Media coverage of the plight of General Practitioners has been intensifying over the last few months with a hot topic being that the lack of availability of GPs is leading to increased patient waiting times. Ultimately, this will impact upon the quality of care that patients receive, if it does not already.
The Chair of the Royal College of General Practitioners, Dr Maureen Baker, has spoken out about the increasingly unacceptable waits that patients now have to endure, with new statistics from a 6 month GP survey indicating that a total of 58.9 million patients in England will have waited for a consultation for a week or more by the end of 2014. This is an increase of almost 50% from the 40 million who waited the same period of time during 2012. The proportion of patients waiting for over a week has been steadily increasing, and has now reached 16%, or 1 in 6.
Dr Baker has branded the “devastating statistics” a “national disgrace” and said “we cannot gamble with people’s health in this way”. She has attributed the problem to too few GPs having to meet the rising demand in their services meaning that they are stretched and overworked. Additionally, GPs are apparently under-resourced, with their share of the NHS budget proportionately falling from 10.95% in 2005-06 to 8.39% in 2012-13, at a time when the population, in particular the elderly population, is increasing.
Dr Baker also commented that such long waits were “unacceptable” and highlighted the importance of rapid appointments so as not to miss opportunities in diagnosing illnesses. Whatever the reasons for the increase in waiting times, there is little doubt that longer waits will ultimately have a serious impact on patient health and, accordingly, this will almost inevitably result in more patients being avoidably injured.
All of this comes at a time when the politicians are intent on reducing access to justice for injured victims of medical accidents. So, not only does the modern day patient have to risk suffering poorer medical care, but they also now have less chance of legal redress when that medical care unacceptably harms them: adding insult to injury. Notwithstanding the government’s drive to reduce access to justice, it remains the case that every injured patient should still have an entitlement to appropriate legal redress when a doctor or other health professional has been negligent in their treatment of that patient, whatever the underlying reasons for the negligence; overworked and under-resourced GPs are, and should remain, no exception. It is always worth remembering that GPs are (or should be) insured against negligence.
Your GP will, of course, usually be your first port of call if you become ill. However, a GP’s expertise tends to be in their patient rather than in any individual disease or branch of medicine, as much of a GP’s time is spent dealing with family and social matters as well as medical matters. Therefore, most GPs usually do not have a particular area of specialisation (although some may have a particular interest in a specific area of medicine) and have to undergo training covering all the major branches of medicine.
Notwithstanding that GPs have to be familiar with a vast array of medical problems, medical negligence cases against GPs tend to involve their failure to do the basics adequately or appropriately, rather than more complex things. It is not, however, just GPs’ delays in diagnosis, including those due to long waiting times, that can result in problems. For example, in the clinical negligence context many cases against GPs involve:
- Inadequate history-taking from and/or examination of the patient;
- The failure to investigate properly a patient’s problem with the appropriate tests;
- The failure to make the appropriate referral to a specialist;
- Failing to appreciate the seriousness of a condition and/or to act promptly enough in administering appropriate treatment.
Common examples of delayed or missed diagnoses with catastrophic consequences involve conditions such as:
- Meningitis: a life-threatening infection of the lining of the brain;
- Hypoglycaemia: a low sugar level which can cause devastating brain damage if not treated promptly;
- Asthma: a life-threatening respiratory condition;
- Pulmonary embolism: a clot in the lung, which can be fatal but often easily treated;
- Cancer: delays in diagnosis;
- Other conditions, such as myocardial infarction (heart attack), heart failure and pulmonary oedema (fluid on the lungs), amongst many others.