Don’t panic! And of course, you won’t. Because, as Prof Stokes-Lampard correctly points out, ‘Emergency Measures’ have become the new normal in general practice – and indeed, in the entire NHS, with hospital black alerts being the default state, even in the lazy, hazy days of summer, which is why they elicit a barely stifled yawn rather than whatever it is the hospital administrators who issue them actually expect from us.
But many other things are the new normal, too. Such as the feeling of dread you experience dragging yourself out of bed every Monday morning, patients routinely bringing innumerable problems to one consultation to punish us for making them wait so long for an appointment, including one symptom which only developed between booking and actually seeing us, and men on my journey home blithely urinating in A12 laybys in full view of passing traffic, which I feel must be some kind of metaphor for the NHS which I’ve yet to work out.
All normal and, therefore, to be met not with resolve, apology or disgust, respectively, but with a shrug of the shoulders.
Which is pretty much the way the public is reacting to the unstoppable trend for having to see, at first point of contact, a health care worker other than a GP. My sense of professional pride makes me want patients to react with fear and fury. But they’re not, except in Wales, and I’m not sure they count.
There are three possible reasons for this endemic patient indifference:
1. They don’t care who they see so long as they’re seen now, and are given what they want, also now.
2. They don’t understand that the move to use advanced nurse practitioners, pharmacists et al in the front line is the result of necessity rather than design.
3. They don’t even realise that consultation they’ve just had wasn’t actually with a doctor, which I suspect is happening more than we’re prepared to admit and may even be a misunderstanding we’re happy to cultivate.
Whichever way you cut it, patients haven’t a clue what’s going on. True, that may be the old normal. But now it feels like we’re complicit, and that makes me feel even more depressed as I drive home back up the A12. Either that or it’s those autumnal golden showers.
Dr Tony Copperfield is a jobbing GP in Essex