Dr Tony Copperfield on Prime Minister Rishi Sunak’s plans to cut elective waiting lists despite severe pressure on the health service
Rishi Sunak’s New Year speech was actually the second I’d heard in two days. The other was a little more spontaneous, and came from a paramedic yesterday wanting me to rubber-stamp a no-need-to-convey-to-hospital outcome on an elderly patient. She ummed and ahhed and stumbled over her lines a bit but that was only because she could barely bring herself to the point.
Which was this: they’d received the call for this confused, elderly, pyrexial woman 48 hours ago and, er, had only just arrived. I’m not making this up.
Now, untreated elderly pyrexial women tend to go one of two ways over 48 hours and fortunately the trajectory here had been improvement. That said, had things gone in the opposite direction, there still wouldn’t have been much point taking her to hospital, would there?
And I should add that the patient’s recovery was helped considerably by the actions of an OOH GP who was called to see her by desperate relatives while they awaited the ambulance. Are you listening, Daily Mail? We’ve been conveying patients to hospital ourselves, now we’re actually putting the paramedic gear on and filling in as first-responders. Next week we’ll be running up and down the road with a blue light strapped to our heads going nee-nah, nee-nah.
So great to hear that Rishi, as well as slashing inflation, growing the economy etc etc is going to cut elective waiting lists. Presumably the strategy is simply to hope that so many people die from ambulance and A&E delays that the queues suffer natural shrinkage. Notably, he has not set a target date for this aim as ‘the goals are so complicated’, though as he also plans to turn all children into maths genii, they should be able to help him with the tricky bits.
Whatever. The emphasis on routine care while acute services are crashing and burning around us was a real fall-off-my chair moment. And thanks to speeches from politicians and paramedics, I’m having plenty of those. Let’s hope I don’t break a bone.
Dr Tony Copperfield is a GP in Essex. Read more of his blogs here
And he used the word “flexibility”. I hate that. It pushes the idea that more could be done to get the gallon into the pint pot if somehow the people at the frontline just worked some miracles. I am working hard on being inflexible. The standard of care is the standard of care. If they want speed by corner cutting then they can cut the corner because we all know who they will blame should it go wrong. I was only following orders never seems to wash.
I’m not sure that I agree with everything this chap says, but worth a watch.
You may want to share.
https://www.facebook.com/100081000847425/videos/6390490737630895
Oh how things have changed! Not wishing to be supportive of the Government’s inability or unwillingness to fund the NHS to even barely adequate status, I cannot help but despair over Dr Copperfield’s comment “filling in as first responders”. Although now retired, it was not all that long ago that I would have been the first responder in any case of illness (rather than accident) occurring at my patient’s home. I do understand that the style of practice has changed an awful lot, sometimes for good reason, but complaining about a paramedic not being available to treat an acute infection seems to be going too far.
My daughter is a fairly senior paramedic, and would be a first call in any serious accident or emergency, but I don’t think she would see pyrexia as the sort of thing she was best trained to diagnose and treat. More like something for a doctor with general practice training?
Gerald Freshwater,
Shetland Isles
Robot Rishi at it again.
I too am retired and as someone who is no longer working in NHS general practice think that those of us who are unable or unwilling to still do the job should keep our opinions of how it should be done to ourselves and instead be grateful to those who continue to soldier on.
Things have changed, that’s for sure. Pop out assess for probable MI – and how the hell could anyone tell for sure – at a time before troponin. And most GP did not not carry about ECGs – which missed many/most MIs anyway.
Elderly perons with a stroke – oh well that the sort of thing that happens. And yes, I practised such medicine, having graduated in 1981 (atill wroking BTW). An elderly person with certain symptoms would probably have triggered a ‘sepsis’ alert. We had very little sepsis in them thar days. Mainly because hardly anyone knew what it was, or diagnosed it.
In time people realised that acutely unwell poeple are, almost always, best whipped into hospital pronto. Having a GP head out to asses was, in very many cases, adding unecessary delay. Often deadly delay. It may have made doctors feel important, but it was killing pateints. The idea that GPs should be the fist responders to acute illness is, and was always, ridiculous.