I'm a patient, get me out of here!

Tony Blair has encouraged us all to take more responsibility for our health. Jim Pollard tried - and failed. Trouble is, Tony, the last thing that a hospital wants is a patient taking responsibility.

This article doesn't appear to have much going for it. It's longer than usual and it begins with a speech by the prime minister but trust me - something you might struggle to do if you're a health professional.

At times during Tony Blair's health care speech last month, he sounded like Margaret Thatcher telling us there was no such thing as society as he suggested that there was no such thing as public health and that our health problems were down to lifestyle — questions of personal choice.

While this might be true of smoking and boozing, most people don't choose to be poor, to be unemployed or to live in crap or insecure housing — all social problems that are closely related to poor health.

So, while I can't say that I agreed with everything he said, what about the prime minister's key message — take more responsibility. Is this message more or less likely to get men to check out their health concerns? I had plenty of time to consider this question since, as chance would have it, Blair's speech coincided with my regular visit to the lymphoma clinic at St Thomas's Hospital in London.

Now, I don't know whether the cancer I had ten years ago was caused by my lifestyle choices like smoking but certainly ever since my diagnosis I have tried to take as much responsibility as I can — finding out about the disease, asking the doctors questions about it, following up any concerns and so on — but it's not always easy.

And ironically, on this day of all days, I was to be reminded just how uncomfortable the health service is with patients who try to take responsibility.

After my consultation I needed to have some blood tests. Once upon a time, the consultant would tick boxes on a form to show which tests were required but now he simply clicks his mouse and the list of tests appears at the receptionist's printer for you to pick up on the way out. Good idea, saves time - especially with patients like me who are just having the same tests over and over.

However, for some reason, the print-out didn't include one of the regular tests. I couldn't go back to the consultant to get him to add it as he was by now with another patient so when I got to the blood tests department I asked the blood test guy if he could add it.

'Can you do a thyroid profile. You know, T3, T4, TSH,' I said.

These are the basic tests to see if the thyroid gland is working properly. Mine was fried by radiotherapy and now needs a daily dose of drugs to supplement its paltry output.

Thyroid problems are very common. About 4.5 million people in the UK have them so these are routine tests being done dozens of time every day in every lab.

The guy looked at me as if I were speaking Martian. 'Are you a doctor?' he asked.

"No,' I said, 'I'm just a patient who's had the same tests for ten years.'

The computer system even produces the label for each blood sample vial. Again, saves time as the venepunctrist doesn't have to write it all out by hand. Problem was it meant that he couldn't actually add anything. The idea of writing on an extra label seemed unacceptable. He said the best he could do was to give me an extra vial of my blood which I'd have to take to the haematology department where they actually carried out the tests to have correctly labelled.

OK, so I went up to haematology with my three labelled bottles and one blank bottle and explained to the haematologist what had happened. She asked to see the list of blood tests. Obviously it didn't include the test I was asking for. I explained why I wanted it.

'I can't do it if it's not written here,' she said.

'Would you like me to write it there?'

She looked tempted. Instead, she went off to consult her boss. I could see him in his office, back to me, arse welded to a chair that he never bothered to leave. She came back and said they had to have something from a doctor. I assumed they'd phone down for authorisation.  'OK,' I said. 'It's oncology, lymphoma clinic.'

'You'll have to phone,' she said and handed me the phone.

'What's the extension?'

'I don't know. You'll have to go through switchboard.' Switchboard? These departments are four floors apart and work together every day. My heart sunk.

The switchboard at St Thomas's is answered by a voice-recognition program which was modelled on the hearing of a 98 year-old former sheet-metal worker.

To make matters worse when I eventually got through to a real-life living receptionist she put me through to a fax machine. Second time lucky, I got my consultant's secretary. He said fine and that he'd sort it out.

I told the haematology woman and she asked me whether he was going to send it up, fax it through, email or call. How the hell should I know? Should have phoned him yourself.

The reason I was getting angry was less to do with the massive maze of bureaucracy or that staff within it didn't know basic information like each other's phone numbers — that sort of thing is pretty common in a big organisation — and far more to do with the way they were treating me. Like a kid.

The assumption seemed to be that I couldn't possibly know what I wanted as I was just a patient. 'Right, I said to the haematologist, 'so I'm too stupid to know what blood tests I need but smart enough to know the internal communications systems of the trust inside out'. Believe me, there are brain surgeons who don't understand these systems.

She — like all of the staff — was polite and pleasant throughout even when I was getting pretty sarcastic. But why were they all so unable or unwilling to help me? They didn't have to take my word for anything. The haematologist or her immobile boss could have checked my records on the computer and seen the results of all my previous tests. They could easily have seen that I wasn't making it up but they didn't seem to be authorised to take this tiniest of initiatives.

Perhaps this sort of thing happens a lot, I thought. Perhaps they have to have strict procedures otherwise patients would just order blood tests like Smarties. Maybe but do you buy that?

I really can't see people wandering in off the streets and demanding a full blood count for a bit of a laugh. It's not like falsely claiming benefit or something. Yeah, mate, I conned those idiots into letting me wait in a queue for two hours and then stabbing me in the arm. And I wasn't even entitled to it.

So in short, while my request may have been unusual, it was probably pretty rare and would not have been too difficult to check.

Were they just too lazy? I don't think so. If you think about it the hamatologist made far more work for herself. Instead of just saying 'yes' and labelling my bottle which would have taken 30 seconds, she spent two minutes talking to me, another five with her boss and then there was the faffing about with the phone.

When I left, the best part of half an hour later, the three labelled bottles were in the system but the unlabelled fourth was rolling about on the counter top like a discarded biro as the haematologist awaited authorisation and carried out three of four other tasks too. Hard to accuse her of seeking the quiet life, really.

The result for me was that I left the hospital unsure if a test I needed would be properly carried out. Not a very fine tribute to the collective bedside manor of the trust. And a bit worrying.

I'd been treated like a child and and now I was confused like a child too. Inevitably, because of the caring that happens in hospital, there is always a bit of an adult-child relationship between health professional and patient. When you're very ill, this relationship is very reassuring but when you're well, it's not actually very good for you. Being infantilised - turned into a child - is not healthy.

And, it's not just the patients who are infantilised. I think both the venepunctrist and haematologist believed me and, were they authorised to take even the slightest bit of initiative could have sorted my problem out for me at a stroke. They weren't allowed. The only person who was — presumably - couldn't be bothered to get off his chair to walk five yards to talk to a mere patient. Or perhaps he wasn't authorised either and didn't want to admit it in front of another bloke. I don't know.

Hospitals bring two emasculating attitudes together: the public-sector attitude in which bureaucracy frequently destroys initiative and a patronising medical attitude in which doctors know everything and everyone else knows nothing.

The hierarchical bureaucracy of the public sector is more and more out of sync with private sector practices in which hierarchies are flatter and demarcations flexible. Of course, the private sector is nothing like as customer-focused as it likes to pretend but at least the customer is in the mix there somewhere.

Which brings me to my main concern about this: how many blokes does treatment like this deter from seeking help? Nobody likes being treated like an idiot and male pride is particularly sensitive to this.

The hospital is full of posters pointing out that patients who attack staff will be prosecuted to the full extent of the law. Good thing too. The figures show that there's a serious incident of violent behaviour and verbal abuse every single day in St Thomas's and it must be stopped.

But you can see where the frustration comes from. You treat people like kids, they behave like them. They either have a tantrum and eventually lash out or they pick up their ball and go home.

I wonder how many of the men who leave it too late before going to see a doctor with a life-threatening condition have been put off by some previous humiliating experience at the hands of the caring professions. I certainly wouldn't risk going through this again if I had any choice. Your self-confidence takes a hit. You feel powerless and vulnerable. All of this in a hospital — an environment which is reminding you constantly about your own mortality and the goose-step of time.

I believe that just as public schools are the biggest single reason why state education is not as good as it could be, so private health care is the biggest single blight on the NHS. However, for the first time I can see the attraction of it. He who pays the piper calls the tune. How much easier it would have been to say, 'look, just shut up, do the bloody test and put it on the bill.' And how much better I would have felt having said it.

My life would be longer for a start I'm sure. As it was I had a small dose of the drip, drip of humiliation and marginalisation that compounds into that corrosive stress that kills poorer people prematurely. The NHS — and yes, prime minister, public health policy - is supposed to be about stopping that.

As I said, I support those posters saying that all violent patients will prosecuted but I'd like to suggest another to be displayed alongside:

Health professionals treating patients like kids will not be tolerated. All offenders will be removed from their pedastals immediately.

And the PM agrees. Sort of.

Jim Pollard is only here to edit malehealth because of the talents of St Thomas's staff but that doesn't mean he hasn't the right to criticise occasionally. How are hospitals for you? Share your experiences with malehealth.