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At the heart of general practice since 1960

A hospital-shaped brick wall

General practice would be lovely if it wasn’t for hospitals’ annoying habit of getting in the way, says Copperfield

General practice would be lovely if it wasn't for hospitals' annoying habit of getting in the way, says Copperfield



I really love this job. Oh, hang on, no I don't, it's like stabbing forks in my scrotum. OK, look, I'll explain.

Sometimes, it's lovely. Like when you encounter something incontrovertibly clinical, with none of the usual baggage of uncertainty, anxiety, inappropriate demands etcetera.

It happened the other day: I saw a case of erythema nodosum. No doubt whatsoever. She walked in. She gave a history. She showed me the painful red blobs on her legs. I diagnosed. I gave an explanation. She said ta very much. Then she buggered off. Job done. Brilliant.

Strangely, this is happening to me quite often nowadays. In the last few weeks, I've diagnosed Henoch-Schönlein purpura, Kaposi's varicelliform eruption and aplastic anaemia, to name just three.

If I knew which way to point a camera, I could have singlehandedly taken over Pulse's Snapshot diagnosis column. I tell you this not to appear clever

(I didn't say the diagnoses were right, did I?). It's just that I'm starting to believe that something odd has happened since I hit 50.

Either diseases are like flies and I've turned into a cowpat or, after 25 years at the coalface, I've finally figured out which way round to hold the shovel.

All the more galling, then, that now I've sussed out the job, I'm prevented from getting on with it. Which brings me to the spike in my privates.

Today's surgery illustrates the problem nicely. Of the 18 patients I saw, six – that's a whopping third, stattos – were only there because they've been banging their heads against a hospital-shaped brick wall.

They've been contacting the DGH to enquire after this appointment, that treatment or the other service. And they're confronted by taped messages promising the earth and delivering a black hole. The phone is never answered, their messages aren't listened to, their calls are never returned.

To be honest, until recently I didn't believe the punters when they told me this. I assumed they were just adopting the easy default of hassling me. So I called their bluff.

‘You've been trying to contact the cardiac failure nurse for weeks, have you? I mean, really? Have you? Hmm? Honestly? Have you really, honestly, hmm?'

‘Yes,' she insisted. So I tried. Two weeks later, I was still trying. I'd called every day. I'd left three messages. I'd emailed. I'd texted. I'd put a call out on the World Service. Nothing. So it's true.

The fact is, there are no staff in the DGH. Cuts are biting and admin staff are bitten deepest. The PALS service used to sort out frustrated patients. Guess what? It's impossible to get through to PALS, too. They're understaffed.

And if patients do succeed in making contact, PALS can't get non-existent secretaries to answer the phone either, so they tell patients to go and see their

GP, as though we have some special communications superpower.

This is a cruel waste of time and energy for patients. And it's a frustrating waste of time and energy for us. So someone, somewhere, please sort it out. After all,

I'm busy diagnosing Plummer-Vinson-Paterson-Kelly-Brown syndrome in my next patient.

Dr Tony Copperfield is a GP in Essex

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