Dr Peach: The NHS is a political football

Doc: “I always enjoyed family practice and building relationships with my 12,000 patients.”

How will the NHS look at 100? Dr Chris Peach worked as a GP for 35 years. He talks to The Day about how the NHS has transformed in that time, and the massive challenges it now faces.

It took Dr Peach some time to take the plunge into medicine: “I had this idea that I didn’t like blood,” he recalls. But after some fortifying words of a friend, that is precisely what he did.

Thirty-five years later, after a medical career that took him as far as the Bahamas and the Malaysian jungle, he has no regrets: “I’ve had a very rewarding life.” His proudest moment? Setting up a doctors surgery of his own.

As a General Practitioner (GP), Dr Peach was the first port of call for a whole community of patients. He retired in May, and now reflects on a profession that has changed much in recent years — and not always for the better.

“I don’t think the NHS can continue the way it is at the moment,” Dr Peach warns. He thinks that insufficient funding, poor infrastructure investment, and “bed blocking” caused by an ageing population are serious issues across the organisation.

But it is the transformation in GP services that he is most struck by. “In my youth we provided 24 hour cover to our patients, 365 days a year.”

That all changed in 2004 when the government confirmed a controversial new contract which allowed doctors to forgo evening and weekend work: “That was pretty much the start of the rot,” he says.

“You are now unlikely to see the same GP often because the whole system has been fragmented,” he continues. This loss of continuity can have a big impact. Research released last week found that seeing the same doctor regularly reduces the risk of early death by up to 53%.

Dr Peach claims we must rebuild a system which encourages “individual personal relationships between doctors and patients.”

In terms of funding, he wants to see a percentage of GDP dedicated to health care spending instead of sporadic increases: “At the moment it’s political football — each government comes up with its own crazy ideas of how to sort things out, and they are just as bad as each other.”

Nonetheless, a doctor’s life is one he would recommend to future generations: “It is a very rewarding career.” Although, he quickly adds this caveat: “They would have to be prepared to put up with an awful lot of aggravation.”

How will the NHS look at 100?

“I’m hoping there will be a concept which preserves equanimity and access to health care for all people,” he says. “In a civilised society that’s what one wants. Whether it’s called the NHS is irrelevant as far as I’m concerned. It’s rapidly become the kitemark of a privatised organisation. It’s not funded adequately and it’s falling apart at the seams, so it’s going to be radically different. I really hope for the future generation of doctors that some phoenix arises from the ashes.”

You Decide

  1. Would you consider a career as a doctor?
  2. Should we all pay more tax to fund the NHS?

Activities

  1. Imagine you visit a hospital 100 years in the future. Write a list of all the different technologies you might expect to see. What diseases do you think will have been cured by then? What role will machines play in our care?
  2. After watching the Sky News video under Become An Expert, do some further research on the challenges facing the NHS. In your opinion, what three things present the biggest challenge to the NHS right now? Rank them in order. Discuss your selection with you classmates. Are there any points on which you agree/disagree?

Some People Say...

“Wherever the art of medicine is loved, there is also a love of humanity.”

Hippocrates

What do you think?

Q & A

What do we know?
According to 2016 figures released by the World Health Organisation, Britain’s public spending on health care accounted for 7.7% its GDP. This ranked it as the 6th highest spender out of 15 OECD nations. Germany committed the most public spending to health care at 9.5%, with Sweden close behind on 9.2%.
What do we not know?
The precise impact that technology will have on GP services. Recently, a new range of apps are allowing certain patients to have appointments via video link. Furthermore, others predict that AI technology will one day replace GP’s by providing accurate diagnoses. Dr Peach is sceptical about the potential impact of AI, pointing out that the elderly are less likely to use the technology, and insisting on the importance of human interactions.

Word Watch

General Practitioner
A doctor based in the community who treats patients with minor or chronic illnesses, and refers those with serious conditions to a hospital for secondary treatment.
Infrastructure
Key resources needed in order to run a society, or in this case an organisation. Key NHS infrastructure would include hospitals and large medical equipment.
Research
Lead by researchers at the University of Exeter. The study analysed data from 22 studies in nine countries, including England, France, the US, Canada and South Korea. Eighteen of the studies showed that contact with the same doctor over a two year period meant fewer deaths over the period studied, compared with other patients.
GDP
Gross Domestic Product — the total value of goods and services produced in a country over a year.
Political football
Theresa May recently announced an annual £20 billion cash injection for the NHS. Labour leader Jeremy Corbyn said he would spend more if he were in power.