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Show a little bottle(neck)

flu coadministration

If my GP was to knock at my door today and ask me if there was anything I was worried about, I would have enough queries to fill at least a ten minute consultation, and probably a lot longer. It is equally true that all my grumbles are 99.9% likely to amount to nothing.

When it comes to free healthcare, there is literally a never-ending demand that could be filled if the supply was there. So the Government’s desire to try and satisfy that demand is pointless.

Which brings me on to econsultations. A motion at the UK LMCs Conference – which effectively dictates policy for the BMA GP Committee – calls on the GPC to ‘conduct a full impact assessment of the effect of the roll out of uncapped instantly available e-consultations on the availability of more proven consultation models’.

I couldn’t agree more. Especially during the pandemic, it has become easier than ever to log a query with a GP because it is a case of filling in an online form without having to speak to anyone or explain anything in great detail. (Which, of course, makes the Mail on Sunday’s campaign for GPs to ‘open up’ even more distasteful).

A measure of awkwardness – or, as one LMC representative puts it, a ‘bottleneck’ – to getting through to a GP is an absolutely essential part of the process. It means that I don’t bother you with my Achilles (which is getting much better thank you). And that time you would have spent dealing with my Achilles is spent on a vulnerable patient who is, ironically, less likely to use an econsultation form.

But there is a wider point. The GPC should not focus its efforts on getting the tools to meet demand, in the form of extra staff. Instead, it should be encouraging the bottleneck. And if it is worried about the headlines – well, that battle is already lost.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at


Patrufini Duffy 12 May, 2021 9:08 pm

The NHS and General Practice has cataclysmically evolved, into an artistic e-comedy instead of science. Treating personality disorder, fiction and behaviour, instead of disease and pathology. I’m glad sertraline and loperamide stocks are high.

Simon Gilbert 13 May, 2021 9:27 am

If only someone could invent a mechanism or technology whereby you could dynamically score the value of someone’s willingness and ability to supply an amount of healthcare with the willingness of someone to give up their own stored and earned time value in order to meet that supply…

Nope can’t work it out, best leave it to central planners to allocate resources!

Vinci Ho 19 May, 2021 9:40 am

As I put in my own LMC monthly meeting , this slippery slope fallacy reminds me of ‘changes in quantity will lead to changes in quality ( in the right direction)’ in dialectic materialism . To me , that is a farce.
Everyone seems to have forgotten the words: CONTINUITY of care , which governs our quality in general practice , which ,I admit, is difficult to measure .
For that , I would also refer to those who are keen in quantum mechanics : no matter what scale/system you use to ‘measure’ the behaviour of quantum particles (which presumably dominate the our universe ) , there is always a significant discrepancy deviated from the actual reality. Salute to physicists like Erwin Schrödinger ,Werner Heisenberg etc .