Seeing your doctor face-to-face still a must in modern world
AMONG the many indirect victims of the pandemic is 69-year-old Joy Stokes. It wasn’t the virus that killed the former PE teacher three weeks ago, but the growing use of “telemedicine” as the NHS reduces physical interactions between GPs and patients.
Refused face-to-face appointments, Joy was told over the phone that the pain in her legs and hips was arthritis.
Her requests for scans were refused and she was told to seek physiotherapy. In fact, she was suffering from cancer. By the time it was diagnosed it was too late for life-saving surgery.
Sadly, we can expect many more cases like that of Joy’s. Last October, Macmillan Cancer Care estimated that there were already 50,000 “missing” cancer diagnoses – a number it calculated by comparing the number of diagnoses made in 2020 compared with those in recent years.
Of course, people are still getting cancer – it is just that they have not so far been diagnosed. By the time they are diagnosed their chances of survival will have diminished.
NOT all these missed cancer cases can be blamed on the NHS. Some will be down to the reluctance of patients themselves to seek help. Ministers have repeatedly emphasised that the NHS is still open for non-Covid emergencies, and I have to say that when my wife was worried about breast cancer she was seen very efficiently and given a scan which put our fears at ease.
However, part of the blame must surely lie with the Government trying to use the Covid crisis to push the concept of “telemedicine”, whereby doctors increasingly hold consultations by telephone or internet rather than face to face.
Of course, during the pandemic everyone needs to try to reduce face-to-face contact as much as possible. Medical staff need to be protected just like everyone else – for their own health and the sake of the whole healthcare system, which needs to keep as many staff healthy as possible.
Yet the Government’s enthusiasm for telemedicine goes far beyond the demands of the pandemic. Last July Health Secretary Matt Hancock said in a speech to the Royal College of Physicians: “From now on, all consultations should be teleconsultations unless there’s a compelling clinical reason not to”.
Hancock has long had a messianic zeal for the online world. Three years ago he got into trouble for pushing a smartphonebased GP at Hand service run by healthcare company Babylon during a newspaper interview.
It is only right that GPs should make use of the internet – it makes for far more efficient use of their, and our, time if sometimes matters can be dealt with via email or telephone rather than by us having to travel across town and sit in a GP’s waiting room. But never should the enthusiasm for new technology be used to try to put off patients from seeing a doctor when they sense it is required.
As the distinguished oncologist Karol Sikora wrote in the Express, cancer is often diagnosed after a GP has noticed subtle symptoms like yellowed eyes or skin which it would be extremely difficult to pick up on a Zoom call, even if you can get a good connection, which in many rural areas you cannot.
Moreover, by trying to force people online, the NHS is making life difficult for the people who need the most help: the elderly and disabled, who can struggle to use smartphones.
It may come as news to young policymakers but only 80 per cent of the over-65s have an internet connection at home and only 53 per cent own a smartphone. How are they supposed to seek advice?
The obsession with telemedicine is part of a far wider “digital first” strategy which for years has been trying to deny public services to people who do not use the internet.
LAUNCHING the strategy in 2014, the then Cabinet Secretary Francis Maude made the patronising remark that public services should only be available online “because we think that is a better way for people’s lives”, and dismissing people who didn’t use the internet as “refuseniks”.
What about giving people the choice of how they use public services?We have seen the effect of the policy, in people struggling with the online-only application for Universal Credit. How are you supposed to have a smartphone if you are living rough?
I am not saying that we shouldn’t be able to access public services over the internet. Of course we should. But never should the Government forget those who do not have easy internet access.
The Government needs to drop its digital first strategy and turn it into one of “digital as well”.
‘Cancer is often diagnosed after a GP has noticed subtle symptoms’