Protect the NHS? It’s time to make patients a priority
THE text messages came thick and fast – but each of them had a similar theme: give your GP the widest possible berth.
A computer glitch, presumably, meant that I got about a dozen consecutively in short order, telling me the local surgery was in dire straits.
Due to ‘unforeseen circumstances’ and ‘unprecedented levels of demand’, I’d be better off going to the chemist – anywhere except the GP practice.
I’d be surprised if there wasn’t a link between these texts being churned out and a consequent increase in preventable deaths – imagine a pensioner deciding to delay a trip to her GP to ask about chest pains, and then suffering a heart attack…
Physically locking the doors of surgeries during the first lockdown was an extraordinary move, though one that most of us could have lived with for a short spell.
But it looks like it’s here for the long haul because some senior medics and public health chiefs believe the pandemic has ushered in a new era of virtual healthcare.
As we revealed yesterday, almost one in four outpatient appointments in Scotland is now carried out by phone or videolink: the patient is treated, but only at arm’s length.
Plenty of GPs on the front line are uneasy about the trend.
Dr Mike Smith wrote in the Mail on Sunday last month: ‘Most GPs I know would say that they already listen to their patients, but I wonder if we’ve become so used to saying it that some of us have stopped doing it.’
The best GPs will know probably within minutes, if not seconds, if there are genuine grounds for concern as soon as a patient walks in and starts explaining their symptoms – but it’s easier to miss them in remote consultations.
Dr Martin Scurr, who writes for the Mail, has warned that the loss of continuity of care – seeing the same GP – and the push for more care to be conducted online or by text means that assessing ‘alarm symptoms’ and arranging tests is ‘difficult, to say the least’.
He wrote recently that many patients require ‘not just a conversation (‘the history’) but a physical examination and other investigations in order to reach that point of dismissal of other possibilities’.
It’s worth remembering that we are all customers, of course, because we pay for the NHS through (often pretty eye-watering) taxes.
Yet negotiating the obstacle course of the GP’s receptionist desk is an exercise that requires stamina and guile – you’re made to feel that you have got it wrong, and that you’re maybe even a hypochondriac and a time-waster.
The pandemic has exacerbated existing fault-lines within the NHS – but the contingencies that were introduced to tackle Covid may be here to stay.
While you’re being told to steer clear of your GP’s surgery, there’s a lot that you can do, for now at least.
As we’ve seen in recent weeks, you can watch tennis or football unmasked and with no social distancing, or board a crowded plane.
Then there are the hundreds of football fans who travelled to London for the Scotland-England Euro 2020 match – and brought back Covid as a souvenir.
But seeing the doctor in person is deemed too dangerous, necessitating a phonecall, or maybe (if you sounded like you’re really struggling) a Zoom call, if you can figure out how to make one, and have the equipment to do so.
There’s a point where extreme caution – though justifiable against the backdrop of escalating Covid case numbers – becomes counterproductive, because of all the treatable non-Covid diseases that have been avoidably missed.
And surely the evidence suggests that we’ve strayed well beyond that point.
We all appreciate that the NHS has been and continues to be under pressure, and its dedicated medics deserve immense praise and credit for their contribution since March last year.
And as the vaccination drive continues (although it’s losing momentum), many of them have been diverted to staff immunisation hubs.
Consultation: but in-person appointments could become a thing of the past
As restrictions ease, there was always bound to be a flood of patients seeking medical help for non-Covid conditions.
Yet while it’s true that some hospitals are at full capacity, the link between Covid diagnoses and hospitalisations – and deaths – has been severely weakened.
We can’t afford to make the same mistakes again, with the NHS pulling down the shutters – we were all only too happy to protect it by staying at home, but wasn’t it also supposed to protect us?
Almost 4,000 fewer people were diagnosed with cancer during lockdown – with approximately 1,000 of those believed to be ‘missing’ breast cancer patients.
These are horrifying statistics, and they might even lead you to conclude that it was more than a little premature for ministers to have ordered the dismantling of the NHS Louisa Jordan field hospital in Glasgow (at a cost of £7million).
And yet in November a United Nations climate change summit is scheduled to take place in Glasgow, which will see tens of thousands of delegates descending on the city.
A country that can countenance an event which could become a Covid super-spreader (who knows where we’ll be in the winter?) but decrees GP surgeries to be out of bounds for all but the worst-afflicted, if you’re lucky, has got its priorities wrong.
UK Health Secretary Sajid Javid has spoken of his shock at the number of patients waiting for hospital treatment – it could be as many as 13million.
If paying private hospitals to treat NHS patients could help clear the backlog, Mr Javid said, then that was ‘fine with [him]’.
You can expect a little more resistance to that idea from the statist SNP and its Left-wing allies in the Green Party, who are bound to prioritise the protection of their ideological commitments ahead of protecting patients.
But radical measures are needed.
We love the NHS, and many of us clapped for it in the early days of the coronavirus crisis – but the pandemic should also trigger a long, hard look at what it could be doing better, and how.
Politicians, fearful of electoral consequences, are terrified of talking about privatisation and charging for GP appointments.
But are we really saying that the system as it stands is perfect?
It won’t do to keep throwing more cash at it (though in the short term that would be a good start), as so much of it is sucked into bureaucrats’ salaries rather than being spent where it should be.
Most of us all too readily forgive the NHS its faults, knowing the alternatives are far worse – but the danger is that poor standards of healthcare become endemic.
We can’t hope to rescue our most cherished public service until we start putting patients first – and confront the ugly reality that without major reform it will remain on life support.
*This column appeared in the Scottish Daily Mail on July 13, 2020.