We think of Ken Clarke as Maggie’s best Chancellor but, whilst Minister of Health, he was usually at war with the health service. A 1990 poll of GPs revealed 73 per cent of them thought the NHS unsafe in Tory hands, but Ken blocked a proposed private health insurance scheme. His alternative big ideas were GP fund-holding and patient choice. Clarke was one of the most able politicians of his generation, but do you really feel you have a choice of GP or hospital? Would you pop over to Southampton for an X-Ray?
When their turn came, the Blair government also tried sorting things out, but their legacy was to make GP contracts worse – for us, not them, of course. Prior to Blair’s disastrous renegotiation, GPs were fully responsible for out-of-hours cover; afterwards, they opted out. Tony B’s negotiators didn’t seem to understand that offered the opportunity to avoid working nights and weekends, while simultaneously enjoying a substantial pay rise. GPs would jump at the chance. His solution to our decaying hospitals was to spend vast sums of money rebuilding them, using PFI – a ruinously expensive way to fund anything.
It’s claimed that GPs are now ‘seeing’ more people than ever, but that includes telephone and on-line consultations, which are hardly the same, are they? I’ve just been listening to a radio phone-in; we can’t know if the callers were representative, but several practice nurses called, claiming the GPs they work for had been hiding during the pandemic. Some have been ‘working from home’, others in the surgery, but only for telephone consultations, refusing face-to-face patient contact because they ‘had to protect themselves’! Would you hide behind a nurse during a pandemic? No, nor me.
Choose your battles’ is sound advice, but occasionally a fight is unavoidable, and tackling Britain’s GP problem has challenged as many Health Secretaries as I can remember.
The nurses also claimed their doctors expected them to keep seeing patients, to make assessments and offer treatments on their behalf. One said she saw a nasty, possibly life-threatening skin infection and begged her GP to take a look, but he refused. I really hope these are exceptional examples and that most GPs are dedicated and hardworking professionals, because seeing your doctor matters, and appointments are hard to come by.
Sixty years ago, our GP in south Ealing was Dr Bentovim. Born in Jerusalem, he’d been called-up to serve in the Turkish army during WW1, but deserted to join the British. After the war, he began the arduous process of qualifying in medicine here, as no further education facilities existed back home in Palestine. He was broke, which for a medical student in those days must have been a huge challenge. Once qualified, he served our local community day and night. He spoke Hebrew and had a wonderful way with his patients. Dr Bentovim always called me ‘the terrible Turk’; he was one of the first foreigners I encountered, and I was very fond of him.
Whenever I hear someone say ‘we should train more of our own doctors’ I think of him and wonder, because of his accent, how many patients assumed he’d trained overseas. I really rate Sajid Javid, and hopefully he’s now the right man for the job and doesn’t just pretend that all doctors are the same. As the politician responsible, he must persuade the work-shy to do more. He should also give more money to pharmacists, because they’re definitely underpaid and can make an immediate difference. GPs are always unhappy with their lot, but even they must agree, we can’t just go on as we are.