For most of us, our local GP practice is the first place we go when we're unwell - whether it's related to our physical or mental health. That's why it's surprising to learn that less than half (46 per cent) of trainee GPs in England undertook a training placement in a mental health setting in 2015, according to data obtained from Mind.
The primary role of GPs has always been, and will continue to be, to treat common medical conditions and to refer patients to hospitals and other services for urgent and specialist treatment. Whilst there have always been GPs who are interested in signposting patients to community-based social care and support services, they have tended to be in the minority.
I lied to a patient today. I didn't feel good about it, but I didn't know what else to say. It was a man I was visiting at home, let's call him Stan. An elderly patient who is normally in excellent health and rarely comes to the surgery. He was down for a home visit to check his chest after being unwell for a few days. Before I went out I looked at his notes, and saw we hadn't seen him for a good six months. Quite uncommon for a lot of older patients. He isn't a smoker, isn't on much in the way of medicine, and had rung the surgery last week. The notes were from my colleague. They were brief...
Mr Cameron and Mr Hunt - maybe it's time you took responsibility for this horrific mess. Turn to the NHS staff. Turn to the patients and relatives. Apologise, say you got it wrong and let's fix the most important thing this country has. You forget when the NHS is broken, it isn't just about headlines and careers, it's about lives. People are dying because of you. Time to stand up and face the music.
Your safety is being put at risk. My greatest fear is that nothing changes, the NHS slowly crumbles, stretching more and more, doctors too tired to concentrate, patient care suffering, safety put at risk. You as a patient know this from your experiences every day. If the NHS is going to survive for the future, all of us - patients, public, professionals and politicians, need to accept that it isn't working. We need an honest discussion about its future. We need to start talking.
Much as City firms have benefited significantly from developing innovative flexible working schemes to attract and retain talented staff, it strikes me that a solution that could go a long way in addressing GP recruitment issues is actually to encourage more flexible working, for both sexes, not to try and restrict it.
I was asked this week why the NHS doesn't fund all the new technologies available for patients, particularly those with cancer. And when I instantly replied "Because we can't afford to", I surprised myself. Because no-one seems to say that when they talk about the NHS. And the NHS doesn't like to say no.
Had I known that GPs were, of course, the root of all the problems in the NHS, with their daily failures to diagnose cancer, whilst simultaneously over-referring for all cancers, and ridiculous ideas that patients may share some responsibility for their own health, I would have instantly dismissed this career option. Instead I found myself working for the hundred, probably thousands of surgeries which are failing their patients. I was out on the streets, inviting half a million illegal immigrants to register and use the entire NHS free of charge.
There are 10 appointments left for today. There are 10,000 patients. My three colleagues are here all day, but one can't help with the home visits. They have a meeting about commissioning services in the local area. A brilliant idea from the government. But there is no time or money allocated for them to attend this meeting. So that means there are just three of us. At 8.10 there are 20 patients waiting for me to ring them back. At 8.30 there are 53.