Nye Bevan famously said that he was only able to persuade family doctors to support the creation of the NHS because he ‘stuffed their mouths with gold’. But at least he obtained good service from them — including home visits. Until Tony Blair awarded GPs hefty pay rises while allowing them simultaneously to opt out of night-time and weekend work, they were responsible for their patients’ care 24 hours a day, seven days a week — with practices often pooling resources to provide continuous cover.
But the role of GPs has become increasingly unclear: do patients have a right to be seen in person? It was revealed this week that locum GPs are being offered £100 an hour to conduct telephone appointments from their own homes. Average GPs’ pay now exceeds £100,000 a year for the first time, having risen by 11 per cent in the past four years. Yet it seems to have become harder than ever for an NHS patient to see a GP.
The pandemic threw up obvious challenges, but there is a limit to how long GPs can use Covid-19 as an excuse for refusing to see patients face-to-face. Other parts of society have largely returned to normal. Shops and restaurants no longer have to enforce social distancing. Even nightclubs are open. Yet GP surgeries continue to operate as if we are still in the darkest depths of lockdown. Just 57 per cent of GPs consultations in July were held face-to-face — a little higher than the 47 per cent recorded in April last year but still far below the levels prior to the pandemic. In January 2020, four in five consultations were held face-to-face.
The risk is that the pandemic is used by the NHS and by GPs themselves as an excuse to push for a system of remote consultations.