Seems sensible

Michelle Heaton receives shockingly blunt NHS letter saying she is no longer eligible for cervical screening after her hysterectomy ‘because you no longer have a cervix’

I guess we don’t ask transwomen to check their balls for testicular cancer either. What a waste of NHS resources this all is, eh?

20 thoughts on “Seems sensible”

  1. This letter isn’t shockingly blunt: it’s simple, and designed for clarity, as not everyone who reads it will make the link from the operation they had to screening for a different disease.

    Or have English as a first language.

    It’s standard British government syntax: th outcome of the decision making process, followed by the reason for decision.

  2. They should have addressed it to ‘former Liberty X singer and cervix-owner’ or printed it on pink paper to soften the blow.

  3. 21st century people can be deeply shocked and hurt by something they already know.

    May as well give it all up now, luv.

  4. There is apparently no operation that can remove bureaucracy-speak in the passive tense:

    “‘We have been advised that . . . ”

    Who, exactly, advised whom? How many NHS functionaries take part in these kinds of communications, anyway?

  5. Bloke in North Dorset

    Amusing as this story is there is a wider lesson about cost management in a Government bureaucracy.

    If this had been a private company, eg Walmart, someone would have looked at this letter and thought: “what’s going on here? Its costing us £20 [guess, but I’d say at least] in all up costs to send this letter and we’re doing 50,000 of them a year, that’s £1m to be saved if we add it to the check-list* of instructions for when the patient is discharged.”

    *Not that I believe they are organised enough to have a check-list, but that’s another issue.

    And if anyone doesn’t believe that companies like Walmart are that anal, this from last week’s Economist should set them right:

    “When Walmart sets a goal, companies usually find ways to meet it. In its bid to promote sustainability, for example, Walmart wanted General Mills, a big food company, to fit its Hamburger Helper noodles into a smaller box. General Mills replaced curved noodles with straight ones, which lie flatter. The switch took 500 lorries off the road each year and freed shelf space for other goods. Walmart worked with makers of detergent to develop concentrated versions, in smaller bottles. Over three years the switch saved more than 57,000 tonnes of cardboard, 43,000 tonnes of plastic resin and 400m gallons of water.”

  6. The Meissen Bison

    How long can it be before the vagocracy rises up in arms against this inhumane treatment of a sister?

  7. When a patient is discharged from hospital, the consultant sends a letter to the GP telling them what’s been done. After a total hysterectomy, the GP is supposed to inform the cervical screening service (on-line) that the patient no longer has a cervix.

    Apparently the cervical screening service then sends a letter to the patient. I suppose this is a safety check in case there’s been a mistake. It looks as if the letter is generated automatically by the notification system, so the cost should be modest.

  8. There was a case in Somerset I think where a male to female transgender woman wanted to go on the list for smear tests.
    Cue a dismissive response – you haven’t got a cervix to test.
    Result – a complaint about discriminatory treatment and a £4,000 legal bill.
    So a routine information letter becomes reasonable.

  9. It’s not clear cut whether you need a smear after your cervix has been removed. If you have a diagnosis of carcinoma of the cervix or high grade precancerous change (CIN 3), you may still need a smear (or several) until the smear of the vaginal vault is reported as negative.

    The letter and response is bunk.

  10. ” vaginal vault”
    Did you have to, Andy?
    That’s conjuring up all sorts of images, going to intrude every time I see one, now.

  11. Bloke in North Dorset


    I don’t doubt that there is a simple bureaucratic rational to what happened. The point I was trying to make is that in a profit/cost driven organisation someone would have been looking at the problem from a different angle.

    And the cost of sending even automated letters is not cheap. The £20 I used was based on some work I did where a local council said that was their basic cost in 2005*. I guess the NHS is similar. Even automated letters need IT people and automated printing and envelope stuffing has a cost, and we are talking about the Simple Shopper.

    *And to complete the costs a phone contact was costed at £33

  12. I googled this, the first hit was an advert for an automated medical mailing system “Believe it or not, the cost to send a standard 2nd class recall letter to a patient is approximately 90p, including stamps, stationary and admin time.”

    I think they mean ‘stationery’. i don’t believe it exactly, but I don’t expect it to be out by an order of magnitude.

    Be that as it may, the NHS could decide not to send the checking letters. But I suspect that your profit-driven organization would judge that the legal risk in case of error wasn’t worth the saving.

  13. JimW – ‘a male to female transgender woman wanted to go on the list for smear tests’

    I’m not sure that a man stupid enough to believe that a ‘sex change’ operation really would make him a real woman can be trusted to make a sensible judgement about whether to have his cock and balls removed or not.

  14. In an alternate universe…

    “Michelle Heaton is outraged having received a letter inviting her for a smear test despite having a hysterectomy”

  15. SJW,

    That’s the cost of just printing and sending the letter. That doesn’t deal with training people, a writer writing the letter, legal checking it, corporate checking it, the data transfer to the letter system etc etc.

    That’s how you end up with £20/letter. Legal spend some time checking the letter, that’s £500 every time it changes. Corporate check it, that’s another £500 cross charged, every time. You need staff to build the data feed and manage it. That’s £10K minimum. And of course, this is the NHS we’re talking about, so it’s all gold plated and inefficient. They don’t outsource in a ruthless, cost-cutting way. They have a gazillion boxes to tick just to get on the approved suppliers list which means you get horribly expensive suppliers. In the end, they get someone like me, but my rate is nearly tripled for all this nonsense.

  16. An American thing. Little noodles which you cook with ground beef to make it go further.

    Not a million miles away from meat and potato pie say….

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