Category Archives: family doctor

The near-impossibility of seeing a GP

Dalrymple, who is no doctor-botherer, says that getting to see a GP, or family doctor, in Great Britain’s sovietised health system is

difficult, intimidating and unpleasant. I have to run a gamut of procedures to do so, and face a receptionist who treats me as a fraud trying to get something to which I am not entitled. And I have no practitioner whom I can call my doctor. The NHS has crowded out private competition, and the nearest private doctor is 25 miles away.

If Dalrymple wants to see a doctor,

it is easier, quicker and more pleasant for me to go to France than to the health centre 300 yards from my house in England.

It reveals something about Britain that is not true in France:

In our dealings with the National Health Service, we are a nation of paupers who must accept what we are given by grace and favour of the system.

Getting to see a GP is a labour of Hercules

Securing a five-minute slot with a family doctor in Britain’s Soviet-style health system is extremely difficult. It is necessary, Dalrymple explains, for the patient

to lie or exaggerate. He must become expert at doing so.

If you are lucky enough to be granted an appointment, for three weeks’ time,

it is awarded as if it were a minor decoration — an OBE, say, for exceptional persistence. You have joined the privileged few. You should be proud and grateful.

The humane, reassuring family doctor

Screen Shot 2015-05-13 at 22.21.08Dalrymple draws attention to a passage in James Hilton’s 1934 novel Goodbye, Mr. Chips. Mr Chipping’s doctor, Merivale,

visits him every fortnight or so and drinks a glass of sherry with him. Dr Merivale is the epitome of the reassuring family doctor:

My dear fellow, you’re fitter than I am. You’re past the age when people get these horrible diseases; you’re one of the few lucky ones who’re going to die a really natural death. That is, of course, if you die at all. You’re such a remarkable old boy that one never knows.

Screen Shot 2015-05-13 at 22.47.42But when Mr Chipping has a cold or it is very windy, Dr Merivale sometimes takes Mrs Wickett (Mr Chipping’s landlady) aside in the lobby and whispers:

Look after him, you know. His chest… it puts a strain on his heart. Nothing really wrong with him — only anno domini, but that’s the most fatal complaint of all, in the end.

Screen Shot 2015-05-14 at 07.25.24

 

The GP is no longer a member of a liberal profession

Sir Luke Fildes, The Doctor, 1891. Tate Gallery

Sir Luke Fildes, The Doctor, 1891. Tate Gallery

He is the executor of government diktats or obiter dicta

Ever increasing numbers of doctors: acute shortages of doctors. Such a miracle, writes Dalrymple, is one that

only our government could have wrought.

Dalrymple points out that about 250,000 doctors are registered in Britain,

but it is more difficult now to get to see any of them. There is said to be a crisis in medical manpower and that this necessitates the importation of a further 3,000 doctors this year. Fewer than two-thirds of doctors in Britain trained here. Britain parasites the rest of the world. It has outsourced a lot of undergraduate medical training.

Bureaucratic fatuity

There is a big shortage of general practitioners (i.e. family doctors or primary care providers). Young doctors do not want to go into general practice; training posts go unfilled. This is to a great extent because of the administrative burden. GPs must

spend untold hours filling forms of a soul-destroying and unnecessary kind. This is a slow kind of torture. The demands placed upon them by a bureaucracy composed of people who have little or no understanding of medical practice are immense.

Rules laid down by fools

GPs’ pay

depends on their compliance with rules laid down by fools, and this is not a happy situation for an educated and intelligent person.

Computerisation has been a factor, because for the bureaucratic mentality,

if a piece of information can be recorded, it ought to be. Before the spread of the computer, the bureaucrats’ dream of replacing all other human activity by form-filling was impossible.

Loss of prestige

The more the work

is reduced to algorithms, the less attractive it is.

The GP

is no longer a member of a liberal profession, but the executor of government diktats or, worse still, of its obiter dicta. Eventually the GP will become redundant. What is done by GPs will be done by computers or nursing assistants.