Dial-a-doctor will only put more stress on patients and the NHS

I’M STILL a bit poorly. Not flat on my back, draw the curtains and ‘please use your indoor voice’ poorly, just not particularly well. The whatever-it-is my husband and I contracted a few weeks back from one of the smaller, more germ-prone members of the family (and all we know for certain is that it’s not Covid-19) is clearly keen to linger.

Sore throats. Crunchy coughs. A general feeling of malaise and achiness that’s seen me in bed before Newsnight every day for a fortnight now.

So it made sense, in my mother’s mind at least, to inquire if I’d been to the doctor. Naturally I was dismissive. It’s a virus, I opined. What’s the point? But it might not be, she countered. You might need antibiotics.

I considered it for a moment, then shook my head. Not because I don’t think there’s a chance she’s right but because, these days, calling the doctor seems very much a last resort.

This week, we learnt that more than half of GP consultations take place by phone. It is an extraordinary statistic in a country where only three years ago phone consultations were the outlier, not the norm.

Patients now struggle to get face-toface appointments at all, and often find they have no choice – the decision instead being made by gatekeepers on practice websites or on the telephone.

The reasons for this are complex. There are fewer GPs coming through the ranks from medical schools while, at the other end of the scale, many have recently retired. Covid has forced surgeries to become creative in how they see patients, while staffing shortages mean they often simply don’t have the manpower to see as many patients as they would like.

But as Dr Sandesh Gulhane, the Scottish Tory health spokesman and a GP himself, remarked: ‘Let’s be clear: the blame for [these figures] lies squarely with the SNP Government, rather than our overstretched GPs.’

He went on to point out that there is a chronic shortfall in GP numbers in Scotland, particularly in rural and remote areas.

There is clearly some merit in phone appointments, otherwise I doubt they’d have taken off the way they have. The argument is that they free up doctors to see patients who are more seriously ill, and while I’m sure that can at times be true, it feels worryingly like many health issues may find a way to slip through the net, even if you have the telephonic ear of the most on-the-ball GP.

And while postcode lottery is an overused phrase these days, when it comes to seeing your GP, I do think there’s some truth in it. I know of at least one person in recent weeks who rang up their GP surgery, was seen that morning, and within ten days had a raft of tests efficiently and easily organised.

I know of another, at a different surgery, who spent weeks trying to see someone face to face while experiencing a rapid decline in health. The eventual phone appointment, delayed for weeks, swiftly revealed they should indeed have been seen face to face. Now, they must wait weeks more for a referral.

There is another issue too, one that is woven deeply into the fabric of Scottish society and has, I think, reared its head once more since the pandemic. ‘Don’t bother the doctor’ is a phrase I grew up hearing, and one I associate with that old-fashioned, almost pre-NHS notion that doctors are exceptionally busy and important people who should only be troubled when it’s a matter of life and death. I thought we’d left it in the past.

YET a lot of the rhetoric both during and since the pandemic has mimicked this tone. Don’t call an ambulance. Don’t go to A&E. Don’t call the surgery. We’ll decide if you need to be seen. For those who are already cautious about ‘bothering the doctor’ (and there are still many, particularly in our older generations), the message they will hear from their own Government is the same one they have been telling themselves for years.

Phone appointments are clearly here to stay. But there must be some middle ground here, and no one can possibly believe that more than half of all GP patients really should be assessed by phone. Because the more it becomes the norm, the more serious health conditions will be missed. And, ultimately, that will put the NHS under more pressure than ever.