NHS reform: I used to trust my GP with my life. Now I depend on Google – Susan Dalgety
The headline from a recent health survey was blunt. Seeing the same GP for more than 15 years cuts the risk of hospital admission and crucially, premature death.
The study was carried out in Norway, where people are assigned a named GP. Unlike here, where – if you’re lucky enough to get an appointment with a doctor – chances are you may never have met them before.
Or maybe I am just unlucky. My medical practice in Musselburgh is one of the largest in the country, with more than 19,000 patients. It gets 40,000 calls a month. Perhaps I should count myself lucky I managed to get seen by a practice nurse recently when I found unexplained bruising on my legs, and panicked that I had a blot clot (they run in our family).
But in the eight years that I have been with the practice, I have seen a GP only twice. The first appointment ended with a clearly stressed male doctor shouting at me for not taking my own blood pressure.
“You need to take responsibility for your condition,” he growled, ignoring my protestations that I had a phobia about blood pressure monitors, and even the sight of one sent my readings sky high.
My next brief encounter with a GP was just before Covid struck. It was less fraught, but barely lasted two minutes. I made the appointment at the behest of the practice nurse who had carried out my annual blood pressure check. “It’s a bit high, you need to see the GP,” she said.
The young woman doctor was confused. “It wasn’t that bad,” she said, as I started to roll up my sleeve. “I don’t need to take it,” she continued, “it will probably be raised just now because you’re stressed. Any other problems? No. Fine, cheerio.”
And that was it. Two GPs in eight years. One angry. The other smiling, but coldly efficient. Neither knew the first thing about me, nor showed any interest in finding out anything. I was a CHI number with a history of chronic hypertension and mild hypochondria – if either of them had scrolled through my records, which I doubt.
When I lived in Polwarth, I was registered with a small practice. I had the same GP for a decade. She grew to understand my foibles and I hers. She guided me through the menopause, diagnosed my hypertension, reassured me that my lumps were not cancerous. I trusted her with my life. Now I depend on Google.
The NHS is a wonderful institution. Perhaps Britain’s greatest modern achievement, but the heart of it – our primary care service – is in need of a significant rethink, and not just in Lothian.
No-one is naïve enough to believe that we can go back to days of the friendly family doctor, who was on first-name terms with all their patients and did house calls as a matter of routine.
But the current set-up, exacerbated by Covid, where it is often impossible to see a GP, let alone the same one for more than two appointments in a row, is untenable. Worse, as the Norwegian survey suggests, it is probably killing people.