How the NHS Blob has been keeping doctors away from their patients
sir – Among all the challenges faced by the NHS (Comment, August 29), little has been said about reduced productivity.
As a cardiac surgeon I was performing up to 350 major cases a year in the 1990s, but by the time I retired 10 years ago that number was around 120.
There were many reasons: a consultant contract (motivated by the erroneous suspicion that consultants were skiving) that decreased my sessions by 30 per cent and increased my pay by 20 per cent; a pension policy that resulted in the risk of actually paying to work extra sessions; the working time directive that reduced the support of trainee surgeons, despite their desire to gain experience; the General Medical Council requirement for revalidation, which, despite the lack of any concrete data that it is beneficial, has become a time-consuming and expensive industry; the necessity to undergo “mandatory and statutory training”, taking front-line staff away from patients; the highly vaunted IT systems, the navigation of which wasted half an hour each day.
The “Blob”, working in committee rooms in Whitehall, divorced from the coal face, may well have thought these initiatives were beneficial – but every one has come at the expense of doctor-patient interactions. We are now seeing the catastrophic results of this approach.
Edward Smith FRCS
London SW20
sir – To say it is possible to quantify the number of people without access to a GP at 1.5million (Leading Article, August 30) is not accurate.
This is the number who can’t access a GP because their surgery has closed. It does not include those patients who cannot access a GP even though their surgery is still open.
Vanessa Howard
Stockton-on-tees, Co Durham
sir – Your Leading Article bemoans the current shortage of GPS, then states: “They also have a very cosy deal.” So why don’t market forces solve the problem? Why are doctors shunning this deal?
My work has recently led me to meet numerous GPS in Leicestershire. They are almost all miserable. The problem is not their remuneration; it is that the job they are asked to do is just not enjoyable any more.
This is down to how the NHS expects them to work. They know that in delivering what the NHS demands, they cannot deliver what their patients need. That’s what needs reform.
Peter Furness
Whissendine, Rutland
sir – A well-organised GP can deliver great service.
I had cause to call my GP at 8.30am with an urgent problem. The call was returned by a doctor 20 minutes later, and I was seen an hour after that. I was given a thorough examination and prescribed medication. It can be done. Tim Banks