The article itself extrapolates the suggestions of one coroner that remote consultations “may” have affected patient safety, to the headline “Deadly Toll of Remote GPs”. It’s quite a leap.
As doctors, patient safety is at the forefront of our minds. It is a conversation which we will never shy away from; to do so would neglect our duty as clinicians. We take allegations of this kind very seriously; and in fact, have been raising concerns about patient safety ourselves for many years, as NHS funding has been systematically cut by the government, staffing levels have fallen, and patient experiences both in hospital and in primary care have not always been optimal, particularly at times of intense pressure. We were doing so before the pandemic, and we continue to do so now.
It may help to understand some of the facts. GPs were instructed to keep communities safeduring the pandemic. At the time, GPs had not been sent safe Personal Protective Equipment (PPE) by the government. In the absence of support, many were forced to go to hardware shops and find what they could, fashioning PPE out of old laminator sheets and screens made from Perspex which they hammered together to try to keep patients safe when they attended the surgeries. They continued to do home visits and in-patient consultations right the way through both waves ofthe pandemic. And horrifyingly many GPs died of COVID-19.
Overall, more than 1500 frontline health and social care workers have died in the UK; our healthcare worker death toll is one in the highest in the world.
Through the pandemic, the pressure has not let up. GPs in England were asked to set up thefirst vaccination centres. They were not offered any up-front funding to find staff. They succeeded regardless; it was their gargantuan efforts in the run-up to Christmas 2020 which propelled the UK into a hugely successful vaccination campaign. They did this alongside their clinical work. In January 2021, GPs in England conducted 1 million more consultations per week than in January 2020. Some of these over telephone, some face-to-face. Many patients now prefer telephone consultations for the convenience; they don’t need to attend a surgery. Crucially, all of this was achieved despite the UK’s low GP numbers. In the UK in 2019 we had just 76 GPs per 100,000 people. In some areas this falls to 54 GPsper 100,000. As a comparison, in 2018 Cyprus had 105/100,000, and Belgium had 115/100,000. Portugal had 244/100,000. There has been little, if any, media coverage of GPs’ astounding commitments and dedication during the pandemic.
Cynically, one might suggest that the current, unrelenting media attacks on GPs are politically motivated. We were all left reeling this week after the new tax announcements, and someone had to take the blame in the right-wing media. The public are being taxed to pay for an NHS crisis which was knowingly engineered deliberately by a government who have made more than £40 billion in departmental cuts since 2010. There is now a healthcare crisis many years in the making, and many people are dissatisfied. GPs; overworked, exhausted, struggling under unrelenting pressure, make an easy target.
One might even suggest thata concerted effort to undermine trust in GPs will assist the sell-off to private companies (with US health insurance company Centene/Operose taking overthe care of 500,000 NHS patients in 2021, and the subsequent hiring of Operose’sex CEO Samantha Jones as Boris Johnson’s “advisor on NHS transformation and socialcare”, accelerating NHS privatisation in certainly on the cards). These escalating attacks against GPs are an effective political diversion; the Health and CareBill is in committee stage in Parliament. The Bill, if enacted, will allow private health companies onto newly created health boards. Patient decisions will be made by those seeking a profit from the NHS. It’s a new frontier. Newsworthy – one would expect. The media’s silence on this developmentis deafening.
Public discourse seems to have been missed out of the government’s new NHS plan. Despite an intense media focus on lack of patient autonomy in the role of telephone consultations, the government has not put the Health and Care Bill up for public consultation. The doctor-patient relationship is the focus of intense scrutiny. But what of the government-patient relationship?
The challenges the NHS faces have never been greater, we all know that. And in order to move forward, we need a national conversation. How much do we value a public healthcare system? Do we care about the infiltration of profit-makers into the NHS? Do we want our staffing levels to match those of other European countries? The public deserve to discuss this, and the government must listen.They hold the purse strings. It’s time for them to share the responsibility forthe health of the nation.