Wednesday, July 25, 2007

GPs vindicated?

The Department of Health has just published the results two surveys into patient views of General Practitioners (GP, or family doctor to our non-U.K. readers) in England.

There has been much political diatribe over the last few months that, since the government gave the GPs a new contract and, (supposedly I will say, as I have not seen statistics on this), they are earning more money, working less irregular hours and the government actually wants them to work more hours and more irregular hours (early mornings, evenings and weekends).

But as the GPs are meeting the targets of their new contracts (set by the government), they don´t see why they should. It seems to me the government did not set its targets effectively.

Anyway, the patients´ surveys (commissioned by our last Health Secretary, Ms Hewitt) are generally favourable to the GPs.

84% of patients are content with their GPs opening hours. That leaves 16% who are not – perhaps that 16% needs to be analysed as to occupation, working hours etc. If, for example, they were found to be more mobile (transportation etc), they could be offered an alternative GP practice with more flexible working hours (generally larger) but presumably at the cost of transportation.

In some areas some patients were dissatisfied with access times – small rural practices, with a widely-spread geographical base, understandably do have more difficulty in this.

Making an advance (48 hours or more) booking, more important, the further away you are from your GP, was considered a problem.

Rural GPs also had more difficulty in discussing choices of secondary referrals for treatment at hospitals. This is, I feel, mostly a problem of information infrastructure in the NHS whereby small isolated GPs are not provided with adequate information about choices, or do not have the time to process this information and, of course, patient transportation problems.

“Deprived” areas suffer similar problems.

Ethnic minorities are less satisfied than the white indigenous British population. I am not surprised – I think you would find this throughout the NHS from hospitals to doctors to nurses to porters to cleaners to patients. We have posted on NHS, hospital and GP access to interpreting and translation services here and here.

Cultural services for the patients in the NHS are not sensitive (and I am not saying they should or should not be) – on our ward, for the first four weeks that we lived there, we had an “orthodox” Jew (skull-cap and tresses), next to a “fundamental” Pakistani-origin Muslim (salwar kameez and hijab), next to a Pakistani (salwar kameez only) Roman Catholic Christian, next to a white British National Party (i.e. fascist/racist) voter … next to Nanda, black African, nominally Roman Catholic Christian. The prayer room at the hospital does not discriminate.

But the NHS must provide the linguistic services … according to the BBC report our new Health Secretary, Alan Johnson, highlighted ethnic discrepancies as something which needed investigating.

Is this a small change from Ms Kelly´s opinion that all NHS patients, who are not in A&E, should speak English?

1 comment:

Angus said...

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