THE GREAT GP SURRENDER
Giving every patient the right to a face-to-face appointment is impossible, claims top doctor
ONE of Britain’s top health chiefs yesterday defiantly dismissed calls to give all patients the right to face-to-face care.
Martin Marshall, chairman of the Royal College of GPs, told MPs that patients who ‘absolutely need’ to be in the same room as their doctor are being seen.
But Covid safety measures and high demand mean it is not possible to offer in-person consultations to people simply because they would ‘like’ one. It was impossible to deliver, he said.
Professor Marshall acknowledged the proportion of patients seen in surgeries has fallen from eight in ten before the pandemic to fewer than six in ten now. But he insisted the rate of consultations, via telephone or online, is ‘about right’. He added: ‘I don’t think we’re going to go back to 80 per cent being face to face.’
His appearance at the Commons health committee came a day after the Scottish Daily Mail launched a campaign to improve access to family doctors. The Mail is demanding that faceto-face GP appointments are the default, and that anyone who wants to see their family doctor in-person should be able to do so. Incentives should be provided for local surgeries if necessary.
The number of GPs in Scotland was 5,134 last year, a rise of 89 compared to 2019. But that does not take into account how many work full time. The most recent figures show a decrease in the proportion of GPs working full time in Scotland, from 51 per cent of GPs in 2013 to 37 per cent in 2017.
Experts are demanding action amid fears that cancers and other serious conditions are being missed remotely. Boris Johnson and UK Health Secretary Sajid Javid are among those pushing for more in-person care.
Last night, Dennis Reed, from Silver Voices – a campaign group for the over-60s which is demanding a legal right to face-to-face appointments – hit back at Professor Marshall. He said he was ‘shrugging his shoulders and surrendering before the battle is over’. Mr Reed added: ‘He needs to keep on fighting for more resources so we can all get the care we need.’
Caroline Abrahams, of charity Age UK, backed calls for increased investment in GP services and warned pensioners had been left feeling ‘cast adrift’.
She said: ‘This is not acceptable and we have to change it fast, to regain public confidence and reassure them that whoever they are, they will not be left behind.’ Senior Tories also backed the campaign. Former Tory leader Iain Duncan Smith said: ‘It’s really important for GPs to try to get back to face-to-face appointments.’
Professor Marshall told MPs that there are patients who ‘absolutely need to have face-toface contact in order to get the high quality care to pick up the right diagnosis’, while others simply ‘like’ in-person appointments and GPs do not have the capacity to deliver this.
He said: ‘People are saying the patient should have a right. There’s no point in having a right if it’s undeliverable and it is essentially undeliverable at the moment.’
He said GP workload had gone up during the pandemic ‘and indeed over the last decade’, adding: ‘The pandemic isn’t over. We’d like to think it is. It might be over for pubs and nightclubs [but] it’s not over for health services.’
Professor Marshall said about 80 per cent of GP appointments were face-to-face before the pandemic, dropping to 10 per cent in the first wave. The figure is now around 56 per cent.
He told MPs 56 per cent is ‘where we should be’, adding that face-to-face appointments ‘aren’t needed by everybody’.
Professor Marshall said there is a ‘risk’ that serious illnesses are being missed as a result of GPs conducting more remote consultations. But he thinks it is happening ‘less’ now as doctors have learned who they need to see in person.