healthmedicinet

The Dispatches programme features a series of examples of this, including a
grandmother who suffers from panic attacks who admits calling 999 for an
ambulance up to 20 times a year; a GP receptionist who says she has had an
umbrella thrown at her by a patient who could not get an appointment; and a
doctor admitting that patients ask for aspirin on prescription despite it
costing just 19p.

Dr Martyn Lobley, of Thamesmead Medical, in south east London, told
Dispatches: “You may have the most miserable tonsillitis but it’s going to
get better, you may have a dreadful cough but it’s going to burn itself off
out, you may have a really painful tennis elbow like mine and I know in six
weeks time that’ll stop hurting and I don’t play tennis so I don’t deserve
this but I’m not going to go and tell my GP I’ve got tennis elbow because
what’s he going to do? He’ll say get some Ibuprofen gel and rub it on which
is what I’m doing.”

Around 12 million GP appointments are missed each year, costing the NHS £160
million annually, yet at the same time 34 million people will fail to get an
appointment this year because their family doctor is overstretched.

A survey conducted for the programme showed that six in ten people supported
charging for missed appointments and people who arrive in AE because
they are drunk.

But the major political parties are all against such moves.

Dr Clifford Mann, president of the College of Emergency Medicine said just
because people left AE with just advice it does not automatically mean
they should not have been there.

“We have told people, if you think you are having a stroke, dial 999, if you
have severe central chest pain, dial 999, if you child is pale and floppy
with a rash, dial 999. We cannot then say that most of these people are not
having a stroke, heart attack or have meningitis so they shouldn’t be in AE.

“If your GP referred you to an urgent cancer clinic and after tests were
carried out you were given the all clear, you wouldn’t say you shouldn’t
have gone.

“However our own evidence suggests that around 15 per cent of people attending
AE – 2m people – could be safely redirected without being seen by a
doctor, a further 25 per cent need some tests which can be carried out
safely by a GP in a co-located urgent care centre but will not need
treatment.

“AE doesn’t stand for anything and everything, there are some
people who would be better seen elsewhere or at the very least co-located
urgent care centres staffed by GPs, mental health nurses, dental
practitioners.”

“Dr Helen Stokes-Lampard, honorary treasurer of the Royal College of GPs, has
said: “Practices work hard to ensure that, wherever possible, patients are
reminded about their appointments via text messages, e-mails or phone calls.

“Charging for GP appointments would fundamentally change one of the founding
principles of general practice – that healthcare is free at the point of
need.

“Asking patients to pay would undoubtedly deter many people from seeking
medical help in the early stages of illness when they can be dealt with
cost-effectively and efficiently in primary care, rather than requiring
expensive specialist care and increasing admissions to emergency
departments.

“The solution is more investment in general practice so that we can recruit
more doctors and create more appointments – and longer appointments – for
our patients close to home so that they are not forced to turn to other and
more expensive parts of the health service.”

A Department of Health spokesman yesterday said: “The NHS will remain free at
the point of use. We know that with an ageing population there’s more
pressure on hospitals, which is why we are investing in community services
to keep people living healthier at home for longer.

“NHS 111 helps patients access the right services, directing millions of
people to the right place every year.”

A spokesman for NHS England said: “The NHS is there 24 hours a day, seven days
a week for those who need it. Our AE departments are trusted by the
public and it is important that people know the NHS will be there for them
if they need treatment and care.

“But it is also important that patients and the public know about and use the
full range of health services in their local area. The NHS works hard to
ensure people know where to go to get the best care and that they can use
services appropriately. NHS 111 can direct people to the most appropriate
service if they are unsure.