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Gold, incentives and meh

GP or parent? The days of mollycoddling our patients must end

Dr David Turner writes

One gun, one bullet, one shot, no consequences to yourself.

This is my fantasy game. You have a free shot at anybody involved in the NHS. They can be living or dead and you can travel back in time if necessary.

The only condition to their assassination is that their death should maximally benefit the health service in Britain.

Now I can hear the metaphorical bullets whizzing past my head already, like a scene from a cheap western movie. Jeremy C-word is already lying on the floor looking like a bloodied Swiss cheese, as are most health secretaries since the role was created. I can’t imagine, as a profession, we would be shy in dishing out the lead to the snivelling Whitehall desk jockeys who spend their days thinking up yet more pointless box ticking exercises for us.

All good cathartic stuff, but sadly I don’t think the cessation of life in any of these individuals would make much difference to the slow-motion train crash that is the NHS. I think we need to delve a bit deeper to attack the root causes of the current mess we are in.

Now I have no idea who this/these individuals are, or indeed if their work pre or post-dated the creation of the NHS, but I think the rot set in when we were encouraged as a profession to start talking to adult patients like children.

‘Just pop up on the couch.’

‘Let’s have a quick look at your tummy.’

‘Can you wee in this pot for me?’

We are all guilty of talking to fully grown adult patients in this way from time to time and if the work of Dr Berne has any validity, then we spend a lot of time being the parent and the patient acting the child.

It is little wonder that our emergency surgeries are full of adults with colds, in-growing toenails, and verrucas - to some extent we only have ourselves to blame. We have used our medical authority to disempower patients and turn them into gibbering idiots who can’t make the simplest decisions about their own health. And then we get angry with them.

It’s not all their fault, nor is it all ours; it’s the remnants of the ‘doctor knows best’ culture from a previous age which still permeates our work today.

Unfortunately, what this means for the NHS is, the queues keep getting longer. That said, wouldn’t it be delicious to travel back in time to the late 1980s and position yourself on the banks of the Isis with a sniper rifle and take out Jeremy as he drifted down the river.

Imagine the headline: ‘Hunt killed on a punt’.

Dr David Turner is a GP in west London

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Readers' comments (21)

  • What are you talking about.The reason our emergency surgeries are full of adults with colds, in-growing toenails, and verrucas is because IT'S FREE !!!

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  • He created the tax funded, centrally controlled NHS true. The politically driven and free at the point of abuse NHS has been created by some of the clowns in charge since.

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  • I don't think that you can separate the NHS from the all-consuming sense of entitlement that pervades all walks of life these days.
    Everyone is entitled to expect benefits that cover essentials like Sky TV, holidays and tumble dryers, and now the NHS is going to prescribe their fags.

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  • Just baffling the UK has its head in the sand and doesn't adopt co-payments and insurance like the rest of the western world and whose systems manage to treat the most vulnerable better. And this doesn't have to include the US. (Funny how no one else has gone down the 'as much as you can eat', turn up without ID, no insurance insurance NHS shambles).

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  • we also use these "Just pop up on the couch.’

    ‘Let’s have a quick look at your tummy.’

    ways of talking to lower patient expectations in a sense, to downplay the imoprtance of the examination. In a way we are either trying to be friendly/approachable and reduce risk of complaint which is good, or it could be perceived as unprofessional and infantilising .

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  • "Anonymous | GP registrar | 20 August 2015 11:34am
    Just baffling the UK has its head in the sand"

    The "free" NHS is a cult religion for Britain. Logic and examples from the outside world will never hold any sway with the cult members.

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  • at the risk of coming over all Ben Elton, can I stick up for Nye please? In his 1940's world, people had a sense of society and responsibility, thus did not take the piss out of a system designed to make sure you didn't die of Pnemoconiosis in your bloody twenties. Then along came the Grocers daughter and her me me me, sod the rest of you, every man for himself society was born; free universal healthcare in this context is impossible. But my bullet would be preserved for Virginia Bottomley, who started the patient entitlement culture we see now, while at the same time starting the comparative data trend which morphed into the CQC. Nye, Attlee and the rest could never have anticipated what a shallow, selfish, moronic society we would become.

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  • We see people complaining, arguing and generally being disgruntled by all services, whether this is in the bank, a post office or at the check-in desk at the airport.

    Unfortunately this new culture and way of behaving pervades everywhere in the UK.

    Even if the NHS was completely privatised this culture would not change. That is the way things are today in the UK.

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  • The same complaint culture is seen by MPs. Our local Tory MPs secretary has been in the job for 30 years. She told me that complaints used to take up one day of her time per week. She now spends four days a week dealing with complaints.

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  • Just now had one patient ranting about not getting malaria prophylaxis on NHS prescription, but she had money to go to Dominican republic on holiday. Waiting for the day when this abuse of free NHS ends.

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