Monday, 25 March 2013

A Report by The Patients Association

A report by The Patients Association (this appears to be an organisation that has done away with apostrophes – I just thought I would say that in case you thought it was I who were remiss) bewails its perception of GP services being increasingly difficult to get hold of. It is entitled ‘Primary Care: Access Denied’ and you can see a synopsis of it on .

Well, speaking from the perspective of a patient who was himself once a doctor at the sharp end of primary care, I can feel some sympathy. But I also know quite a bit about the constraints that bedevil general practitioners and their nursing colleagues in the community. The fact is that their political and professional masters have dumped upon them such a mountain of stuff they are expected to achieve that has nothing to do with face to face interaction with actual patients that they have far fewer hours to spend in the consulting room than they did, oh, twenty or thirty years ago when I was still hard at it: targets to be met; reports to be compiled; meetings to be held; and the complete nonsense they call ‘revalidation’ – a hugely time demanding tick-box exercise that purports to ensure that never again with a Shipman loom up among us. It is actually a joke, only not a very funny one. Harold Shipman will be laughing in his grave (we GPs know he would have passed Revalidation with flying colours).

But there are other factors too that stymie the efficient functioning and delivery of care by the NHS. For example, the monumental waste that is inherent in it, such as vast and costly IT schemes that come apart and are ditched (I was gobsmacked when I first saw a skip full of redundant computer monitors outside an office. Such a sight has become commonplace now, and I would lay odds that a goodly number of those offices are NHS premises).

But the single greatest impediment that in my view the Patients Association ought to but never does address and mean it is the way those they claim to champion actually use (and misuse) the National Health Service. What have they to say about appointments made with the GP or nurse that are never kept? What have they to say about the hundreds of thousands of pounds worth of drugs that are prescribed but never taken? What have they to say about appointments demanded by patients for the sole reason that they can get over-the-counter drugs free (paracetamol, mouth washes, moisturising creams etc.) on a prescription exempted from charge. And don’t tell me that the GP should resist such requests: as likely as not such a refusal would result in a complaint that can take hours to respond to and resolve properly. The list goes on.

There are individual instances that beggar belief. Once, when I was running a Saturday morning surgery a patient rang and asked if I could look across the street to see if the launderette was open. You don’t believe me, do you? Well, don’t if you don’t want to. The Patients Association might be happier to put it about that the reason we gave up on Saturday morning surgeries was because we wanted to spend more time on the golf course.

Believe what you want. I worked bloody hard in general practice for 40 years. Much of it I enjoyed. But like many of my colleagues, I don’t think it is a job worth doing any more.


  1. My mother is 96.
    She has an overworked G.P. who takes very good care of her.
    She has had successive hip and knee replacements in her 90s to keep her independent.

    She is horrified when her 'carers' tell her of pestering their G.Ps for trivia for themselves and their children.

    She remembers the NHS being set up and what a boon it was....and now it is taken for granted.

    It strikes me that this government wants to privatise the NHS.
    Those who abuse it will then find out what the alternative is.....but that's no compensation for those who need its services and respect those providing them.

  2. Privatise the NHS? I think not. A politician's priority is to attract votes at almost any cost. The NHS is, for all its shortfalls, a massive sacred cow. Polical tinkering that smacks even ever so slightly of a threat to the 'free at the point of delivery' - the Holy Grail of the Welfare State can be almost guaranteed to result in a government being voted out of office.
    But what you and I are talking about is the free availability of a doctor's time to the patient (if a doctor can be had at all, the Patients Association will remind me). The one thing I never had in my consulting room was a till. Neither did I have a credit card machine. But my dentist (excellent service) certainly does as I found out this month when I coughed up nearly £300 for a crown on the NHS. But then people don't die when denied the services of a dentist. Toothache may be dreadful, but it doesn't kill you. The nagging headache that you take along to the GP almost certainly isn't caused by a lethal brain tumour, but a doctor who ignores that very remote possibilty is less than circumspect. Opticians too operate as businesses, and I imagine their greatest money spinner is the sale of spectacle frames that are no more than fashion accessories - just bits of wire and plastic that will set you back far more than a good photo-printer for your computer, and far, far more than a cordless elecric drill from B&Q. Funny how people are prepared to waste money on such tat, yet react with horror at the thought of having to cough up for cough mixture (which we all know is useless anyway).