Investment may be needed, but GPs must restore a full service

THE vast majority of patients have a good relationship with the GPs at their local surgery and can get an appointment when they need one. But there are too many examples when, for a variety of reasons, the service expected falls short.

GPs responded angrily last week when the Health Secretary Sajid Javid called for a return to more faceto-face consultations and announced a package of measures, including new funding, to help pay for more staff, including locum GPs.

The funding, many warned, would not be sufficient and the availability of locum doctors to do the work was limited. Plus, many argued, patients were often happy with a telephone consultation and seeing patients over the phone or online meant many more minor ailments could be dealt with.

There is clearly a crisis across the NHS and that includes with primary care. Coronavirus obviously made things more difficult and heralded in the “telephone triage” – where patients are assessed over the phone to decide if they need to see the GP face to face.

This may suit some patients. But those GPs who suggest it is a better way of working and most patients prefer it are misreading the mood of the majority.

Most people would rather see a doctor than talk to one over the phone or try to use the camera on their mobile as a means of communication about a problem or a concern. Psychologists have long reminded us that the verbal part of any communication is a very small percentage of the total.

Body language, expressions and other non-verbal signals make up between 70% and 93% of human discourse with others. GPs who pick up on those signs and signals can question patients more deeply to get at the root of a problem.

And with mental health issues now one of the most significant health concerns of our age, digging into those things that might be unsaid but which are truly troubling a patient is vital.

There were very good reasons to moving to online or telephone consultations during Covid. The whole world moved to “Zoom” for months during the height of the pandemic. If rates continue to rise we may need to consider a return to some of those restrictions.

But in the medium to long term we need an NHS, from primary care to specialist treatment, that is truly fit for purpose. GPs might be right to complain that politicians fail to understand the pressures they are under, but accepting face to face consultations are the exception rather than the rule is giving up.

Ministers are right to want to get patients back into the surgery wherever possible and right to urge doctors to see more patients face to face. If the Health Secretary has underestimated what needs to change to make that happen, then he needs to address the shortfall.

But doctors and politicians need to get on the same page. Patients want the full service from their GPs and to be able to go and see the doctor if they have a problem. They have put up with the changes imposed by Covid, but they can’t last forever.