Family doctor's threaten industrial action.

 

Family doctors are threatening industrial action against government plans that would, inter alia, compel them to see patients face-to-face and force them to disclose their NHS earnings of at least, £150,000 per annum. They also oppose league tables that would show the number of face-to-face appointments carried out by GP practices. The Government's £250m "support package", has been denounced by the British Medical Association (BMA), as a "Bully's Charter."

According to NHS England, around 90% of GP's work part-time. The average age at which doctors now retire is 59-years and a GP's average salary in England is £100,700, roughly twice what a French GP earns. Professor Martin Marshall, Chairman of the Royal College of General Practitioner's, says: "Good, safe, and personalised care, can be delivered remotely and is not confined to general practice."  He also thinks that criticism of GP's is "demoralising and indefensible."

Just 61% of GP appointments were carried out face-to-face in September, compared with pre-pandemic levels of 80% of consultations. Statistics also show that half of all appointments are now carried out by other practice staff such as a nurse, or physio, rather than a doctor. Difficulties in getting to see a GP, have led to more people using A&E, the NHS Helpline, emergency services, and the increasing use, of the private healthcare sector - access for cash, which has put the NHS under increasing pressure. Many doctors and nurses who work in NHS hospitals, have questioned why it's okay for them to deal personally with patients, but not mollycoddled GP's. In response, the GP's say their NHS contracts don't require them to do face-to-face appointments, unless its absolutely necessary.

Some critics, such as Alison Much, the senior coroner for Greater Manchester, have said that remote GP appointments may be a contributory factor in the deaths of people because important information can be missed during telephone appointment's, that may have been picked up if a patient had been seen in person. 

David Nash, a 26-year old law student from Leeds, had four remote consultations with doctors and nurses at a Leeds GP practice over a 19-day period before he died on 4 November 2020. None of the clinicians spotted that he had developed mastoiditis in his ear, which caused a brain abscess that led to meningitis. He had presented four times in short succession with a range of escalating symptoms. He'd had a fever for nine days and despite a negative Covid-19 test, there was no clear diagnosis. His father told the press that mastoiditis is readily treatable with antibiotics. 

The case of David Nash is not an isolated case; there have been many other such cases. Like all professions, the medical profession, has vested interest to protect that may not be in the long-term interests of their patients. Although GP's have contracts with the NHS, many GP practices are run as private businesses. We should not forget that when the NHS was first proposed, many doctors objected to the principal of a state run health care system that was free at the point of use. Apart from other things, they thought it would effect them financially. When, Aneurin Bevan, was asked how he'd got the doctor's to co-operate, he said: "I stuffed their mouths with gold." The National Health Service in Britain, is almost synonymous with the name of Aneurin Bevan, who was a Welsh Labour MP and socialist.