Progress in General Practice

Dr Vernon Coleman

When I was in general practice some decades ago, in the 1970s and early 1980s, we ran the whole caboodle with three doctors, two and a half receptionists (we could have managed with one without the damned official requirement that we run an appointments system, which everyone hated) and a secretary who was also officially described as the practice manager.

The three of us looked after just under 10,000 patients, did our own daily home visits and with the aid of three other GPs from another practice, we provided a 24 hour a day service for a combined total of around 20,000 patients for 365 days a year. Between us we covered all evenings, all weekends and all bank holidays including Christmas. A district nurse and a health visitor popped in to our surgery building occasionally but we took our own blood samples, removed stitches, syringed ears and so on.

I checked the other day and found that my old practice still exists and now has five GP partners, eight salaried GPs, four registered nurses (one of whom is allowed to prescribe drugs), two health care assistants, a phlebotomist, a practice manager, a quality and performance manager (whatever that is), two reception managers, five dispensers, twelve receptionists, a senior administrator, five administrators, two prescription clerks, a medical records summariser and two medical secretaries.

Iím not kidding. I wonder how many patients they look after.

I suspect all these people spend a good deal of time in meetings and dealing with paperwork and I am pretty sure they cost the NHS a massive amount of money. I hate to think how much time is spent working out the holiday rota.

I hope I am unduly sceptical but if this small army of health professionals is anything like the rest of Englandís GP practices it is possible that they provide a daytime only service with relatively few house calls and no out of hoursí visits at nights, weekends or bank holidays.

I think thatís what they call progress.

Taken from Vernon Colemanís book `Memories, Volume 2í which is available as a laminated hardback, a paperback and an eBook.

Copyright Vernon Coleman May 2022