Alastair Stewart: What is the GP service really about these days?

The coronavirus has disrupted GP services in a bid to protect the men and women in this vital service. But as the threat receded the disruption didn’t.

Folk still found it difficult to get face to face appointments. More and more were asked to use phone calls and zoom. Fine for some; not so for many especially the old, the less techy and the vulnerable.

Already fewer than 50% can get an appointment immediately; many have to wait weeks… And tonight NHS England has said regular health checks for the over-75s may be halted because of pressures caused by the booster programme.

Now comes the instruction from the Health Secretary that they should be the frontline in the booster campaign at the expense of their other functions.

The scale of the challenge is huge - fully 28% in care homes, among the most vulnerable - are yet to get boosted.

But pressing GPs into the frontline is fraught.

Diagnoses will suffer, referrals will suffer - more will be missed and more life-saving operations delayed.

The GPs themselves admit it will create serious problems.

The vice chairman of the Royal College of GPs, Gary Howsam, says “we can’t be doing all things all the time”.

And the public purse glues open, too.

The booster bonus is raised from £22.58 to £30….

Dr Farrell Jameel, Chair of the BMA’s GP committee says they just don’t have the capacity to meet the new challenge - despite the lure of extra lucre.

Sajid Javid remains confident they could play a full part in delivering 25 million booster jabs by the end of January.

Someone’s not listening to someone….

But it raises once again a more serious question.

What is the GP service really about, these days?

It is a service from men and women that has gone from the days of Bill Simpson’s ‘Dr Findlay’s Casebook’ – or even Martin Clunes’ grumpy ‘Doc Martin’ – known, trusted and accessible members of the community - to a group of private businesses with their own budgets and a secrecy over earnings.

The gateway service is slowly transforming to something unrecognisable.

I can see the need for a short term plan to bolster boosters but pharmacies, walk-in health centres, service medics… let us milk them before we further curtail the availability of GPs.

And once we are in calmer waters let us ask what it is we want from the GP service, which we fund, and ask for a little more candour from the Government over what it thinks it is for and is supposed to doing.

This morning as I had a coffee I saw an advert poster for a ‘walk-in’ private GP service: prices start at £35…

Evolution or revolution, we need to pause, when we can, and ask what about those who can’t afford that and, anyway, is that what we really want?

It might be but it would be nice to have been asked.