No politician will ever tell you that the NHS will be privatised but that’s exactly the direction it is headed in - Andy Brown

You only miss what you’ve got when it's gone. Sometimes it disappears so slowly that you don’t notice until it is too late. No one ever stood for election and told us that the provision of good quality NHS dental care for all would stop being available in many parts of Yorkshire.

We quietly drifted into a situation where there are children with rotting teeth who haven’t seen a dentist in years and people pulling out their own teeth at home because they can’t afford treatment and are in agony.

What is happening right now to many GP services bears a worrying resemblance to this gradual erosion of a reliable service. Most of us assume that when we need to see our doctor we’ll meet someone who has the time to listen to our concerns and make decisions safely in the knowledge that they are part of the team of professionals who are running the practice.

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That isn’t how the vast majority of the GP services work any more. Instead of practices run by doctors who are focusing on your needs we have increasingly remote networks of ‘providers’ that employ GPs like jobbing labourers. All too often it seems as if the service is run for the convenience of the operators not for that of the users of the service supported by healthcare professionals who are free to focus on assessing your needs.

A GP at their desk. PIC: Anthony Devlin/PA WireA GP at their desk. PIC: Anthony Devlin/PA Wire
A GP at their desk. PIC: Anthony Devlin/PA Wire

For many the experience of using the service begins with the long wait for a phone call to be answered. If you are lucky enough, well enough and able bodied enough to persist and you get through then it is unlikely you will be asked for the name of your GP and allocated an opportunity to speak to someone who has seen you before. It is much more likely that you will be triaged and allocated at random to the next available appointment slot with a doctor who has at best 15 minutes to read your notes, listen to your problem, check out your condition, explain what needs to be done and fill out the necessary paperwork.

Any discussion of your general health and well being is most unlikely. It has become standard practice in many surgeries to tell you that you need to book another appointment if you try to raise a second problem that you have with your health. Increasingly providers are pushing people down the route of accessing the service by interacting with an online assessment process that intimidates many and is rarely designed with sufficient skill to genuinely improve the service.

People who turn up at the surgery in person because they can’t get through on the phone or get a sensible answer online are turned away and told nothing can be done face to face. If they complain too much they risk being struck off the list and joining the ranks of those who are struggling to get onto any GP’s books.

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Almost none of this alienating experience is the product of the work of the dedicated teams of staff who are trying to provide a service that is increasingly stretched. Yet many of those staff are experiencing routine abuse and incredibly tough working conditions as the public takes its frustrations out on the staff who are trying their best to help them.

Instead of feeling like someone whose work is appreciated by a grateful community, too many staff feel like a cog in the wheel of an organisation that has plonked them into the frontline without the back up to deliver the service the way they would like it done.

Few people work for the NHS because they expect to get rich quick after experiencing an easy life.

The attraction for most was always that they could do work which meant something and was worthwhile. They were proud to be part of a service which was working for the good of others.

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It is a lot harder to get motivated to serve the public if you are working for a company which is busy squirrelling away profits for remote shareholders.

Done well the GP service can be one of the keys to improve the quality of the whole of the NHS and a place where nurse practitioners and doctors take the pressure off over stretched Accident and Emergency services by doing the basics of health care locally. Done badly it risks becoming every bit as efficient and as motivated by the best public interests as a privatised water company.

No politician will ever tell you that the NHS will be privatised and turned into a rump service for the poor on their watch. There never will be a day when the NHS gets abolished. Yet there is a real risk that this is where we are heading in practice.

We need a clear focus on strengthening our GP services and turning them into the jewel in the crown of local first point of contact health care.

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Alarmingly politicians from the Conservative Party, Reform UK and Labour are all talking about transferring more NHS services to private providers.

Either we stop the drift to a privatised service now or we lose the availability of good quality free local healthcare in every community.

Andy Brown is the Green Party councillor for Aire Valley in North Yorkshire.

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