GP APPOINTMENTS – by Mary Nelis

Where have all the GPs gone? That’s a question being asked these days by a lot of patients all over the North.

 I am old enough to remember the days before General Practice, the days before The National Health Service. There were viruses in those days too, illnesses like diphtheria, scarlet fever, TB, measles and a lot of sickness associated with poverty and bad housing. Those were the days when doctors sometimes got paid with chickens if people had no money. Doctors were held in awe by the community but every street had its substitute ‘doctor,’ the handy women who helped the sick and washed the dead.

 The arrival of The National Health Service was a revolution in patient care for the sick especially the disadvantaged.  My grandparents registered with the practice I am still with today. The four doctors who knew my grandparents, knew me and my children. There are eight GPs in this practice now and I don’t know any of them. In the street where I lived in Creggan there were fifty houses and five hundred weans. The family doctor was a permanent fixture in the street for those were the days when doctors came out to visit the sick face-to-face in their homes. It was a good system long gone.

Over the years it was replaced by a system where if one needed medical help they would phone their GP or appear at the surgery and the GP would see them and sort out their medical problems.  Granted there is no doubt that in the past, many people sought appointments with their doctors for trivial matters and many of the good doctors were grossly overworked. But in this enlightened age and with the availability of excellent chemists and community counselling services, such people are in a minority.

But getting to see our GPs over the past years has become a big problem.  It’s a problem that even precedes Covid 19. I recently posted a question on this difficulty on social media and was amazed at the response. Over a hundred people posted or replied or contacted me and it was clear that they were of the opinion that the majority of GPs have gone AWOL especially since the pandemic.

In the main, surgeries are closed. Some may be open but many require patients to stand outside in the street and wait to be called –  that’s if they have won the phone lottery and that’s hard to do.

The current system for most people and most surgeries requires patients to phone for an appointment in a time limited period and if they are fortunate enough to get an answer they are required to describe their medical problems to an anonymous person,  prior to repeating the exercise to a GP who may call back .

It’s humiliating to even try to tell someone over the phone your medical problems. The majority of people have little understanding of the medical terms for their complaints especially if they are of a sensitive nature. There is also the question of privacy. 

Under the current system not only do people struggle describing the problem but in a number of instances patients have been asked to take a photograph of their problem and send it by e mail or Whats App to the surgery. Can you imagine how difficult it would be to take a photo of a gynae problem or abdominal pain even if one has a knowledge of photography or computers or smart phones? Yet a number of patients have been asked to perform such tasks. But how much more difficult is this for the elderly or people with language difficulties?

In addition there is a perception that the sick are being encouraged to avail of the Private Health Care Service where it seems one can get instant appointments. Many, who cannot access their GP or who have been told that waiting lists for hospital care is years long, have out of desperation taken this route though many cannot afford it. I know of families who have had a whip- round to pay for private treatment for those they love. It is a disgrace. 

We all know the need for doctors and all medical staff to protect themselves from this deadly virus but it seems that the current system was in place prior to Covid. One wonders if patients were consulted of such profound changes.

There is no doubt that the pandemic has increased the work load for many GPs who during the worst days of this dreaded virus were seconded to Covid wards and who risked their lives to care for the chronically sick. So many owe their lives to the efforts of these good doctors.

But it’s sad that many of our excellent GPs are now nothing more than a listening ear for patients.  The result of this is that people with serious illnesses may remain undiagnosed and the psychological effects of those worrying are being seen in the ever-increasing numbers opting to go to A&E. This in itself is alarming in terms of the spread of this virus, apart from the future problems this may pose for an already cash-strapped Health Service.

There is no doubt that the Health Service as we know it is under attack from a heartless Tory Government in Westminster. The pandemic has been an opportunity for more stringent cut-backs in England, but Westminster cut- backs to our own Health Service have been ongoing for years prior to Covid. Most people accept the need for a radical change to the entire Health Service structure including GP arrangements.    

The current system is not working. Ask those trying this morning between 8.30 and nine o clock. They cannot even get an answer to  the phone.

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