CREEPING DANGER OF A PRIVATE GP SYSTEM

MY PARTNER’S father is 88 and earlier this year his health began to deteriorate. over a three-week period, we repeatedly requested a home visit from his GP without any success.

in the end, he suffered a stroke and has now been in hospital for six weeks. i think it highly likely that this outcome could have been avoided if a doctor from his local practice, someone who knew him or who had access to his medical history, had been able to visit.

Sadly, experiences such as this are becoming increasingly common as the NHS struggles to return to ‘normal’ service after the pandemic. Yes, waiting lists are soaring — currently at 6.4 million and counting. Many A&E units are stretched to breaking point, while ambulance response times grow and staff shortages worsen.

A key factor in this looming meltdown is the calamitous state of general practice. once a central pillar of healthcare in Britain — GPs are the gatekeepers of the NHS — its foundations are crumbling.

Despair

The needs of the public are no longer being met, while the core principle of free access for all is under threat as never before.

in the last week alone, two reports have laid bare the scale of the deterioration in the provision of primary care.

on Monday, the Mail revealed that in the worst-hit parts of the country, more than a quarter of consultations with family doctors now take five minutes or less.

And across England, out of 3.5million consultations in April, only half lasted more than ten minutes.

This study came in the wake of another depressing analysis showing that the number of people turning to private GP services has increased dramatically in the past two years.

According to a newspaper poll, no fewer than 1.6 million people have paid for a private consultation for the first time amid growing disillusionment with the service offered by NHS GPs.

in truth, this should come as no surprise. The British Social Attitudes survey last year found that just 38 per cent of patients were satisfied with the performance of their local practices, a staggering drop of 30 percentage points since 2019 and the lowest level since the survey began almost 40 years ago.

As an NHS GP myself, i despair at what is happening and understand the frustrations of the public.

But unless action is taken, i also fear the crisis will accelerate the emergence of a two-tier GP service, with those who can afford to pay for an appointment getting first-class care from doctors — whose training, don’t forget, is funded by the taxpayer — while the rest of the population has to settle for an inadequate ‘safety net’ service.

i have sympathy with those who feel compelled to seek private consultations. however, my own experience of working for one of the big commercial providers of GP services gives me pause.

My first objection is that the system smashes the central ethos of the NHS — that care should be free at the point of delivery, available to all regardless of their wealth or income.

The appointment fee of £40 charged by the company i worked for may have been affordable to middle-class patients, but it was well beyond the reach of the disadvantaged, or pensioners on a fixed budget — the people who are likely to have the most serious health problems.

As the cost-of-living crisis takes hold, that is even more likely to be the case now.

Radical

in addition, the quality of care provided by private GPs is often limited by an inability to access NHS patient records.

Moreover, the doctor-patient dynamic changes when payment is involved. The patient becomes the client, and doctors can find their authority undermined as demands may be made for certain kinds of treatment.

i also believe that the growth of the private sector brings into question the huge funds invested by the taxpayer in training NHS doctors. Should private firms scoop the rewards of this investment?

i am not against choice — those who want to seek private treatment from a GP or consultant should have the freedom to do so.

But unless there is a radical improvement in NHS GP services, this is a trend that will accelerate and imperil access to primary care.

So how has it come to this? one reason, i believe, is that our engagement with the public is becoming far too limited.

At my own practice, we are able to offer appointments that last 15 minutes, which is the minimum amount of time needed for a