Beam me up, doctor

SKYPE will bring your GP into your home—or so we are assured by the Government. For many living in the countryside, that can’t be all bad, given the increasing distance of medical services from the rural customer.

When, 40 years ago, I first moved into my village of 200 people, we had a one-man practice: a doctor available all hours and doing home visits as a matter of course. Medicines were dispensed and left in a cupboard on the outside wall of his surgery for those who couldn’t pick them up during opening hours.

We all felt personally looked after whatever job we did and whatever our state of health. That’s how he saw the Nhs—extending the privileges that we once had to pay for to all who needed them.

Forty years later, we have a group practice and none of us really knows any of the halfdozen partners. You get whoever’s there when you book an appointment, home visits are nonexistent and the connection of the doctors with village life hardly exists.

Of course, we have computers, proper record keeping, new diagnostic tools and a much greater demand on the service. The old system couldn’t survive in a world where there is so little of the self-discipline that once meant patients only troubled the doctor when it was really necessary.

Nonetheless, the rural service we have today has diminished so much that, before we welcome Skype consultations into our homes, we might look to see what could be done to regain some of the good things we’ve lost.

We should take the primary blame ourselves. Many people use the doctor as a first resort, never thinking of a visit to the pharmacy—or even grinning and bearing the normal ups and downs of life. That’s not to say we shouldn’t consult the doctor when we need to, but the unnecessary pressure by some patients simply reduces the service available to the rest.

Indeed, so offhand are we about the NHS that, every year, we fail to turn up to six million GP appointments. It should be a rule that, if you miss an appointment, you are automatically charged, unless you can provide a clear and unavoidable reason. Further appointments should simply not be booked until the charge is paid. Doctors could also further discourage unnecessary visits by universally refusing to prescribe over-the-counter medicines that people could and should get for themselves.

If we, the patients, take our own responsibilities more seriously, we could demand to be taken more seriously as customers. For all the wonderful work done by doctors and nurses in surgeries and hospitals around the country, there is an arrogance, particularly among the bureaucrats in the NHS, that is unacceptable.

Bureaucrats are often our first point of contact, yet we are customers, we pay for the service and they have a duty to provide it as helpfully and conveniently as possible. They are not doing us customers a favour.

Without doubt, there are many who are enormously kind and accommodating, but this is far from universal. If we’re to have any chance of accepting Skype, we must first have surgeries at which the telephone is answered promptly and helpfully by a real person. We must have doctors whose names we know, who play a part in the local community and whom, as individuals, we trust.

Then, their use of Skype would be seen as an additional service bringing them closer to the customer, instead of another example of technology replacing real human contact.

We must have doctors whose names we know, who play a part in the local community

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