Set The Alarm

Once again there is some media attention on doctors and, more especially, the out of hours service. The particular case that has been the focus of all the attention is not my main topic here but it is worth saying that seeing/speaking to so many different doctors over the bank holiday may not have actually influenced the case that much. While continuity is important for cases it actually bears more relevance for long on-going situations. In an acute case such as this the fact that Penny Campbell had to go over what had happened each time she saw a doctor would not make a large difference as eveything would be fresh in her mind. In fact, even had the case notes been available, the doctors would probably have asked her to go over it all again anyway.

But I am digressing. I want to discuss out-of-hours. There are a lot of complaints about out-of-hours service and how it isn't what it once was. That you can't get you own doctor to come out and see you at two in the morning. That you have to visit a special out-of-hours clinic. That they don't know you.

I can understand why people miss seeing their own doctor, it is a very important relationship and trust is key. But just think about what really used to happen. A local practice could not afford to employ someone to specifically cover for nights. They have the right number of doctors (this goes for vets as well) to cover the day to day duties. Then, each night and at weekends, someone is on-call. Now consider what occurs during the night. That doctor on-call gets rung up at 0400 hrs. He goes out and visits his patient. The patient is happy, they have seen who they want. But that doctor doesn't get back to bed. Instead he comes in and works a normal day at the surgery. So all the patients he sees that day are being examined and treated by someone who is suffering from sleep deprivation. Mondays are even worse if you see the doctor who has had a bad weekend on-call and been up both nights.

Going to an out-of-call service is a small price to pay for seeing doctors who are fully awake and at their best because they are working at night but then have the day to sleep, while your own doctor is as fresh as a daisy every morning and eager to see you.

Addendum - I note that Brown, who said he would be against spin, has already managed to get in with commetns about reform to the service without having proper time to examine the case.