Can we fix the problem of GP appointments? Medical Matters with Derry GP Dr Tom Black
The annual statistics for my GP practice have just arrived and the average patient now has more than seven face-to-face consultations per year, more than three GP phone consultations and more than 20 contacts (administration encounters) with the practice every year. So pretty much in contact with their GP practice every 10 days on average. This doesn’t include house calls, district nurse visits, prescriptions, blood results, hospital letters and other enquiries that the GPs have to sort out. Hundreds of thousands of patient contacts per year for fewer than 7,000 patients.
These are astonishing figures and there’s no wonder the phone lines are blocked because no service could keep up with this demand and I should point out that we have fewer GPs and lower funding than we had 30 years ago when the face-to-face consultation rate was about 3 consultations per patient per year - half of what it is now.
Despite this I know that patients say they can’t get an appointment and the department of health says we need to improve patient access. Let me ask the obvious question. Given that we have doubled the consultation rate during my career in the practice what would solve this problem of GP access?
It’s worth pointing out the patients in other European countries go to their GPs much less often and those patients in the Republic of Ireland who pay for their appointments go less than half as often and have much better health outcomes and life expectancy than their northern cousins.
So have we reached peak healthcare? Are we going to the doctor more often than we need to although obviously not as often as some people want to. We definitely have a problem in Northern Ireland where patients do less for themselves and expect their GP to do more for them. The most important things that you can do for your health are exercise, a good diet, don’t smoke, don’t drink to excess, avoid things like gambling and illegal drugs and keep a reasonable weight. After four generations of folk being looked after by the NHS, we seem to have become disenabled to the extent that patients expect someone else to take on responsibility for their health. This doesn’t take away from the fact that people have health needs that aren’t being met in general practice and people have to endure the torture of hospital waiting lists. Are we doing too little for patients with genuine needs and too much for those with wants and demands?
We have an NHS in Northern Ireland which is overwhelmed by workload such that staff are stressed and burnt out. We have funding levels that can’t cope with the levels of ill health that people have ,not to mention the diseases that didn’t used to be diseases.
We need people to look after themselves better and avoid the bad habits that lead to ill health. Otherwise we won’t have enough funding or healthcare workers to look after us.
Politicians won’t explain this to the public and they won’t increase taxes to pay for more healthcare. They will make promises they can’t keep and they will pressurise and stress the few healthcare workers we have left to try and maximise their “productivity “. A nightmare!