Tuesday 31 August 2010

Is NHS Direct the wrong prescription?

As a stern, unbending Tory, I naturally applaud the idea of cutting Government spending. But the cuts need to be made with the keen eye and steady hand of a top surgeon, not by a half-blind madman wielding a scythe.

If you had asked me a year ago whether it was right to scrap the NHS Direct helpline, as the Government plans to do, I would instantly have agreed that it was a huge waste of money, providing cushy jobs for nurses and succour for hypochondriacs.

But that was before I took the huge leap into the unknown of becoming a first-time parent, and faced the endless succession of coughs, rashes, swellings, bumps and abrasions that probably amount to nothing but might just be the herald of that potentially fatal condition you would never forgive yourself for failing to detect.

My wife has found the nurses of NHS Direct invaluable at providing timely advice and reassurance. Her many friends with year-old babies all speak highly of the service, too.

How can it possibly save money to get rid of it, when in most instances the alternative would be a visit to a GP or an A&E Department, at infinitely greater cost to the NHS?

The minister concerned says that the same service can be provided more cost-effectively through the new “111” non-emergency number, now being piloted right here.

And the key, money-saving difference? Apparently fewer qualified nurses manning the phones and more “trained telephone operators”. I am pretty sure that is what they also call those helpful people manning the telecoms and IT helpdesks; the ones who can’t actually answer any question that isn’t on the cards they’ve been given to read out. These provide precisely the same information as the “frequently asked questions” that anyone with half a brain will have read on the website before picking up the phone.

The only value I have found in these services is the entertainment of asking a wholly unexpected question such as “What’s the weather like in Bangalore, then?” and listening to the frantic shuffling of paper at the other end.

Apart from cost, NHS Direct apparently has to go because GPs don’t like it. The Government’s Big Idea is that GPs are the linchpin of the NHS and should basically run everything. Well, Coco the Clown may well be the linchpin of the circus, but that does not mean we should take his advice on how to erect the big top.

And have you actually tried getting to see an NHS GP lately? Once upon a time I had a doctor who knew me and my medical history; now I see a different locum every time I go to the surgery, and usually have to wait a day or more to do that.

My practice has gone down the route of allowing appointments to be booked online, weeks in advance, so that every slot with one of the partners is filled by forward-thinking repeat visitors, rather than patients with chaotically unplanned illnesses.

Many friends face the alternative madness of the 8.30a.m. telephone roulette, with the phone on permanent redial, because appointments can only be booked on the same day.

House calls? You must be joking. My sick neighbour waited most of a day for the out-of-hours service to chauffeur a mainly German-speaking locum all the way from Penrith.

I don’t blame GPs. If someone had offered me a vast pay rise to work 9-5 Monday-Friday instead of being on call 24/7, I would have grabbed it, too. But unless we can recapture something of the spirit of my parents’ Dr Gilchrist from the 1950s, prepared to turn out at all hours and in all weathers to take a look at a sickly child, I would urge the Government to think long and hard before flicking the “off” switch on NHS Direct.

Originally published in The Journal, Newcastle upon Tyne.

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