With apologies to the Times and Dr Hammond I reproduce the article below. I agree, and moreover I believe it’s going to get worse, as the minimum period to train a GP from start of Medical School is 10 years. Please read Medical Students’ Debt…. The NHS impending failure is due to “unlimited demand, limited resources, and no disincentive to make a claim”. The paternalism of the NHS (everything for everyone for ever) discourages autonomy which is inferred by Dr Hammond’s last paragraph. Unfortunately we have a Regional Health service (not an NHS) with Post-Code differences, gaming by patients located near frontiers, or who need access to “choice”, especially if they live in Wales (we should all rage against it’s dying). An NHS designed for assertive and informed people only (Be pushy!) – is that what we really want? Without overt as opposed to covert rationing, (note recent cancer posting) and encouraging autonomy for non-fearful conditions, the slow implosion will continue…..
“GP services are on “the brink of extinction”, according to Dr Maureen Baker, the leader of the Royal College of GPs. It’s a polite way of saying they aren’t always safe. Surgeries see 90 per cent of “patient contacts”, currently 340 million a year, at a fraction of the NHS budget (just 8 per cent).
It has ever been thus, but as patient expectations have risen with their life expectancy, the model of ten-minute consultations just isn’t working. Trying to treat patients with six illnesses and seven symptoms on 13 drugs in so little time is frankly dangerous.
I stopped being a GP in 2012 because it is so stressful and unsafe, and joined a specialist team treating young people with chronic fatigue syndrome/ME. It’s a horrible and complicated disease, but I now have 90-minute consultations.
Finally, I’m able to practise a standard of NHS care that I can be proud of. In the NHS the 20 per cent of patients with multiple long-term illnesses use 80 per cent of resources. They too need long consultations with specialist teams and continuity of care to keep them in their homes. With this approach, hospital admissions can be halved, with big savings, but it needs investment.
Dr Baker is asking for 11 per cent of the NHS budget and another 10,000 GPs. In the NHS, your care is crucially dependent on whether you have access to a professional team working in modern premises. Most chronic diseases are now managed in general practice and referral to nearly every other branch of the NHS requires you to go through a GP. Even if you go private, many insurers insist you go via a GP. If you have poor GP services, your chances of surviving the NHS take a big dent.
Instead of focusing just on GPs, we need to join up hospital, community and social care services. Staff must share expertise and information quickly across the system, and ensure patients get the right care in the right setting. This will need a common culture, budget and IT system and, like training 10,000 GPs, will not happen overnight.
In the meantime, patients who want to should be given control over their medical records and access to the best information to manage their illnesses and stay well.
By far the biggest health gains are through changing how we live our lives, and you don’t need a GP for that. Which is probably just as well.” (you do need education, information, willpower, and ability to game – something Times’ readers probably have, but which many people do not.)