The following is something I have been thinking about for a while and decided it was time to put it on the blog. It’s not nearly as exciting as some of our other topics, but I think it’s relevant. So here goes:
I am very interested in what’s going on in the UK with their National Health Service for two reasons. I want to understand it better to be able to judge its role in “Doc Martin” and because I want to know how it compares to our health care in the US. I read the BBC News every day for many reasons and I’ve been collecting articles about the NHS. Before I lose track of all the articles, I wanted to post them and make some comments about them.
The way I propose to list these articles is not in chronological order, but in order of significance based on how their content affects health care and can be a reflection of what we see on DM.
The first article was published recently (Nov.) and refers to at risk GP surgeries. Ever since the “doctor’s friend” showed up in Portwenn, I’ve wondered how GPs are monitored. This article makes clear that there is a Care Quality Commission that is a watchdog that pays attention to how patients are treated. According to the article “the CQC look at whether surgeries are safe, effective, caring, responsive, and well-led.” Thus, Gavin Peters was properly looking into the GP in Portwenn following some complaints, and ME was performing all his duties correctly with the possible exception of the “caring” part. As they say in the article, “‘it is only when we inspect we can determine if a practice provides safe, high-quality and compassionate care,'” said CQC chief inspector of general practice Prof Steve Field.” Compassion is the question in ME’s surgery. It’s not clear if ME ever took that course Peters recommended. But it’s clear that caring and compassion are considered essential ingredients to good health care in UK. (Of course, I think we can all agree that those sentiments are important to good care here too. Not only do we prefer to be treated with compassion, but also there have been studies that demonstrate the value of compassionate care by doctors on the outcome of their treatment, e.g. http://www.psychologytoday.com/blog/the-joy-giving/201107/compassionate-medical-care-benefits-professionals-patients-students-and-3)
Another article notes a small number of GP practices have been getting complaints and the CQC has ranked all GP surgeries based on risk of providing poor care. And there has been an increase in complaints made about NHS care, according to this article. Then there is the concern that GPs may be missing diagnoses of lung cancer as a result of not having the proper tools. This article also blames patients for not seeking medical care in a timely fashion. I can imagine that how welcoming the GP is towards his/her patients would be a factor here. There is some tightrope line that must be walked between making sure patients who make appointments are the ones who have valid complaints and patients who need to be seen don’t neglect to come in. On the other hand, there is also a move to punish doctors more harshly for making mistakes, according to this article. In one case reported by the BBC, a doctor was sacked because of substandard care.
In a related article, there is a discussion of how many GPs will be retiring soon, leaving the remaining GPs to take care of more patients. In addition, there is a shortage of GPs entering the medical profession and this article mentions that the NHS needs to increase spending on training GPs and more GPs will need to be recruited. If ME decides to return to doing surgery, finding a new GP for Portwenn might not be so easy. Also, as an adjunct to the first article, the CQC may not have many options when it comes to demanding more compassion from Martin; they may just have to be content that he has so many of the other qualities.
Surgeons are not immune to oversight by the NHS and one article reports that they must publish their mortality rates or be sanctioned.
Not surprisingly, the NHS has some money problems and, according to this article increased funding is something that’s been requested. In October there was a strike by health care workers demanding more pay.
The systems of health care are quite different between the UK and US, yet UK is struggling with many of the same issues we have here in US. The show hasn’t done much with these problems, although I remember Pauline thinking she should get paid more because she was now a phlebotomist as well as a receptionist. Also, like the UK, the US is seeing a shortage of physicians and it’s a concern in terms of access to care, see this article for one. The other thing that we see in DM that is of interest is the procedure for registering with a GP in UK. The GP is usually associated with your postal code and the length of time you plan to be a resident in said location. The minimum stay is 3 months to qualify to register with a GP. New patients can be rejected if the GP is not accepting new patients. In US physicians may consider their practices full too and be unable to take on new patients, but there are no residency requirements. In DM there have been a few occasions when new patients have visited Dr. Ellingham to register, e.g. Julie, the Oakwoods, and it seems they have departed before being residents for 3 months. I’m not sure what actually would have happened with their registration. All of the above provides some opportunity for a secondary storyline.
Originally posted 2014-12-13 13:02:47.