A couple of weekends ago I was working as an on-call psychiatrist at my local emergency department. In those 12 hours I saw for myself the horrific and tragic repercussions of patients not being able to see their GPs.
It was total chaos. There were people scared and in pain, many of them with conditions that should have been treated by their GP weeks before, but which had now worsened.
Perhaps the saddest was that of a woman brought in by her partner after a suicide attempt. She had been suffering from acute anxiety for some time after a devastating bereavement, but she simply couldn’t get an appointment with the GP.
In desperation, her partner personally went to the GP’s office and an associate doctor (someone who has some medical training, but is not a doctor) called her and referred her to a mental health crisis team, but for some reason the team never came. above.
Desperate, this distraught woman attempted suicide and almost succeeded. If her GP had seen her quickly, it is possible that she and her partner would not have suffered the trauma of her near-death. She would not have been in a hospital bed, cared for by me for several hours, nor detained under the Mental Health Act.
Getting an appointment to see a doctor can mean waiting up to a month
The emergency treatment and ongoing care you will now need cost the NHS many times more than a GP appointment would have cost you.
Unfortunately, this situation is something that I and other medical professionals now see all the time. Having easy access to a family doctor, who knew you and your history, whether someone who cared or someone who only asked for help when you were really desperate, was once the norm.
But new figures show that this is now the exception. In many areas, this valuable continuity of care has been lost and it is virtually impossible to see a doctor within a week, let alone the same doctor.
In some areas, one in ten patients waits more than a month. These numbers are 38 percent worse than last year, and the trajectory is only going in one direction.
A month is too long to wait to see a doctor. What may seem like minor, annoying symptoms (a little bleeding from the anus, a few episodes of coughing up blood, or a small growth) are sometimes a sign of something serious. If treated early, the prognosis is usually good. But patients are deterred from making an appointment if they have to wait a month. They don’t want to overload a system that is clearly under so much pressure. Even for those who are not put off by long waits, things can get drastically worse within a month, as they do with some cancers or, as in my patient’s case, with mental health.
The result? Increased pain and anxiety and often more complex and expensive treatments. Or avoidable death.
The pandemic normalized online consultations. So rather than having to wait a month to see a doctor, people are increasingly willing to pay £70 to get a quick, private consultation with a GP online.
Although I am not in private practice (I have been an NHS doctor all my life), even Yo he became private when he faced a months-long wait to fix a broken ankle and again a serious chest infection. If I had waited for the NHS to treat me, I would not have been able to continue working, leaving my own patients in misery.
More and more doctors, exhausted by the demands of NHS work, are turning to the private sector for better pay and conditions.
When I was in medical school, none of my classmates admitted to aspiring to work in private practice. Now, many of the medical students I teach openly state that this is their goal. It’s better paid (tempting if you have a lot of debt from medical school) and private practice is much more family-friendly, especially if you can log in from home for a couple of hours.
Private practice is attracting more and more doctors, creating a two-tier system in which those who can pay to see a doctor privately receive treatment or are referred more quickly, outpacing those who have to wait weeks to see to an NHS GP.
This is not the fault of GPs. Almost every NHS GP I know is on their knees, working with great dedication and under incredible pressure. But they are disillusioned and exhausted that successive NHS chiefs and governments have not invested enough in primary care.
Instead of plugging the gaps by hiring foreign doctors – often from developing countries where they are greatly needed – more training should have been done here.
They are now recruiting more GPs, but it takes a minimum of 12 years to train a fully qualified GP.
The relationship between GPs and their patients, a cornerstone of the NHS, is breaking down. We must prevent our health service from completely collapsing.
