The NHS, Again

The BBC reports that
'Family doctors are not prepared to shore up an emergency healthcare system left unsafe by "political meddling", a GP has warned'

Whilst there may be some political problems, the main problem with emergency health care is the total abrogation by most GPs of any responsibility for their patients' care outside surgery hours. In the case of my local surgery the hours are from 8:00 am to 6:30 pm, Mondays to Fridays. This is just fifty two and a half hours out of a total of the hundred and sixty eight hours in a week. So for over one hundred hours a week, plus Bank Holidays, they offload the responsibility onto someone else. Nice work, if you can get it!

But who is that someone else? Last time I needed an emergency doctor of a weekend and phoned the surgery, there was a recorded message giving me a number to phone which belonged to an out of hours service run by a company called Harmoni. We have used this service twice in the past, on one occasion they sent a doctor who came about three hours later, and on the other, we were advised to go to our local A&E. But looking at the surgery website this morning whilst ordering a repeat prescription, I found this new instruction:

Out-of-Hours - Evening & Weekends

For medical advice when the surgery is closed please call 111

So patients are now told to phone the 111 number, which replaces the old "NHS Direct", rather than a company providing the surgery with an out-of-hours service, a company which presumably had some contractual obligation to the practice and indirectly with their patients.

Now one phones an NHS organisation, with the result that if the person manning the phone decides that you need medical attention, rather than just advice, you will be referred to A&E. And, of course, if one can't drive, there is no option but to call an ambulance. In our case, the A&E at the nearest hospital was closed earlier this year and we now a choice of two other hospitals which are considerably further away. As far as I can ascertain, neither of these have had their facilities upgraded to cope with the extra workload, one of them in fact coming under a different Health Authority.

Whilst one can't blame GP's for the A&E closures, I believe that we can blame them for for the poor availability of out of hours medical services. With six or more doctors at the local surgery, I can see no reason why they should not provide the out of hours service for their patients on a shift basis, particularly as they live nearby and have all the patients' records available for consultation.

So whatever the BMA GP chairman says, I still believe that it is the GP's who are largely, but not entirely responsible for the present problems.

Perhaps our doctors might like to think about the public perception of teachers once they became unionised. In my younger days, the most respected people in our community were the local doctors and schoolteachers. These days, teachers are seen as just local council jobsworths, and our doctors are rapidly heading the same way. Is this what they really want to be, just civil servants providing a service during office hours?