Primary Care

How many of you, my dear readers, have heard some horrifying stories about NHS24? They are, of course legion and as such are deeply disturbing. It is the remoteness of it all that concerns me. When I worked in General Practice, my partners and I had care of our patients 24/7. We knew them all and their histories we carried in our heads. Woken at night by the telephone we usually knew who was at the other end of the line by their voice and we also knew that a diagnosis could rarely be gained by the call alone. I will not say that we did not prefer to stay in our beds but sleep would be impossible! Reluctantly we got up and the further away the patient, the better our mood as by the time we reached them we had quietened down! We were with them in the time it took to get dressed and be down the road in the car.

It is a different story now. First of all one has to go through all the various tiers of command with repeated confirmations of rank, name, number etc and while all this is going on you can hardly get a breath or your loved one is slowly choking and becoming more and more blue. The doctor will arrive hours later if you are lucky because he is miles away on another call. My advice has always been call the ambulance if you are getting no sense in a few minutes. This is wrong, of course, but is usually the only practical answer. Mind you, if you are seeking urgent attention during 9 to 5 and during week days only, you will normally get a good response. However it is not always practical to be ill during these hours!

How times have changed. My remuneration for a night call between 11pm and 7am was £5. For night duty now the fee can be in the order of £1000. Who are these doctors earning these fees? Many are your own GPs! I don't blame them as this is the system in which they work. That does not mean that it is in the interests of the patient as it is not. May be it is easy to say it now that I have retired but life in the good old days was hard but it was rewarding. We gained and I hope the patient did too.

We, the patients can be getting a raw deal and I strongly believe that the service given in the past far outweighs that given now. To get GPs to return to the former care regimes will be difficult but I would tell them the service offered would be so much better and they will feel so much more rewarded.

There is a real need to rethink the health service, cut out waste in the huge management costs, stop chasing crazy targets and just simply get down to looking after people. Lastly how often have you heard that "experts" have found a new way for you to live your life, only to have this corrected by another team of "experts" a short time later? Drives you mad!