GPs: send us money, not patients
We had ‘fun’ trying to see a doctor the other day.
Our local medical practice is now a big business, with multiple GPs. Yet getting an appointment is an obstacle course. When we phoned (only available during their set hours) we got the modern automated routing system and ended up 30th in the queue to speak to somebody.
But I remembered that a few years ago we went to a ‘walk-in centre’ a mile away that took my details including the name of my usual GP, then had a doctor examine me and issue a prescription. So down we went again.
The waiting area was empty as a school in the summer holidays and the receptionist told us it wasn’t a walk-in centre any more. We drove miles to another one: there was a notice posted behind the shatterproof glass announcing that they weren’t one now, either, because Covid.
So we thought action directe might work: go to our health centre in person. Oh no, you can’t do it in person; you can either go online or phone and press for a ringback.
We did the second thing. My wife was called back, not by a GP but by a nurse who took the information, talked to the doctor and relayed the verdict. A prescription would be emailed to our local pharmacy.
Now, what if my wife was bad at describing her symptoms? What if she had been a prescription drug addict lying to get some more from Dr Feelgood? What if, unawares, she had some additional ailment that only an expert medico would have spotted on seeing her walk into the consulting room?
The alternative was to go on the computer, fill in a form, register as a user, supply a password etc. Apart from the faff, what if - like so many in our city - English is not your first language, or not even your second? What if you don’t have a smartphone or can’t manage the complexities of a PC?
This is another operational disaster bred by politics. In 2004 GPs’ representatives came to the Labour Government to ask for release from the obligation to provide cover ‘out of hours’; they were amazed when the government simply rolled over.
Context is all: a General Election was looming. Tony Blair (given the Order of the Garter this week amid noisy protests) had won in 2001 with a Commons majority of 167 seats. Since then, he had bounced us into Gulf War Two with false claims about Saddam Hussein’s ‘weapons of mass destruction’; there were massive demonstrations before it started and the public controversy has continued ever since.
The NHS is Labour’s post-WWII’s totemic achievement and almost a religion in the unthinking devotion it commands; the last thing Blair needed was trouble on that front as he prepared to ‘go to the country’ in 2005.
Even with that hasty capitulation, Labour’s majority withered by over 100.
One of the MP throwouts was Oona (now Baroness) King - she lost her seat with its strong Muslim voter contingent to George Galloway, an opponent of the Iraq war. In 2007 as a campaigner for Gordon Brown in the Labour leadership contest, she admitted the GP contract had been a ‘fiasco’.
Both Labour and Conservative governments have been trying to repair the damage ever since, mainly by throwing (our) money at the problem. For example, GPs’ earnings soared 60 per cent in the three years to 2012.
‘All art constantly aspires towards the condition of music,’ said Walter Pater; and all business aspires to the condition of rent. The first four buzzing suggestions on this list of ways to maximise GP practice profits are all to do with using information technology to distance the doctor from the patient.
Since the NHS has become an electoral campaign tool for politicians, the relationship between doctors and patients has changed. No longer does some TV Peak District doctor drive across the moor to see how Mrs Hepplethwaite is getting on; he/she gets orders from above and is paid for extras - mass screenings for aortic aneurysms, follow-up diabetes checkups, mass Covid jabbings and so on.
This will explain why so many GPs are retiring early, or working part-time to reduce their tax bills and have more time for their leisure pursuits. A 2018 survey found that 15% of GPs worked less than 15 hours a week.
‘Ideally, just send us the money,’ is the message.