Dr David Turner lambasts an article lauding A&G as the way to keep people out of hospital, arguing that increased investment in general practice would actually do the trick
Come on, own up. Who are all these GPs admitting patients to hospital with earache and IBS?
Because, according to BBC News, a ‘new’ scheme called – wait for it – advice and guidance is being rolled out to help ‘two million people receive faster and more convenient care by the end of 2025/26’.
I am always up for ripping apart medical items in the lay press. Indeed, it makes for a nice distraction during coffee breaks – or it would do if we had any. But it’s not often I find myself being able to savage a news item so voraciously.
It claims this ‘new’ scheme will mean ‘GPs will work more closely with specialists to access expert advice more quickly for conditions such as irritable bowel syndrome, menopause symptoms and ear infections. And yes, I did check the date of publication. It was not 1 April.
I feel a bit like a lion in a petting zoo at this point; there is too much choice about where the massacre should begin.
I will assume for a moment the author of this item has either spent the last 10 years on a remote island in the Pacific with no access to modern communication methods, or has simply been the victim of a massive wind up. I cannot believe anybody working in health journalism would really believe we need advice about how to treat otitis media or prescribe HRT.
The article continues: ‘Patients with tinnitus and needing earwax removal often end up being referred to specialists when they could be helped outside hospitals’.
Have we been missing a trick here? Could we have been sending our patients to hospital for ear irrigation rather than subsidising the service out of our own pockets in the surgery? I am not usually one to side with secondary care, but if I had ever referred a patient to ENT for ear wax removal, I would expect the consultant to pay me a personal visit and demonstrate how to use the ear irrigation kit on a very different part of my anatomy.
Joking aside, not only is this ode to A&G poorly researched journalism, but it also depicts GPs as being worse than hopeless. If Joe Public gets the idea that we need a specialist to tell us how to write a prescription for oestrogen gel and ear sprays it really doesn’t help our cause in arguing for a larger slice of the NHS budget.
The article states £80m in funding are being provided to fund A&G. If you ask me how GPs are meant to manage more conditions in the community, more efficiently, more speedily and at a fraction of the cost hospitals charge? You might want to add another zero to that figure.
And that – really – would keep millions out of the hospital system.
Dr David Turner is a GP in Hertfordshire
As a Generalist who has been taught the methods of both ear irrigation/syringing, and also aspiration by vacuum, I used to do both: However, that option has now been removed from my armamentarium, and I now Refer every single patient needing ear wax removal to a Specialist, as that is what is required of me, and the equipment is no longer available to me. Not a Hospital Consultant in ENT, but a specialist in ear irrigation (and not specifically any thing else related)at the local NHS service; although they are also advised that they can access rivate care closer and quicker, and easier, so most do that.
I suppose I could purchase my own set of equipment and sterilizer, etc, but as I am a locum, I would not expect to have to do so – unless I decide to set up in private practice as an ear-clearer in competition with specialists at the High Street OPticians’ shops.