Hi there.
Today let's do some English listening practice.
I'm going to talk to you about a problem that I see in our
health service in the UK today.
And I'm wondering whether it's the same in your country, too.
My aim is to give you an interesting topic to listen to while your brain is
doing its English language learning.
And meanwhile, you'll learn useful phrases and vocabulary for
making a doctor's appointment and dealing with healthcare services.
One of the things that we're really proud of in the UK is our NHS
or our National Health Service.
I think we're really lucky to have this service.
And I think people around the world are quite envious of our
situation, where our healthcare is 'free at the point of access'.
I'll explain that phrase.
It means that it's not free.
It doesn't come without a charge.
But you don't get charged at 'point of access'.
So if you're ill, you can make a doctor's appointment and have
access to a doctor without paying.
And if it's something more serious, you can go into hospital, either as an
emergency or as an inpatient, if you need to stay in hospital because you
need surgery, you need an operation or you are too ill to be at home.
So all of these services are 'free at the point of access'.
They're free when you need them.
But they're not free.
They are paid for by all of us who pay taxes.
So that's what 'free at the point of access' means.
So it's a great setup and it's a great service.
And we've had this since the end of the Second World War, pretty much.
So we're all used to the NHS.
Prescriptions are a little different.
A 'prescription', P R E S C R I P T I O N.
A 'prescription' is that instruction from your doctor to your pharmacist
for a particular set of pills or medicines or creams or tablets.
That's a 'prescription'.
And in England, we pay for our prescriptions, or at least most people do.
If you are over 60 or pregnant or under 16, you don't pay.
Everybody else pretty much, pays £9.35 every time they need medicine.
But this is still good because many medicines cost a lot more than that.
So it's what we call 'subsidised'.
That means 'we get help with the cost'- it's a 'subsidy'.
In Scotland, prescriptions are free, free of charge.
So the NHS is a great institution, but there are some things happening in
the NHS, which perhaps mean that there are more difficulties than there were.
During the pandemic, it was really difficult to get a doctor's appointment.
Now, doctors in the UK - everybody can register with a doctor's
surgery and have access to a GP.
We use the term GP, 'general practitioner' to mean the type of
general doctor that you might see, might make an appointment with.
If you go to the doctor, you are a 'patient', P A T I E N T.
That means that you're 'someone that goes to see the doctor'.
And we might talk about the 'doctor's surgery'.
' Surgery' can mean a number of things.
It can refer to the physical building where doctors see their
patients, where the GPS are.
It also means 'the organization within the building'.
So a 'surgery' consists of nurses, doctors, reception staff, a waiting area,
different rooms for the GPS to work in.
That's a 'surgery'.
You also hear 'surgery' used where someone's got to have an operation.
So if you 'have surgery', you're generally given an anaesthetic
and they operate on you.
That's also called 'surgery'.
So it's one of those words that we use in a medical context,
in a few different ways.
So what's the problem with the doctors?
Well, in the UK, your GP is the 'gatekeeper' to other services.
You can't get access to any health service without going through your GP.
And a 'gatekeeper'?
That might literally mean 'someone who looks after a gate', but more
commonly these days we use this term as a metaphor to mean 'someone that
controls the access to something'.
That's a 'gatekeeper'.
And GPs are the 'gatekeepers' of other NHS services.
Only in an emergency is it different.
In the UK, if you have a medical emergency, you go to A&E - that's
'Accident and Emergency'.
In the US, it's called the 'Emergency Room'.
During the COVID pandemic, it was very difficult to get a GP's appointment.
And in fact, the appointments that were given out were pretty
much all telephone appointments.
The reasons for that are understandable.
Even though the pandemic is not as serious as it was, and most people are
back to work, going out, life is 'as normal' again, you still cannot get an
appointment to see your GP very easily.
It's a very difficult process.
I had reason to make a GP appointment last week and it took five different
telephone calls to achieve this.
Instead of being able to phone up and speak to a receptionist and make a
booking, an appointment there and then, there's a whole different process now.
First of all, face to face, in person appointments seem to be very rare.
You're lucky if you can get one of those - everything is by telephone still.
The other problem is you used to ring up and ask for an appointment
and they would tell you what times the doctor was available.
So you would come off your telephone call knowing when your appointment was.
Now they don't do that.
They say, 'Ah, when the doctors have spoken about what it is you want
to bring, they will send you a text message and then you will need to wait
on that day for the doctor's call'.
This is very difficult, if you work!
If you're retired or if you're at home all day, then maybe it's okay to wait all
day for the call from your doctor and to not know when that call is going to come.
But if you're working, that's incredibly difficult and not very practical.
It can feel sometimes as though the process of accessing healthcare in
the UK, of booking an appointment with your GP is made so difficult
that it will put a lot of people off.
And sometimes those people may have serious health
problems that need a diagnosis.
That's D I A G N O S I S.
And a 'diagnosis' is when a doctor looks at you and determines what
the problem is, gives it a name.
Particularly older people may be put off by this process - lots of
messages that say 'The doctor's busy'.
'Only ring if it's urgent'.
I think many people will be put off.
And their health conditions will go without a 'diagnosis', they'll
be 'undiagnosed' and they may get worse, they may become serious.
We talk in therapy about 'the doorknob moment'.
'Doorknob', D O O R K N O B.
A 'knob' is the thing, the handle, the thing that you turn as you want
to open the door to leave a room.
So 'the doorknob moment' means 'that time when someone's about to leave the room
and they tell you the really important thing, the really important information'.
That's what we call 'a doorknob moment'.
And I think that happens with a doctor's appointment, with a GP's appointment.
'Cause often people go for something fairly minor and it's as they're
leaving the room and they say, ' Oh, well actually doctor, there is
this other problem as well'.
And that's when the more serious thing comes to light.
That's when the more serious problem is talked about.
So access is the first problem - how difficult it is to get a doctor's
appointment in the first place.
And the fact that it's a telephone appointment?
Well, of course there are things they just can't see in a telephone appointment.
And then there's no opportunity for 'the door knob moment'.
People are less likely to mention to their doctor something else that they're 'a
little bit worried about, but it wasn't the main thing that they're coming with'.
We've already got a problem with a backlog.
That's B A C K L O G.
And a 'backlog' is 'a build-up of work that hasn't been attended to'.
There's already 'a backlog' in the NHS.
There's a huge waiting list for operations, and there are
problems like cancer diagnosis.
So C A N C E R- that's a really serious illness.
And there's a delay in diagnosis for many people.
That makes the situation a whole lot worse.
So that's already happening because of the effect of the COVID 19 pandemic.
But add into that, that there is less access to doctor services - the
situation can only get worse.
And of course, this is not just in the UK.
I'm interested to hear what is happening in your country.
The World Health Organization, or WHO said in June 2022,
'Due to travel restrictions and the enormous strain on health systems of
fighting COVID 19, cancer services have been disrupted across the entire
WHO European region, significantly delaying diagnosis and treatment,
directly impacting the chances of a cure or survival for hundreds
of thousands of cancer patients.'
The 'strain' on health services?
That's S T R A I N.
That means 'the pressure, the difficulties faced by health systems'.
This is affecting pregnant women.
'Pregnant' P R E G N A N T - that means 'women who are having
a baby' - they're affected.
They won't receive the same level of antenatal care - the
care before the baby is born.
And they've also got the worry in some places, of perhaps having
to give birth, perhaps having to have their babies without their
partners or family members present.
That's really difficult.
Also many routine services are lacking.
'Routine', R O U T I N E means 'you do it according to a schedule'.
It happens according to different timings.
So there might be a 'schedule for vaccination' for children and for babies.
That's being affected.
We probably should be doing more 'preventative medicine'.
'Preventative', P R E V E N T A T I V E.
That means you try and see problems ahead of time.
You try and work with the difficulties before they get too bad.
You do things to 'prevent' health problems.
That's really important.
And those routine checks and tests are also not being carried out.
So again, a lot of the people whose routine checks and tests
would reveal more serious illness - they're not being diagnosed either.
So we're storing up a great big problem.
This isn't just me being critical of the NHS.
I know there are difficulties.
I know there are fewer doctors and fewer nurses than we need, and we are still very
lucky to have our NHS, our health service.
It will take a while for it to get back to normal.
But my worry is that perhaps we're losing something precious here.
We had great access to healthcare and we don't have it anymore.
Some of this is down to the backlog.
Some of this perhaps will right itself in time.
But one of my worries is - has the service been reduced on purpose?
Has it been seen as an opportunity to cut costs, to reduce services,
to make healthcare less accessible because it's too expensive?
I don't know for sure, but that's one of my worries.
It feels a bit difficult at the moment in the UK.
This is what's happening in our NHS.
Our trains?
Well, the train drivers and the train workers are going on strike.
So our transport systems, aren't great at the moment.
And if you want to get away on holiday, if you go to our airports, then that's a
bit difficult too, because there are not enough staff to help you get on the plane.
So there are many flights being cancelled as well.
Not great.
Oh, and just now we also don't really have a prime minister anymore.
So there's another problem!
Oh dear.
It's one of those times where perhaps it's a good idea - the sun is out,
let's just go in the garden and forget about it all for a while!
Let's go and do something nice!
But let me know whether there are problems like this in your country too.
Let me know what the situation is in your country.
We're interested in hearing your stories too.
Listen to this podcast.
A number of times, it's great English listening practice, and
it gives you some really good health-related vocabulary to learn.
And by the way, don't forget to subscribe or review us if you want to
help Adept English - if you want to help more people find Adept English.
Enough for now.
Have a lovely day.
Speak to you again soon.
Goodbye.