The UK Government is getting round its deliberately manufactured shortage of doctors by the simple expedient of lowering standards. The shortage was manufactured in many ways. For example, medical schools were told to admit more female than male students (even though it was known that women doctors would often choose to work part-time). Second, the medical establishment and the Government allowed GPs to cut their working week to three days. Third, the General Medical Council (which controls licensing in the UK) introduced an unpopular ‘revalidation’ scheme which added a new layer of bureaucracy to practice and also meant that once a doctor retired he or she was likely to be lost to medicine forever.
So, having created the shortage, the Government has introduced a raft of brilliant ways to lower the quality of care (and to save money too).
Undeterred by the fact that allowing nurses to make diagnoses and to prescribe potentially lethal drugs hasn’t been an entirely wonderful success (that’s my polite way of saying that it has been an unmitigated disaster), the Government is now going to allow pharmacists to start prescribing too. Your friendly pharmacy will, for example, be allowed to prescribe antibiotics. My immediate fear is that they will, to save money, be instructed by the authorities to prescribe very short courses. The ultimate danger is that this will lead to even more antibiotic resistance and, in the end, to far more deaths caused by uncontrollable infections. The next step will be to allow members of the public to buy antibiotics over the counter and I doubt if that will cause more problems than have been created by doctors.
Pharmacists will also be allowed to provide blood checks and patients will be allowed to refer themselves for physiotherapy, hearing tests and podiatry. (Good luck to them. Antoinette is still waiting for the hospital physiotherapy appointment she was promised three years ago.)
This is all part of the deliberate process of downgrading medical care in the UK and will allow GPs to get on with the two things they are now paid to do: to fill in forms and to organise vaccination programmes. (The vaccinations are, of course, given by members of staff, thereby ensuring that doctors don’t have to endure any contact with members of the public.)
And the plans don’t end with pharmacists.
The Government plans to introduce a new breed of cheap, cut-price doctors who won’t go to medical school but who will serve some sort of general, fast track apprenticeship. I suspect that if all goes according to plan these new cheapo doctors will, in the diagnosis and treatment stakes, lie somewhere between a boy scout and someone who’s taken a 20 minute first aid course.
But, on the plus side, they will probably also be able to mend your sticking garden gate and put a new light bulb in that tricky standard lamp in the living room.
Where is all this heading?
Well, I’m pretty certain that before long we will all be advised to obtain our medical advice from a neighbour. But which neighbour should you choose?
Here’s my advice on how to choose the correct neighbour for medical advice.
Look for a woman aged at least 60.
She will wear elastic stockings designed to disguise her varicose veins and prevent her ankles swelling to elephantine proportions. These stockings will be elderly, loose and wrinkled.
She will wear a full pinafore (which ties around the neck and the waist). The pinafore will be made of a cotton material – usually but not invariably decorated with a floral print. It will NOT be plastic and it will NOT contain a humorous or rude message.
Her hair will contain no fewer than three, and no more than seven, curlers. Fewer than three curlers suggest that she is too careless about her appearance to be a skilled diagnostician. More than seven curlers suggest that she is too interested in herself. She may wear a small, cotton print headscarf around her hair. If she does then it will be tied in a large knot at the front of her head.
Unless pointing at something, she will stand with her arms crossed and resting on her bosom. Her bosom will always be immense.
She will have a smouldering, half-smoked, un-tipped cigarette hanging from her lower lip. She will never be seen to light a cigarette and she will never be seen with a new cigarette in her mouth.
When available for consultation she will stand on her front doorstep.
The woman you see will never ask to be paid. She will, however, expect you to pass on to her any secrets, gossip or intimate information you might have. She will expect a full and accurate account of your economic status, any idiosyncratic behaviour you know about concerning other neighbours, your family prospects, your plans for the purchase of soft furnishings and any impending court appearances.
Meanwhile, I heartily recommend that you read my book How to stop your doctor killing you. It is packed with valuable advice designed to help you stay alive.