My local NHS surgery used to be a shining example of care and efficiency. Whenever I needed an appointment to see a nurse or a doctor I either called up, or dropped by, and was usually given a scheduled date sometime in the following 10 days. If my ailment was more urgent than that, I could sit and wait to see someone in person, and rarely sat for longer than 90 minutes. I live in Paddington (or Bayswater, W2, Hyde Park Estate or Edgware Road, however you might want to describe it), and I am a member of a community that contains a fairly representative London spread — a community that also appeared to be thrilled by our local surgery.
Then, around five years ago, everything changed; it suddenly became incredibly difficult to see a doctor, as the introduction of a new system meant we now had to try and talk to a doctor on the phone. Predictably, the system didn’t work, as the doctor either didn’t call at the allotted time, or rang for such a short time that it was impossible to answer the phone, even if it was right there on the desk in front of me.
Consequently, I started to either ignore my symptoms, in the hope they’d eventually disappear, or I trudged to A&E at St Mary’s Hospital and waited for six or seven hours before being seen by a never-less-than-charming but always beleaguered nurse. The care was always exemplary, but because I was in a hospital the staff had to carry out lots of tests just to prove that I didn’t have a litany of other ailments I might reasonably have. This wasn’t their fault, and indeed they were taking extraordinary care of me, but a lot of this prep work was unnecessary and made the process even more protracted and expensive.
To alleviate this process, something else that doesn’t work has been introduced — an app called PATCHS, which is as confusing as it is broken. Consequently, I haven’t seen my local GP this decade, and probably never will.
When I speak to GPs who are friends of mine they tend to say the same things: the amount of scrutiny they are now subjected to, and the vast amount of digital paperwork they are asked to complete, makes it even more difficult to see patients. Some GPs say the biggest culprit is the Care Quality Commission, a politically orchestrated body which regulates all health social care services in England. The Commission has already had its fair share of well-documented problems, while some GPs who also work in the private sector feel they are unnecessarily demonised. And while some say the sector-wide phone system has improved working practices, all admit that it discourages genuinely ill people from seeking help. They also agree that an organisation that employs more than a million people cannot, with any success, be managed by one person, and that for the NHS to survive it needs to be broken up.
In Ireland, as many people know, there are charges if you want to see a GP. The cost varies between €40 and €60 per visit, although you’ll need to pay more if you then need blood tests, X-rays or additional treatment. Medical care there is means-tested, which gives you special dispensation if you can’t afford it or are old. And it makes complete sense. Of course, neither the Tories nor Labour would countenance such a scheme here as they would be vilified for edging down the road of privatisation, even though there are senior members of both parties who know it’s a good idea.
It’s more than that: it’s an excellent idea, and one that might alleviate some of the issues affecting the service. It would help streamline the chaos of the appointment system, reduce the burden on waiting lists, raise a modicum of much-needed cash, and allow someone like me — who is lucky enough to be able to afford appointment fees and would have no qualms about paying them — to see a doctor. I already (willingly) pay for private referral questionnaires, so why should appointments be different? I can pay, so make me pay. That way, everyone wins. A little.
