London has a greater proportion of its population who are not registered
with a GP than anywhere else in the country. This is partly related to low
levels of recruitment and retention of GPs, but is also partly related to a
large transient population including commuters, tourists, students,
transient workers, refugees and homeless. We also tend to see lower levels
of "simple injuries" because of much lower levels of industry, agriculture
and recreational sport. We also have greater numbers of elderly in most
boroughs, although this is not usually a primary care issue, but does add to
the complexity of our workload generally. Add to that drug abuse,
psychiatry, violence and language barriers, and you might appreciate why the
inner city of London can be a challenging place to work, although I suspect
other metropolitan areas might come close.
So I don't sympathise at all; I have enough to do without also being a GP to
the citizens of my borough and many of the surrounding boroughs, as so many
patients prefer my hospital because my neighbouring hospitals' waiting times
are worse. I'm certainly not prepared to offer a casual no-appointment
drop-in GP service with a 75 minute turnaround time! Of course primary care
problems take a long time to sort out, that's precisely my point, and that's
why we have problems running see and treat in such departments. I might
occasionally have fleeting moments of "empathy" with such patients,
depending on their situation, but it still doesn't motivate me to suddenly
become a GP to such patients, just because they couldn't be bothered waiting
to see their GP or even registering with one in the first place!
Adrian Fogarty
----- Original Message -----
From: "Adrian Kerner" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, January 29, 2003 12:25 AM
Subject: Re: Trick & Teat is Dead
> Bill writes "" I imagine London hospitals have to deal with many more
> "primary care" problems rather than genuine A&E minors which would make
"see
> & treat" more difficult.""
>
> What makes "LONDON" any different to the rest of the UK?
>
> I believe that the 'primary care' problems, can actually take much longer
to
> sort, than A&E problems. Is it justice to say, I DON'T/ I CAN'T/ I CAN'T
be
> ****ed to sort out your problem?
>
> These are complex issues...........................
>
> Today, and yesterday, I have sorted many problems, that have been 'failed'
> by primary care. Interesting. I'm Primary Care trained (ALSO).......I
> sympathise with these patients who have been failed by the
> """"""""NHS""""""""""".
>
> Regards
>
> Adrian.
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