GENERAL PRACTICE – IS TIME RUNNING OUT?

As you’re all probably aware, on Thursday lunchtime Liz Truss resigned! In the speech she gave outside 10 Downing Street she said the reason she was leaving was her recognising that, given the situation, she could not deliver the mandate on which she was elected by the Conservative party.

I know how she feels. I too recognise that, given the situation, I can not deliver the mandate that I have been given as a GP, namely that of providing good medical care to my patients.

Despite the strenuous efforts being made by those I work alongside in primary care as well as those of my colleagues who work in hospitals, social care settings and the emergency services, I daily see an NHS that is on its knees. Much like all GPs, this year I have experienced:

• social services ringing me to inform me of their regret that they are unable to provide care for frail elderly patients who live alone and are unable to look after themselves
• occasions when patients I have referred into hospital for urgent medical attention have had to wait for up to 19 hours for an ambulance
• on call days which have been frankly unsafe during which I have personally had to manage over a hundred separate patient interactions without a break
• excessively long waits for my patients to be offered outpatient appointments including somebody whom I suspected of having a progressive neurological disease who had to wait months to see a consultant and then wait months more for a letter telling me that my suspicions were probably correct and that I should treat her myself despite in times past that treatment being within the realm of the specialist
• countless situations when alternative drugs have had to be issued because the medications patients’ need, including on occasions such basic medicines as penicillin, have not been available in local pharmacies
• patients who, after approaching two years, are still waiting to be seen by those delivering speciality services to those with complex mental health needs
• a GP practice within the town where I work collapse and 1500 of their patients being reallocated to my practice with just two weeks notice. Months later we have not had a single application in response to the job advertising for the additional doctor we require to adequately provide care for these patients.
• hospitals repeatedly failing to meet the target set to ensure that patients with possible cancer diagnoses are seen in a timely fashion
• hospital labs not being able to provide certain specific blood tests for want of the required resources for that test to be done

Now don’t get me wrong, the NHS continues to do sterling work, but all the above reflect the degree to which it is now struggling. I could of course go on, as I am sure could all my colleagues, but the above is sufficient to make clear that the many high profile cases that have been reported in the media really are just the tip of a very large iceberg. And with an already understaffed NHS being made up by doctors and nurses who are leaving their respective professions in droves, the situation seems certain to only get worse.

The day before she resigned, the soon to be former Prime Minister said that she was a fighter, and not a quitter. I like to think that, for today at least, the same is true for me. But like Liz Truss, somebody who perhaps believed her words were true even though, a mere twenty-fours hours later, circumstances proved that they weren’t, I too must recognise that circumstances may yet dictate that my capacity to fight may not last as long as I would like. My time as a doctor is inevitably limited, perhaps more limited than even I currently realise. Even so, despite being told to try harder and do better by those who seem to have little understanding of the pressure the NHS is already under, I do intend to carry on for at least a little longer.

I am though no fool. I am not the answer. Nor is any individual GP. And that is something we must hope that the press, the public and our political leaders recognise too.

Because if they don’t, time might be running out, not just for this government, but for General Practice too.

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Related blogs regarding the difficulties with the NHS:

To read ‘On being overwhelmed’, click here

To read ‘I’ll miss this when we’re gone’, click here

To read ‘General Practice – still a sweet sorrow’, click here

To read ‘Mr Benn – the GP’, click here

To read ‘A GP called Paddington’, click here

To read ‘Scooby Doo and the Deserted Medical Centre’, click here

To read ‘Bagpuss and the NHS’, click here

To read ‘A Dream of an Antiques Roadshow’, click here

To read ‘The NHS Emporium’, click here

To read ‘Jeepy Leepy and the NHS’, click here

To read ‘The Three Little GPs and the Big Bad Secretary of State for Health’, click here

To read ‘The Happy Practice – A Cautionary Tale’, click here

To read ‘The State of Disrepair Shop’, click here

This blog is an adapted version of a blog written yesterday entitled ‘Friday Bloody Friday’. Unlike the above version which was intended for a specifically medical readership, the original concluded with a specific Christian viewpoint. That original blog can be read here.