We know general practice has been underfunded for years. We know the GP recruitment crisis has been allowed to fester. We know that GP waiting times have been increasing through no fault of the profession. We know there is a huge amount of pointless bureaucracy.
We know that hospitals have faced underfunding and A&Es have been unable to cope. We know that rationing has been brought in and seen patients denied care.
We know that the NHS has been operating close to breaking point for a decade now. And, sadly much of this is coming home to roost now.
But now is not the time for recriminations. Because we are now on a war footing and everything we do has to help us get through the worst public health crisis of the past 100 years. This is not just the virus. It is also all the genuine patients that you saw day in day out before this virus hit. Their problems won’t go away.
My wife is a kidney transplant patient – she is in the ‘shielded’ category – and my dad is 93 years old. Everyone knows people in this situation – my family is certainly not extraordinary in this way.
But most of us have the option of staying isolated for however long we need. This isn’t an option for you. You are the front line of this battle. I know from speaking to GPs that anxiety levels are through the roof. It’s not surprising – the weight of the nation is on you.
Pulse will continue to scrutinise on issues that can help you immediately
You need the support. All we can do at Pulse is continue to scrutinise on issues that can help you immediately, like when PPE is not being delivered to the people who need it the most, or the health authorities drag their feet in cancelling the pointless bureaucracy as they did with CQC inspections or online bookings. Criticising the authorities gave them no choice but to address this. That’s the tiny part we can play in this.
But I’d also say, we all have to put our inherent scepticism around health authorities to one side. We have to trust that public health officials are acting in good faith to minimise the harm this virus will cause. Put away any ideas that there is an ulterior motive like punishing GPs, for example.
Officials will make mistakes. They will drastically change course. They will fail to prioritise correctly. This is inevitable. But the only way through this is to follow their advice. We must all recognise they are doing an impossible job and seem to be genuinely doing the best they can.
If patients also follow their advice, then your role in this will be clear, but no less daunting. You should not see anyone with the virus. But you will be seeing all the other patients, potentially well beyond your competence at times given that hospitals will inevitably have a lower threshold for not admitting or discharging early very sick or complex patients – something the guidance makes explicit. This is as important as your secondary care colleagues seeing those with the virus.
The time for reassessments of the way the NHS has been treated over the past decade will come. Once this is all finished – whenever that is – politicians will need to have a hard look at themselves. Their first duty is to keep its citizens safe, and above all else this is protecting the health of the nation. This has not been the practice in the past ten years, and especially not since 2016.
And patients will also need to think what the NHS is for. If something good comes out of all this, it will be personal responsibility for the health of the nation – an appreciation of better hygiene and whether they need to use the NHS for their self-limiting illness.
But, as I say, that is for later. For now, all I can say is good luck, everyone.
Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at firstname.lastname@example.org