SARAH VINE
ON REMOTE GPS
I was saved after seeing a GP. Getting an appointment today is like trying to get past a Soviet border guard. It’s unnacceptable — and it’s dangerous
Twice in my life i’ve owed everything to a GP — once when my son was a baby and a few years later when i had peritonitis. The doctors’ experience and quickthinking made the difference between life and death. Both have since retired, but i owe them an inestimable debt of gratitude.
it is because of those experiences, and other smaller, equally memorable ones, that i am a huge supporter of general practice. GPs are vital, the linchpin of the nation’s health. Their contribution is invaluable.
But here’s the thing. Had i not been able to take my son to see the GP face to face, it is possible his illness — mastoiditis — would not have been detected. Thanks to antibiotics it has become, as the doctor said then, a disease you only really read about in medical textbooks.
it was certainly the first case he had seen, despite being a seasoned practitioner. even with a physical examination the problem is hard to spot. Luckily he did, and my son — then just a few months’ old — was rushed to our local hospital, and then St Thomas’ in London, where surgeons drilled a hole in his head to drain an abscess on his brain caused by the infection.
And it was a similar story with my leaky appendix. i’d had stomach pains and vague sickness on and off. That day i woke feeling particularly icky, so rang the surgery and was given an afternoon appointment — which i almost cancelled when, at lunchtime, i felt perkier.
But i went anyway, said i was feeling a little better and my GP said she would have a general prod to be safe. She did her thing, then requested an ambulance. i spent the next two weeks in hospital recovering from a four-hour operation. i’ve never felt so ill in my life.
The outcome in both cases would have been very different had the consultations taken place by phone — or online. it was the human interaction that made all the difference.
That is why the current situation, in which just 57 per cent of GP appointments are in person compared with 80 per cent before covid, is not only unacceptable: it’s dangerous. And why this newspaper is so right to insist that we do better.
dr chaand nagpaul, chair of the BMA council, can rant all he likes about covid safety measures and ‘an onslaught of abuse and media scapegoating of GPs and their staff’. The fact remains: patients are suffering, even dying, and it is his job — and duty — to do something about it.
Of course, there are many brilliant practitioners out there, who, despite the obstacles, manage to offer firstclass care. But it is a postcode lottery and shouldn’t be.
The fact dr nagpaul is so defensive is, in many ways, the root of the problem. There seems to be a fundamental refusal to accept the existence of a problem, let alone that he and his members should in any way be held accountable.
instead of excuses, he should offer solutions. instead of bleating about workload, he should find out why, if GPs are, as he claims, ‘seeing more patients than ever, working longer hours than ever’ it does not seem to be translating into adequate care.
Though he is referring to nHS appointments, many GPs are also seeing patients privately, as they are free to. Given the difficulties many patients have getting a slot with a GP and the number of private helplines springing up, i do wonder if there might not be some crossover.
Abuse is unacceptable, but many patients feel exasperated at being unable to see a doctor face to face.
Yet there are frustrations on both sides: my surgery, for example, has a long recorded message designed to put off as many callers as possible — and when you do finally get through, they’re about as helpful as a Soviet border guard. i’ve been trying to get an appointment for weeks. i’ve all but given up.
i still have huge respect for GPs, who do so much for us all and who have been a vital part of the fightback against covid-19. But this relentless drive to move to a remote working model is not OK.
Of course there are times when a telephone conversation is appropriate — as when i had swine flu in 2008, my GP dealt with me remotely, prescribing treatment and antibiotics for secondary infection.
But as a general rule, people need to see their doctors. normal service
must be resumed as soon as possible. it is up to the BMA and no 10 to make it happen. ideally before the forthcoming national insurance rise reminds us of quite how much we’re paying for this shambles.