Written evidence submitted by John bache (FGP0127)

Retired Accident and Emergency Consultant with 35 years of experience of working as a doctor on the front line of the NHS


Through no fault of their own, General Practitioners (GPs) have metamorphosed from facilitators to obstructors.  This transformation began, as predicted, when GPs abrogated their responsibility for 24-hour care for their patients, and the change has been exacerbated by the current pandemic.


Let me give a couple of hypothetical examples with achievable solutions.


Example 1

Every few years, patient A develops a patch of eczema on his elbow.  This has always responded to Betnovate.  When it recurred, he telephoned his GP for an appointment.  He was told to ring back at 8.00am the next morning.  This was difficult as he would be going to work on the train.  He telephoned work to say he would be late.  He rang the practice at 8.00amOf course, it was engaged.  He continued trying for thirty minutes and then gave in.  He arrived late for work and at lunchtime went to a pharmacy to try to buy Betnovate over the counter.  The pharmacist informed him that he would require a doctor’s prescription.  Patient A then found some Betnovate which was well out of date and used that.




Example 2

Patient B developed severe osteoarthritis in both knees a few years ago.  She had bilateral total knee replacements.  These were brilliantly successful and enabled her to resume her very active lifestyle, both at work and undertaking her hobbies, which included charity work.  She then developed osteoarthritis in the ankle and her mobility was severely affected as a result of great pain on trying to walk: every step was painful.  She tried to contact her GP but again experienced the ridiculous situation of unsuccessfully telephoning at 8.00am.  She eventually attended A&E, where an X-ray confirmed severe arthritis and she was advised to contact her GP with a view to his arranging an orthopaedic appointment.  Back to square one, with the added complication that she is now suffering from understandable reactive depression, as a direct result of her inability to see an orthopaedic surgeon.





Some over-arching thoughts




Long-term solutions (over five years)






Short-term solutions (five years or less)









Dec 2021