Editor Jaimie Kaffash gives his take on the controversial blog that divided opinion
Our columnist Dr Katie Musgrave has caused quite the stir. Her blog, We have medicalised normal life and it’s destroying the NHS, has been slammed on social media and emails I’ve received from patients and doctors. However, the response from GPs – especially in the comments on the blog – have been overwhelmingly supportive.
If you haven’t read it – and I would advise that you do, whether you agree with it or not – Katie’s point is that the NHS and especially GPs are dealing with problems that it shouldn’t need to, at a time when it is unable to fulfil its basic functions. She says she finds herself ‘explor[ing] the minutiae of a lady’s menopausal flushes’, ‘counsel[ling] anxious parents on sleep training, reflux and weaning’, or ‘discussing tantrums or mood swings’.
Now, the first thing to say is that PulseToday is a website specifically for GPs, and this blog was written for a GP audience. Personally, when I first read it, I thought it was fascinating. But, if I am honest, I profoundly disagreed with it (perhaps partly because I am not the one who is dealing with this level of demand). But the more I thought about it, the more I thought that at its heart, the point is undeniable that normal life has been medicalised.
Where I disagree with Katie is the role of patients’ responsibility for this. For me, these ‘menopausal ladies’ and overly anxious patients are not doing anything wrong. Nor, I have to say, is the NHS to blame. We have medicalised normal life because the societal support structures are no longer there.
The austerity of the past 12 years has not only led to NHS funding being cut, but even more drastically other services. Across all public sectors, the support is not there: education, housing, council spending, public health and, more than anything, social care. Meanwhile, the economy is in dire straits, and we have climate change on the horizon (if not already here). A lot of these people’s problems are born of anxiety, because there is so much to be anxious about.
So these members of the public who are struggling with normal life either have nowhere else to turn or have personal problems that have developed into actual health issues.
The fact is that – through no fault of GPs – it is no fun trying to access NHS services at the moment (we all know how many GPs are needed, and that this Government has given up even trying to find them). Yet patients, who in an ideal world would be going to the right public service in the first place, still go through the process of getting an appointment. I would suspect that in many cases, the ‘lady’s menopausal flushes’ are hiding an issue big enough for them to access a GP in the first place.
This is easy for me to say. I am not the person getting more and more burnt out, dealing with people for whom general practice is the last resort but who really shouldn’t be there. The sentiments expressed by Katie and commenters are completely understandable.
But let’s place the blame at the right place – at the door of this Government and its predecessors.
Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at editor@pulsetoday.co.uk
There was a typo in the original piece where it said ‘No, I have to say, the NHS is to blame’. This was supposed to read ‘Nor, I have to say, is the NHS to blame’
I disagree Jaimie. Do you remember this:
https://www.pulsetoday.co.uk/news/workload/gp-practice-writes-16-page-open-letter-to-patients-after-seeing-demand-double/
Blame is at the person’s door. They picked up the phone. They hypothesised, consumed and regurgitated the nonsense. They got themselves into the mouse trap and revolving door. Soon to be medically coded and hammered by a US insurance company. Naivety is a dangerous game. Walking with your face in your phone whilst crossing the road, with your coffee and dog is a kamikaze manoeuvre. And you are to blame. Not the car. Like we place blame at a racists door. And paedophile. And drink driver. And now medicalised time waster. For decades they have never been called out, instead nurtured in cotton wool and empathy for their distance from reality and absent knowledge of themselves and impending mortality. Out of fear for a complaint perhaps. But, that’s dissolved in a beleaguered system. These 10-20% individuals are having a laugh, at everyone’s expense, clogging and blocking. Distracting you from meaningful work. Draining limited energy and interest and shafting a burnout deplete workforce, who really couldn’t care less. They are also robbing others from resources and access, and disrespect professional opinion and experts and a diagnosis of nothing. Blame is at their door. But, decades of privilege and freedoms come with cataclysmic carnage, if the mind is not controlled. It is now public versus public, in the soon dog eat dog 2023 world. We are just calling “them” out to warn you, because you can’t see them. Katie’s article is truth. It’s nauseating and painful but true. These are the non-mask wearers, the antibiotic resistant addicts, deniers, personality spectrums, hypochondriacs, cocaine-party goers, recurrent “DNA-stuff you” consumerists whose ego and mind have consumed their humanity and organic nature. They are punch drunk on what ifs, and scared of themselves and a mirror, detached and floating in an ether of unknowing that they created. It is only getting worse. They stayed in ignorance. They are, yes, perhaps socially conditioned, but are now the ultimate endemic disease spreading like a rash, void of reasoning, rationale and perspective. Stuck in a matrix of fear. I don’t blame the NHS entirely for that, I do blame it for no rules, no barriers, no plan. If you consume junk, you become junk. If you smoke, you are to blame, no one else. The same lot that fill A+E with abuse and trivial rubbish, spill and fill our gutter the next day in their thousands, consuming like locusts – and where walk-in centres held them, and drowned them in antibiotics and hugs, that no longer exists and they are lost. Lonely banter. No nannying and tree hugging is warranted to get you through life. The institutes, I agree, brainwashed doctors in their training to “negotiate” a “patient-centered” model. That now combusts in the faces of people and academics who can’t model this blazing inferno any longer. Add the GMC and CQC into the medicalised abyss and you have a bonfire of half pointless “activity”. It is an addiction – with blame attached to choices made – loneliness and irresponsibility now being called out – this sick new normal is utterly abnormal and chokes everything. There are enough doctors and nurses, just not enough to handle made-up anxiety. The clear message is, move on, the world doesn’t owe you anything, and yes, you will die at some point, but most likely not from this whimsical proposition. And – you’re not that special anymore, you really should protect your medical records, before your insurers ask for your history.
“The austerity of the past 12 years”
https://www.bbc.co.uk/news/health-38887694
Austerity didn’t happen. Keep believing/spreading the false narrative. If even the editor of a supposedly objective site for doctors of all viewpoints is biased to the “left”, then turn this into an echo chamber, why don’t you?
“the societal support structures are no longer there.”
And why do you think that might have happened? Could it be because you tell people that the state is now responsible for their “well-being”? From “cradle to grave”? That they don’t have to worry about financial responsibility any more for their welfare/healthcare?
I believe that underlying this debate is the loss of the alternative support structures – historically, religion & the priest, and even more importantly the loss of the extended family/community support.
We now have families spread across the country & support is just not there when needed such as with young babies. We also have eroded the state support, social services, social care, benefits – all have all been significantly watered down & it is a scandal that we have the levels of child poverty that currently exist in a so called first world country.
Who else do people currently have to go to in our society? Despite all the recent negative publicity around primary care the patient still sees the GP as someone they can trust & can speak to in confidence about their issues whether these be medical or otherwise – where else do they have to go?
I too feel that menopausal women deserve being treated seriously & that was an unfortunate example in Dr Musgrave’s article (possibly driven by the much larger volume of this aspect of care that she faces compared to myself) but the baby related problems for example would historically have been dealt with by advice from grandma or great grandma & a more substantial health visiting service.
I agree with the comments that we sadly face the situation of having to choose what matters most & having to prioritise need. We do indeed face really tough years ahead with dwindling numbers of clinicians and increasing demand which politicians only encourage rather than helping us to manage. The days of what I want, when I want it & from whom I want it are behind us and this message has to get out to the public at large.
However, the solution to this crisis requires the reconstruction of a meaningful society with strong social care for our elderly & better support for our younger families. We cannot force extended families to return but strong community groups and strong local communities need to be forged to provide some of that local support.
The UK is not the place that I grew up in – we have got rid of some of the worst aspects of the 60s/70s society but replaced them with others arguably as bad. The country needs strong leadership with clear direction towards making the UK a better place to live in – we are a symptom of the wider society & until we do something to fix the “illness” that afflicts our whole society then we will continue to struggle with the current situation.
Don’t think GP’s actually blame anyone, as you say Jamie, you’re not actually on the front line and not surprisingly you have a different take on the nuance of the narrative. GP is a subject that every Tom,Dick and Harry thinks that they have an answer to,and the truth is unless you actually do the job you have not got a clue what it’s like. It’s amazing how even personel who work beside us don’t appreciate just what variety and complexity we deal with often in ten minutes! Secondary care certainly don’t have a clue and while after a few weeks brushing up, an average GP could make a good fist of doing their role(obviously leaving aside surgical technically) the reverse would not be the case. Joe Public certainly doesn’t have an idea whatsoever!
Unfortunately, the capacity to deal with all and sundry has gone so not surprisingly us GP’s are feeling we are totally isolated with little option but to up sticks and do whatever option preserves our health/sanity. Hopefully, at the end of this exercise, the long overdue chat about reality, self responsibility and tolerance will take place.
What they said ^.
Apart from all that, the job’s awesome.
Jaimie, you fail to mention a key group in this…..journalists.. some go into the profession “for good” and maintain moral standards and some commit moral crimes against society either under duress from the editor/owner or because they have no moral standards……
When will these journalists be called out and will you openly call them out……their crimes against society are many…..gaslighting GPs and other healthcare professionals, fake stories, deliberately stoking demand and false reporting……..
Thebest thing that could happen to society is if these destructive media outlets were closed down and the individuals who worked there were subject to “restorative justice”……
Means tested entitlements – to income, housing etc – crowds out alternatives for those with lower paid jobs. Chronic pain or anxiety then becomes a logical subconscious logical choice leading to real disease in a society where the blessing of the Medical priest is often required.
There is a solution to this but we need a strong leader. Change the system to encourage personal responsibility and bring in charges. Yes they can afford it and it might even safe them to think twice before spending £50 a week on cannabis. If one makes poor decisions such as drugs/alcohol abuse etc, one has to pay for it and not ask society to carry the tab. Even with the system we had, at it’s best, the poor compliance and their overindulgence shall we say has killed them albeit more slowly.