NHS patients and GPs deserve better than another five years of this circus
Dr Alex Gates
Collective primary care groans could be heard recently as the NHS - and general practice - found themselves at the centre of some grandiose manifesto pledges once more.
The promises this time come from a different health secretary, Matt Hancock, a man who somehow surpasses Jeremy Hunt in lack of authenticity and has all the charisma of a squeaky dog toy. A sort of cross between Tigger and Voldemort - enthusiastic yet sinister.
So what is his master plan, in an attempt to lure those voters gullible enough to digest the spin without it passing straight out the other end?
Well, for starters, we’ve been treated once more to the promise of more GPs - ’Five thousand more?’ I hear you strain. No, friends! SIX thousand! Yes, the Tories’ failure in delivering the promised 5,000 extra GPs at the 2015 general election (there’s actually a deficit of over 1,000) hasn’t deterred them in their latest ambitious quest for your votes.
Hancock hasn’t been specific in addressing how the extra GPs will be delivered, but has promised that more GPs will be trained and a majority Conservative government, if elected, will do more to address the retention crisis facing primary care.
They’ve also announced £33.9billion extra funding for the NHS (cash prices, misleadingly) of which primary care and community services will receive just £4.5bn. This will confuse those who remember Theresa May’s pledge of £20 billion extra for the NHS only last year.
But here’s the bit that really galls. They’ve promised 50 million extra appointments ‘every year’. Yes. 50 MILLION.
A supposed instant increase in capacity by 15%, and in the absence of any more detail promised to the electorate from 2020 onwards.
Now, mathematics is not Mr Hancock’s forte. It is, in fact, remarkably difficult to work out what is.
But this bold lie (sorry, pledge) would mean, in effect, that after six years, general practice would boast twice the number of appointments offered today (by the Tories’ own figures, 307 million appointments this year).
I’ve challenged the health secretary on these figures, and asked him to clarify when the 50 million extra appointments can be expected (next year or 2024-5, Matt?), but he has thus far ignored me.
I’ve explained to him that this additional pressure will do nothing to keep young GPs like me in the profession. He doesn’t care.
This latest announcement isn’t just far-fetched - it’s downright ludicrous.
Where will the funding come from? What about the supporting infrastructure, the reception staff, the phone lines?
50 million more appointments. Each year. 6000 ‘extra’ GPs (despite a recent survey of GPs suggesting almost half were planning on retiring in the next five years).
All delivered as part of the ‘people plan’, a policy apparently taken straight from a manuscript of The Thick of It.
Signposting patients to TrumpDoc.com, where every doctor greets you with fake MEWS
We know what this means. The extra GPs won’t surface and any increase in numbers of trainees will outnumbered by all those retiring or abandoning ship, but we’ll still have to deliver this back-of-an-envelope b*llocks. Hancock will see to that.
Which means increased workload, further erosion of morale and that we’ll most likely be seen holding FaceTime consultations while we’re trying to grout the bathroom.
By 2025, with a two-tier system more embedded than ever, we’ll be signposting our patients to TrumpDoc.com, where every doctor greets you with a pearly smile, a gold stethoscope and fake MEWS. I can see it now and it makes me wince.
Most laughable, however, is the constant stream of social media propaganda from Hancock’s half-wits, proudly boasting that the Conservatives are ‘the party of the NHS’.
You only have to glance at every available graph showing performance data of the NHS over the last ten years to know that this is utter tripe.
Worse A&E waiting times since records began? Check. Patients waiting longer and longer for cancer treatment? Check. The first sustained year-on-year drop in FTE GPs since the 1960s? Check. Dramatic cut in district and mental health nurse numbers? Double tick. A bitter battle with junior doctors. Hell, yeah.
The list of failings is long, but in the world of post-truth politics, statistics no longer matter. Accountability and honesty, integrity and professionalism? All standards we have to comply with, but that no longer apply to the political elite.
The other week, I had to drive a frail, elderly lady with advanced lung cancer and 02 saturations of 80% to A&E myself, because it was 8pm and the emergency ambulance I’d requested failed to turn up.
Wheeling her into A&E to join the back of the queue and seeing the bemused look on the charge nurse’s face as I announced that I was a GP handing my now increasingly dyspnoeic patient wasn’t an experience I wish to repeat.
And I don’t even blame the ambulance service, who are working flat out.
But this is the system now. Patients batted from one place to another because we’re all too busy and overwhelmed to listen to them.
Hours spent exasperatingly trying to explain Q risk. Days spent speaking to frustrated patients, house-bound by pain, as they await a joint replacement which, after months of waiting, is cancelled. Weeks trudging through letters asking us to do the work secondary care no longer have time to do. Years spent on waiting lists for dermatology, gastroenterology, cardiology. Task after task asking secretaries to chase or expedite a referral. It feels uncomfortably unsustainable.
But not to worry, because an election is just around the corner, which means the past can been erased, and we’re all expected to gaze into the future like a clothes catalogue model and trust Mr Hancock as he posts yet another video of himself, disposable coffee cup in hand, on the campaign trail in Surrey like Alan Partridge’s roadie.
Aeshylus, a wise chap from Ancient Greece, said of war ‘truth is the first casualty’. Well, truth is the first casualty in electioneering.
And the NHS is yet again the Tories’ war horse, being ridden towards the cliff edge as they smear the campaigns of their rivals. We cannot survive another five years of this circus. Our patients deserve better.
Dr Alex Gates is a GP near Bath