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There is no such thing as a ‘right’ to face-to-face appointments


GP support package Pulse editorial



This past week has been a traumatic one for GPs. The attack on the staff of a Manchester practice was hard to read for many. Added to the continued media narrative that ‘general practice is closed’, it comes as no surprise if many GPs are questioning their future in the job. 

The latest media attack was in the Mail this week, which claimed the support of the Prime Minister in reinstating the ‘right’ of patients to have an F2F appointment. In fairness to Boris Johnson, the statement from Number 10 didn’t go that far. It simply said GPs must ensure they are offering F2F appointments. But this nuance won’t be picked up by patients, and I hardly think Johnson will try to correct this. . 


But this ‘right’ to a face-to-face appointment simply doesn’t exist. No more than a right to a home visit, or a right to see a specialist when you want or a right to a health MOT exists. This is because there never has been unlimited health resources. 

Our right to free healthcare – which does exist in this country – has always had caveats. Patients have it drummed into them that they need to use urgent services sparingly and the vast majority do.  Rationing of services is a huge problem, but some services have always been rationed, and fairly so, based on clinical necessity. 

Some will point out that the difference here is that before the pandemic, face-to-face appointments were given as standard. But, since March 2020, patients also have ‘rights’ to e-consultations, and remote consultations, if they so wish, thanks to various diktats from the NHS and the previous health secretary. 

For the Government, promoting face-to-face appointments as a ‘right’ is a cheap win. There are no discussions about the feasibility of ‘rights’ – we rightly never discuss whether the school system has the capability to educate every child, or whether we should stop making burglary a crime because the police doesn’t have the capacity to enforce this.  

This means they can ignore the structural problem that demand has increased while the workforce has shrunk. Which, conveniently, is the bit that is their fault. 

Similarly, making it a right also means they don’t even need to put it in the GP contract, which would nominally involve discussing what resources this would need.  

Most importantly, they are able to shift the full responsibility for ensuring this right onto GPs. 

We are currently in the eye of the media storm. It will pass, but it will leave destruction. Patients won’t forget they have a ‘right’ to a F2F appointment. But there needs to be a long think about how GPs allow the Government to play these games. 

Once the media have found a new scapegoat for everything wrong in this country, GP representatives need to be bullish and remind the Government that individual GPs have ‘rights’ to walk away from the NHS if they so wish. 

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

READERS' COMMENTS [5]

Charles Richards 22 September, 2021 2:56 pm

Thank you for a sane report. It is surprisingly rare. I wrote to today@BBC.co.uk something similar if a little more pointed!

Vinci Ho 22 September, 2021 4:54 pm

Well , I wonder if the Health Secretary and the Prime Minister have actually read the NHS Constitution for England (with the patient charter included , clearly stating Rights as well as Responsibilities):
https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england#patients-and-the-public-your-rights-and-the-nhs-pledges-to-you
This is only updated in January 2021
I suppose this government is to break the constitution and forcefully insert face time ‘face consultation by default’ into this constitution??

Abhiramy Rudran 22 September, 2021 7:34 pm

It’s refreshing to read about our rights too!

Cameron Wilson 23 September, 2021 8:34 am

The cards are well and truelly on the table with this one! A bit of cold weather and the usual seasonal infections will ensure that the NHS is overwhelmed to quote the Politicians! Not that it will surprise anyone who has worked in the front line over the years. If you add in any man and his dog has a” Right ” to an appointment, and you can bet that when this is agreed but in two months time ( similar to secondary care btw) another confrontation ensues! Add the contempt that would be shown by “Imposing ” such a condition, walking is the only option. Appalling that it has come to this but suspect inevitable!

Patrufini Duffy 23 September, 2021 5:52 pm

The only face to face this profession needs should be televised. On Channel one, between GPs, Consultants, patients, receptionists, nurses, A+E and political and NHS “leaders”.

But they won’t dare.