Surveys

There is an old joke about the existence of lies, damned lies and statistical evidence. My

attention was brought to bear on a survey that the news media (Daily Mail and Independant both ran big headlines about it) claiming that half of all GP's would be prepared to consider charging their patients for a consultation. The survey questioned 440 GP's out a total that believe is in the region of 40,000. 

I do not have the details of the survey so I am left with a few questions. Was this number just those that responded? Or was it a total number of GP's asked. It can make a difference, if only slight. Sometimes with open questions only those with a strong opinion either way will respond so the response bag can be swayed with whichever group is angriest for instance. Those that are indifferent represent that by not replying. 440 is a significant number as there are approximately 41000 GP's in the country. But 440 is a lot less than 41000. However statisticians will tell you they can extrapolate their answers because they are ever so clever and and have lots of analysis tools at their disposal.

Any one who has dealt with surveys and such will be aware that how you ask the question is important. The news media have splattered their headlines with "51% of ALL GP's want patients to pay for an appointment!" What is more sparse in the coverage is the actual survey or more importantly any real questioning of it's authenticity. The GP rag that published it has got what it wants, attention focused on GP's and their funding, so I guess whatever the survey it has served it's purpose. 

An interesting comment was made by an NHS executive that GP's wanted a fairer trade on the fact that they do 90% of the face to face work on just 9% of the budget. Which got me thinking. 

Let us take a look at that. I have made several visits in the last 2 years to my GP. I have been very happy with the work they have done. but I have, in all that time, spent less than an hour in total in the company of my GP who has also spent some of that making me take an online questionnaire followed by a prescription and "see you in 2 weeks" You gotta admit that is pretty low tech. When you compare to the 30 mins I get with my patients( sorry "clients"). I use my 25 years of experience along with a £130000 ultrasound machine in a heavily air conditioned room with my images being sent over the hospital intranet to a video database. And I am at the low cost end. Take an operating theatre. Surgeon, anaesthetist,  ODA and of course the ever present nurses of which there are at least two (scrub and non scrub). Then you have recovery and all the nurses and doctors before and after surgery. That doesn't include any equipment, processing to keep theatre sterile and all the instruments. Well the list is endless. Which is why GP's only get 9% of the bill. That is the way the cookie crumbles.

I am opposed to the idea of charging for appointments. It goes against everything the NHS was designed for. Health care free at the point of use. 

One of the problems I have noticed within the NHS is that each individual department is  almost, but not quite, completely ignorant of the workings of any other department. Every single department believes it is the hardest working and most put upon section ever. As such they have absolutely no concept of how their work impacts on other sectors. My complaint about Surgical wards is that they seem to believe they have some sort of hot line to my department and I am waiting like Batman to pounce into action at their very behest. So when I say they can't have their investigation done at that very moment because I have actual sick people to look at they become somewhat vexed and act like this wasn't a scenario they had considered.  Rant over. To be fair I do it to Radiology all the time. I am always griping about over pampered Radiographers who earn more than me with less hours and gripe at a lost tea break! what an unthinking swine I am

Radiology tea break!

As a result I shall refrain from suggesting GP's should suck it up on the grounds I probably do not truly understand their workload. However Our A&E's are filling up rather rapidly with people that, by all accounts, could have been seen by a GP. If the result of Patients not getting to see their GP in timely fashion alone is driving them to our doorstep just think what not paying £25 will do to their will power.