内,更新护照花费了我大约800英镑。因为资金被严重削减,这个国家的所有护照服务都被关闭了,取而代之的是向英国提交申请的代理机构,而英国只有四家这样的代理机构。
PS:更糟糕的是,他们从来没有因为疫情而改变任何政策。仍然只面对面申请。一位朋友在新冠肺炎爆发前完成了申请,却被告知前往首都领取护照……首都和他自己的城市都被封锁了。

QVRedit
Not enough GP’s - The U.K. Government has known for years that many were due to retire, yet kept training places too restricted - So now we don’t have enough GO’s for the country..
Brexit has caused more European doctors to leave, so cutting the numbers further.
All down to U.K. Government Policy..
You reap what you sow..
It’s left us with a big problem.
Even if the right actions were taken (they have not been), it would still take 10 years to fix properly.

没有足够的全科医生——英国政府多年来已经知道很多人要退休了,但仍然对训练场所加以限制——所以现在我们的国家没有足够的全科医生。
英国脱欧导致更多的欧洲医生离开了,因此进一步削减了这一数字。
都是英国政府的政策…
种瓜得瓜种豆得豆。
这给我们留下了一个大问题。
即使采取了正确的行动(他们还没有),也需要10年时间才能妥善解决。

gherkinmark
I mean, I don't doubt staff receive lots of abuse from a very vocal minority but this article felt a bit patronising, especially the bit about people coming in with minor conditions. Like, yes, that's what a GP is for ideally? It's frustrating to read on NHS online that you should speak to your GP about a whole host of minor conditions, only to find that your practice won't even consider you for an appointment.

我想说,我不怀疑员工会受到了少数人的辱骂,但这篇文章感觉有点居高临下,尤其是关于那些有不严重疾病的人。是的,这就是全科医生的理想工作吗?在NHS网站上读到,你应该和你的全科医生谈一大堆不严重的病情,结果却发现你的诊所甚至不会考虑你的预约,这让人很沮丧。

SnoozyDragonHartlepool
especially the bit about people coming in with minor conditions. Like, yes, that's what a GP is for ideally?
So rude of these patients to not have attended medical school.

尤其是那些病情不严重的人。就像,是的,这就是全科医生的理想工作吗?
这些没有上过医学院的病人真是太粗鲁了。

hellipHull
Exactly. I went into my GP a couple of years back because I felt my chest being really tight for a couple of weeks. 5 mins later I left the doctors being told you it is caused by stress and not my heart being messed up.
Despite feeling like a bit of a tool, the doctor said it was good I came in regardless.
Instead of encouraging people to go to the doctors for a diagnosis in a 5 minute check, lets just let potential diseases become critical, let the patient suffer and cost the taxpayer tens of thousands for surgeries and care which could have otherwise been prevented.
Absolutely backwards.

完全正确。几年前,我去看了我的全科医生,因为我觉得我的胸闷了几个星期。5分钟后,我离开了医生,他们告诉我这是压力造成的,而不是我的心脏出了问题。
尽管感觉像个工具,那个医生还是说我不顾一切地来看病很好。
与其鼓励人们去看医生进行5分钟的检查,不如让潜在的疾病变得严重,让病人遭受痛苦,让纳税人花费数万美元进行手术和护理,而这些本来是可以避免的。
绝对的倒退。

Bannana_Puncakes
Exactly I was having chest pain and getting very dazed whilst training for a competition a few years back, went to the GP turned out it was just my low blood pressure and some muscular strain. But said it was good I came in because I had the same symptoms as someone who could have been about to drop dead form heart failure.
The whole point of the GP is to clear this up

几年前我在参加比赛训练的时候,确实感到胸痛和头晕,去看全科医生的时候发现那只是我的低血压和肌肉拉伤。但他说幸好我来了,因为我的症状和那些差点死于心力衰竭的人一样。
全科医生的目的就是要澄清这一点

JammyDodger777
I had chest pain a couple of years ago that had been going on for a few days. No other symptoms that would suggest a heart attack but I wanted to see a doctor to get it cleared up.
When I finally got through to a receptionist, they straight told me to call 999.
So I thought fuck it and called for an ambulance, and when they arrived they were shocked to discover that I was in fine health, calmly opening the front door and walking around. They assumed that they were here for someone else and I was to show them to their patient.
When I said it was me that called for them as instructed by my local GP they were stunned. They ran all the tests on me and I was fine, it later turned out I had rib cartilage pain in the sternum that was easily treated.
If I’d seen a doctor at my local GP they would have instantly been able to see I wasn’t having a heart attack and would have saved the trouble of calling out an ambulance that could of gone to someone who actually needed it.

几年前我胸口疼,一直疼了好几天。没有其他症状表明是心脏病发作,但我想去看医生,让症状消失。
当我终于接通接待员时,他们直接让我打999。
所以我想:qnmd,叫了救护车,当他们到达时,他们震惊地发现我健康状况很好,平静地打开前门,四处寻找。他们以为他们是来找别人的,而我是来给他们带路去病人那里的。
当我告诉他们,是我按照当地全科医生的指示去找他们时,他们惊呆了。他们给我做了所有的检查,我都很好,后来发现我的胸骨有肋骨软骨疼痛,很容易治疗。
如果我去当地的全科医生那里看医生,他们就能立即看出我没有心脏病,也就省了叫本可以去找真正需要的人的救护车的麻烦。

ModeratelySalacious
Probably cause dealing with most GPs is a consistently shit experience for most people. Even if you manage to get an appointment there's zero guarantee that whoever you get in the other end actually takes your problem seriously.

可能是因为和大多数全科医生打交道对大多数人来说都是一种糟糕的经历。即使你成功地得到了预约,也不能保证对方会认真对待你的病情。

Apocalyptism
I don't condone abuse, but it should at least be acknowledged that the GPs are absolutely useless at the moment.

我不能容忍虐待行为,但至少应该承认,目前全科医生是绝对没用的。

Annexeda
The NHS has been a national disgrace over the last 15 months so it's hardly a surprise.

NHS在过去的15个月里的表现一直是国家的耻辱,所以这并不令人惊讶。

reheated_tea
Every time I've called the GP it's taken over an hour to get through.
Every time I've called the GP it's taken weeks for an appointment.
Every time I've been seen it's always "Make another appointment to come see me in a few months".
Every time I've had a major issue I've had to fight tooth and nail to have anything done about it.
Every time I've seen any professional I've had to rattle off the relevant medical history sometimes for multiple professionals in one visit.
Every time I've had to be referred to a specialist it's treated as a hassle that the GPs will graciously go through for me.
Every time I've needed bloods I've had to write letters asking why the relevant blood forms are not being dispensed.

每次我打电话给全科医生都要花一个多小时才能打通。
每次我打电话给全科医生,预约都要花上几周的时间。
每次我被问诊时,他们总是说“几个月后再约一次时间来见我”。
每次我有重大问题时,我都得竭尽全力想办法解决。
每次我去看专业医生时,我都要快速说出相关的病史,有时还要在一次就诊中向多个专业医生汇报。
每次我不得不被介绍到一个专科医生时,它都被视为一种全科医生将仁慈地亲切为我解决的麻烦。
每次我需要血液的时候,我都要写信询问为什么相关的血型没有分发。
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Every time I've spoken with the receptionists they have been nothing but polite and professional, but they're clearly heavily overworked.
Every time I've seen a GP they talk about random shite for 5 minutes each time. I appreciate that they appear to care about my life, but that's 5 minutes you could be spending with another patient. Or maybe it isn't, I'm not a Doctor.
Every time I've needed a letter it's taken over a month to be written and signed. Literally just for things like "This patient is being seen for X, please accomodate her"
Every time I've talked about this with anyone, it's always been "The NHS sucks" rather than "The NHS is in desperate need of funding"
Every time I've had an easy time of things like getting antibiotics or painkillers or blood tests, I feel guilty, as if I've cheated the system.
Every time I've used private services, these problems have been way less exagerated, which is awful because that's exactly what the Tories want. They want to privatise healthcare so that they can stick their fingers into the pie.

每次我和接待员交谈时,他们都表现得既礼貌又专业,但他们显然严重过度工作了。
我每次见到一个全科医生,他们都会随便聊上5分钟。我很感激他们关心我的生命,但这五分钟你可以花在其他病人身上。也可能不是,我不是医生,不知道。
每次我需要写证明信,他们都要花一个多月的时间来写和签名。其实就一句类似“这个病人正在接受X检查,请帮助她”这种很简单的信。
每次我和别人谈论这个问题时,总是说“NHS糟透了”,而不是“NHS急需资金”。
每次我很轻松地得到抗生素、止痛药或血液测试,我就会感到内疚,就好像我在NHS体系下作弊了似的。
而每次我使用私人医疗服务时,这些问题的情况都要好得多,这很可怕,因为这正是保守党想要的。他们想要将医疗保健私有化,这样他们就能从中分得一杯羹了。

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