October 2010 was an auspicious month. Amongst many other happenings, it was the month when I first voiced my concerns over the NHS reforms. One of those concerns was that there was (and still is) insufficient money to run the NHS in a way that pleases most patients and also satisfies the politicians who ultimately have to take account of public spending. Whilst many people lauded the Government’s concept of putting GPs in control of running the local services (whilst at the same time dismissing significant numbers of managerial staff who actually knew how to run the NHS), I voiced the concern that it would all end in tears. The money would continue to be insufficient, services would have to be reduced, hospitals would close, the public would be angry, and GPs, powerless to turn a pig’s ear into a silk purse, would get the blame from both patients and politicians. It was a poisoned chalice from the start.
Two years on, that moment of staring into a murky crystal ball is proving to be prescient. Nobody can doubt that the NHS is falling apart. Every day there are stories from across the country where patients are struggling to obtain an appointment to see their GPs, and clinics, wards and hospitals are closing. Most GP practices are inundated with work to a level where they simply cannot cope. Some have already had to close; others are hanging on whilst the doctors strive to maintain a resemblance of a credible service whilst seeing their personal income plummet. Meanwhile, the Government sits emulating the Emperor Nero, informing us all of how wonderful the reforms are, how necessary they are, and how the politicians are not to blame for the terrible mess they have created.
As an example, let us take one of the craziest tasks currently facing GPs. We must, we are told, reduce the number of A&E attendances. If we do not achieve this, we reduce the money coming into our practices. How, we all ask, are we to manage such a herculean task that is effectively out of our control? We may as well be asked to reduce the number of teenagers visiting the cinema on a Saturday night, for all the power we have over such a situation. People visit A&E for numerous reasons: genuine emergencies, convenience, lack of transport, inaccessible out-of-hours services and over-loaded day-time surgeries are just a few. The solutions for many of these issues do not sit within the grasp of most GPs. It is a multi-facetted, multi-organisational problem. It requires socio-economic changes out of reach of GPs. It also requires more money being spent to address it; not a reduction of finance to general practices.
No one group has the solution. However, you can start by helping us all out by not attending A&E for trivial reasons. The clue is in the title ‘Accident and Emergency’. If it is neither of these, please telephone NHS Direct for advice, visit an NHS walk-in centre, or wait until your local surgery is next open. If you do not, you are contributing to the financial waste and the subsequent decline in GP services. The truth is we are all in this mess together.
(First published in the Scunthorpe Telegraph, Thursday, 26th October 2012.)