Let’s face it, seeing a GP in person is vital for our health
WHEN asked how he had persuaded family doctors to agree to the foundation of the NHS, Labour’s post-war health minister Nye Bevan declared that he had “stuffed their mouths with gold”. The offer by the current Health Secretary, Sajid Javid, of £250million to help GPs maintain appointments through what could be a difficult winter isn’t exactly emptying the contents of Fort Knox, but it is nevertheless a substantial sum.
At the very least, you might expect the doctors’ union, the BMA, to welcome the money and to agree to the condition that Javid has put upon it – which is that surgeries must hit targets for face-to-face appointments. But sadly that is not how things work at the BMA.
Rather, spokesman Dr Richard Vautrey said he was “hugely dismayed” by the offer, accusing the Government of being “out of touch” and adding “it is disappointing to see there is no end in sight to the preoccupation with face-to-face appointments”.
If the BMA think that wanting to see a doctor in the flesh is just a preoccupation of the Government, then sorry, it is they who are out of touch. An online petition on the website Change.org demanding that GPs restart face-to-face appointments has so far gathered 560,000 signatures.
MANY doctors, too, have warned of the importance of face-toface appointments. As Professor Karol Sikora, former director of the World Health Organisation’s cancer programme, has argued, it is often subtle symptoms like a patient’s pallor that first leads to a diagnosis of cancer. That is rather harder to spot in a Zoom call – and impossible in a telephone conversation.
There is no reason why GP surgeries should not by now have reverted to their pre-pandemic levels of service. Pubs, shops, theatres have been open for months – and hospital staff have had to see patients face to face throughout the crisis.
Yet GPs seem to be lagging way behind. In July, only 58 per cent of appointments were recorded as being face to face, compared with 80 per cent in January 2020. Moreover, NHS Digital admitted that even the 58 per cent figure might be an exaggeration, as some districts seem to be recording all appointments as face to face, however they were held.
In truth, the NHS has been pushing for years for a shift towards remote appointments, with disgraced former health secretary Matt Hancock a particular advocate – he personally switched from his NHS GP to an online service called Babylon.
It was supposed to increase efficiency. Yet the overall number of appointments has fallen since remote appointments became the norm, from 27.2 million in January 2020 to 25.5 million in July 2021.There has been no great improvement in waiting times. In July, 45.7 per cent of patients were able to get a consultation on the same day, only modestly up on the 41.7 per cent in January 2020. Still, 24.3 per cent are waiting for more than a week.
Nor has there been any great technological revolution. In July, a mere 0.4 per cent of appointments were online, lower than before the pandemic. Most remote appointments were on a plain old telephone, where the doctor can’t see patients’ lumps, bumps and spots. Given that many of the patients most in need of NHS care do not have the internet, it is difficult to see how it could be any other way.
I know that being a GP can be a tough job, and that we don’t train enough doctors – something we need to put right.
But GPs can hardly be said to have had a bad deal. Thanks to a bungled pay deal by the Blair government in 2003, they received a fat pay rise while simultaneously being allowed to opt out of evening and weekend care. Various promises of longer opening hours for surgeries have come to nothing.
IN the past four years GPs’ pay has risen by 11 per cent to reach an average of over £100,000.While I am sure we could do with more GPs, claims about an “exodus” are wide of the mark. While numbers of fully qualified GPs working in the NHS did dip during the first few months of the pandemic, by September last year it had recovered to 39,265, an extra 300 compared with a year earlier.
Surely it is not too much to expect GPs to return to providing the level of service they were before the pandemic. Much as I appreciate being able to speak to a GP – sometimes – without a trek to the surgery, face-to-face consultations have always been the bedrock of primary care. Sajid Javid is quite right to demand that patients be able to see their doctors and not be fobbed off with a phone call.
‘In truth, the NHS has pushed for years for remote appointments’