The Doctor’s Surgery Tom Stuttaford
Tom Stuttaford: The Doctor’s Surgery
Only rarely are doctors confronted by people who don’t agree with the basic principles of the NHS, the most important of which is that medical treatment should be free at the point of delivery to everyone who needs it.
Aneurin Bevan was a patient of my boss when I was a junior hospital doctor. He may have been kicked down the steps of the smartest of London clubs by a member who felt he was too Left-wing to be welcome; however, as a patient he was always polite, charming, amusing and accommodating – in fact, the ideal client. We saw him on the NHS but he once told me that, although he didn’t welcome private medicine, he would not abolish it so long as the poorest in the land could obtain the same treatment without cost that was available to a private patient.
Some branches of the NHS and social care are crumbling fast. British general practice, once the wonder and envy of the world, has now been so altered that it is no longer fit for purpose.
Selecting the right candidates for medical school so that many of the country’s future doctors have the personalities that will enjoy general practice as well as demonstrate a reasonable intelligence is the first essential step to ensure the future of general practice. Selection committees choosing medical students too often seem to have forgotten the well-proven premise that the higher the student’s IQ, the more likely it is that their empathy will begin to fall.
Medicine needs people with great brains who have a determination to overcome the short-sightedness of politicians and civil servants, and the occasional greed of the financiers who run the pharmaceutical industry.
It is unreasonable to expect a newly qualified doctor, who may have excelled at mathematics, physics and chemistry, to settle for being described by someone who has done little for society as ‘only a GP’. Little do they realise that their lives and those of their possibly still unborn baby or their aged grandmother may depend on the diagnostic skills and devotion of their GP.
It may save the NHS money but the more the GP’S role is degraded to being a cog in a large and depersonalised practice, the faster will be the decline in the standards of British medicine, as measured by survival from cancers and happy outcomes from childbirth. The most dexterous surgeon or the most brilliant physician won’t always be able to overcome the disadvantage that a patient will experience if there was a shortage of time available at the initial GP appointment, or if the monstrous difficulties of making the appointment, encouraged a patient to wait too long.
Although no longer in practice, I still hear patients bemoan the loss of the traditional Gp-patient relationship, and the difficulties of arranging to see a doctor. A former patient said to me recently: ‘The government tells us not to go to the GP if we are infectious or are really ill, but without seeing my GP who am I to judge if I am “really” ill?’
She added that it is such nonsense to expect patients to diagnose and categorise the importance of their symptoms that she was forced to conclude that government advice was more directed at saving money than saving lives.