Growing demand for GP care means system is at breaking point

SIR – With a population of 9,000, my wife’s surgery handles 3,000 calls per week, the peak being on Monday, with 900 on average.

Three years ago, they introduced a telephone triage system whereby you receive a same-day reminder from a GP and can be brought in for an in-person consultation if needed. Popular with patients, and with neighboring practices struggling, his surgery is growing at 35 registrations per week.

With this system in place, a doctor can treat 55 to 65 patients over the phone, which averages 10 to 12 for a face-to-face consultation. Going back to the old system would mean that a doctor could treat a total of 30-35.

Access to a GP should be based on need, not demand, so some sort of triage system should be in place.

Classified three quarters of the time, my wife works an average of 56 hours per week. Financially, given the pension fund tax, income tax and national insurance thresholds, she had better work less at this point in her career. At the age of 54, she was exhausted mentally and physically.

The system is at the breaking point, not because GPs are inactive, but because the demand for time is exponential.

Robert blades
Leiston, Suffolk

SIR – Last Friday my seven month old granddaughter got sick. My daughter called the local health center (three kilometers away) and spoke to the doctor on call. He said he could not see the child because the health center would close in 15 minutes. He suggested that she call 111. The triage operator on 111 relayed her findings and my granddaughter was taken by ambulance to the hospital, where she was diagnosed with gastroenteritis.

In 17 years of service as a paramedic, I have never turned down a late job (including some who arrived after a shift was over on our way back to base). I’ve never earned anything close to what a GP earns, but we felt a duty of care to our patients. In fact, not having responded to such an incident would have resulted in a disciplinary hearing and possible dismissal.

It seems to me that some general practitioners no longer know why they accepted the position.

GP White
Kingham, Oxfordshire

SIR – As a general practitioner who regularly continues to try to offer his patients in-person consultations, I fully endorse Nick Stokes’ comments on the British Medical Association (Letters, May 22).

The sad truth is that the BMA has become a leftist union which is no longer representative of the vast majority of doctors. In the process, the best interests of patients (which should by right be the best interests of physicians) have been totally neglected.

Dr Anthony Fincham
Ashford, Kent

SIR – When I was a GP in Australia I only got paid if I saw someone in person. This should correct the lack of availability of appointments here.

Dr John Doherty
Stratford-upon-Avon, Warwickshire

Fear of freedom

SIR – Douglas Carswell (“America Chose to be Free. Why Britain?” Commentary, May 22) rightly asks why Britons are still limited by Covid rules when in large part of America, life has returned to normal.

Internal flights are full there. In Florida, our friends are wondering why the British, where the death rate is now at its lowest since records began, cannot cross the pond for fear of unnecessary quarantine upon their return. They tell us about President Biden’s procrastination; Well, look at Boris Johnson. At least in America state governors can intervene.

The NHS is far from overwhelmed. Vaccines are effective against Covid. Yet in Britain the fear campaign continues unabated.

John pritchard
Ingatestone, Essex

Unfair trade tariffs

SIR – Dame Sharon White (“John Lewis Must Fit or Die, Says Sharon White,” Business, May 21) raises the thorny issue of business rates, which has plagued the real estate industry for years.

Any form of tax levied on a notional value, whether land or buildings, will always be the subject of litigation, appeals and complaints. The whole scoring system has shown this, and furthermore, it is extremely expensive to administer and requires suitably qualified personnel.

The only solution is some form of turnover tax, which would catch even large warehouse operators (Amazon, for example) and encourage regrowth and more diversity on the shrinking high street. Local providers could deliver services knowing they only pay tax on success and wouldn’t be crippled by an unfair scoring system that puts them in the same league as the big multiples.

I speak as a chartered surveyor who took advantage of the quotation calls. Some of my colleagues will oppose my point of view because it is an extremely lucrative source of business, but the rating system has been down for far too long.

Jonathan youens
Bucharest, Romania

Darwin in context

SIR – In his critiques of Charles Darwin (“Darwin’s theories ‘distorted’ by his prejudices, says the professor,” report, May 21), did Dr Agustín Fuentes of Princeton University take into account the fact that in the 150 years since Darwin wrote The Descent of Man, a lot of additional knowledge has accumulated?

Darwin wrote with the knowledge of his time. Stop judging history by today’s standards.

David North-Coombes
Ottershaw, Surrey

Tell dog tales

SIR – In Novel Notes (1893), Jerome K Jerome recounts hearing a story told to a group of friends of a dog (Letters, May 22) “who went to a bakery every morning with a penny in their mouth. for a bun. One day the baker, thinking the dog wouldn’t know the difference, grabbed the dog with a ha’penny bun, whereupon the dog walked straight outside and went to get a policeman.

Jerome notes that such stories are some of Noah’s best-known prehistoric jokes, or things Romulus must have told Remus. Hearing the above, one of the group members whispered, “That made the 28th man he had met whose brother-in-law had owned this dog – not to mention the 117 who owned it themselves.”

Roger croston

The cost of dementia

SIR – My husband has been in an establishment for four years and finances himself (Letters, May 21). He advanced Alzheimer’s disease. I took care of him at home for eight years until he became too much to handle. It cost him savings, which would have paid for our retirement and helped our children and grandchildren.

The emotional strain of having a close relative with dementia is indescribable and, coupled with the financial drain on savings – by no means the fault of the patient – takes this trauma to the extreme. The effect of this on mental health is almost unbearable.

Where are we wrong? Shouldn’t we have saved in our working life or spent our money on cruises? Those who have no savings have their care paid for and are subsidized by those who finance themselves. People with dementia are sick and as such should be funded by the NHS.

Marie Tippins
Leighton Buzzard, Bedfordshire

Gesture policy

SIR – Your report (“Cambridge Donations That Raise an Eyebrow May Be Reported”, May 21) paints a misleading picture of life in Cambridge under our revised Dignity at Work policy and Change the Culture initiative .

We have thousands of students and staff from different backgrounds and countries. They all have the right to feel welcomed and appreciated. We therefore provide a safe way to report concerns and help fight bullying and harassment while raising awareness that small, often unintentional actions can be life-changing.

As stated in our policy on free speech, the university expects everyone to be tolerant of the opinions of others, while remaining courteous. People in any workplace have a right to respectful behavior, even when their opinions are strongly contested, and this is especially the case in a complex and tight-knit community like a university.

Professor Eilís Ferran
Pro-Vice-Chancellor for Institutional and International Relations
Cambridge University

Disconcerting delivery

SIR – When I lived in North Wales in the late 1970s the milkman used to go into the kitchen (Letters, May 21) and put the milk straight into the fridge, which was a bit confusing for the house guests having their breakfast.

Simon verdon
Adderbury, Oxfordshire

The revival of the British open-air theater has left cold

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