Jayne Dowle: What is the right medicine for our struggling GPs?

I always try and respect medical opinion. However, when you have had raging earache for weeks, or your child simply doesn’t seem to be getting better, you just want anything which will make the symptoms disappear. There is nothing more frustrating though than coming away from the doctor empty-handed with the “reassurance” that your persistent malady is just a virus and it will disappear of its own accord.

Oh sorry. There is something more frustrating. It’s when your symptoms get even worse and you end up back in the waiting room wondering if this time you’ll get lucky. Given that these days it usually takes about two weeks to even secure an appointment to see your doctor, this can turn into a very long-winded process indeed. Meanwhile, you might be feeling seriously under the weather, or your child will be off school and having sleepless nights, and you might be wondering just what you pay your taxes for if this is the best that the National Health Service can deliver.

Who knows best? Is it we, the patients, or the doctors? When it comes to prescribing antibiotics, we have no choice but to rely on medical practitioners. However, I don’t think we should ignore this new report, which says that 10 million antibiotic prescriptions are written needlessly every year. It’s our well-being we’re talking about after all.

The NICE findings highlight several major and growing concerns about public health. It is no secret that the global population is developing resistance to antibiotics. Experts predict that by 2035, it may be very difficult to treat common infections as antibiotics will be way past their sell-by date. Doctors are already finding that once-effective medicines can no longer cure skin, ear and throat infections nor, more seriously, bronchitis and pneumonia.

Indeed, according to research from Public Health England, 25,000 patients a year die in Europe after succumbing to an infection caused by bacteria resistant to antibiotics. And then there is the cost. As an example, between 2013 and 2014, the NHS spent £192m a year on providing antibiotics for patients.

Clearly, all of the above are major issues which those who run our Health Service have to take into account. Also, let’s look at this globally. Instead of putting even more responsibility onto the shoulders of beleaguered doctors, shouldn’t NICE be pointing the finger at the multi-billion pound pharmaceutical industry? If antibiotics are losing their potency, surely drugs companies should be putting their best scientists onto the task of finding the next generation of medicines. Shouldn’t governments – with responsibility for public health – be setting aside more funding for such research? And given that the public seem mightily confused about what conditions can be cured by antibiotics and what can’t, wouldn’t it make sense for the government to set aside further funding for a public information campaign? I know all of this costs money, but surely the investment is worth it?

However, aside from the big political questions that all of this throws up, we have to take into account the serious underlying issue – just what do we expect our GPs to do for us? This goes much further than the matter of antibiotics per se. When we finally secure that appointment to see our doctor with a health concern, do we expect too much? If they are guilty of handing out prescriptions too often, is it because they simply don’t have the time or the wherewithal to do anything else?

This argument over antibiotics is just a part of a much bigger picture of frustration and disappointment with the way that our family doctor system fails to meet our needs. Indeed, I’d be tempted to argue that whilst it is important to give the matter serious consideration, it is being thrown up as a smokescreen for some of the fundamental issues which affect the patient/GP relationship.

Instead of NICE tying themselves into knots over antibiotics, and threatening already hard-pressed doctors with being struck off, I’d like to see more focus on establishing just what GPs are expected to offer.

Is it any wonder that they are under fire for handing out prescriptions when they are under so much pressure to deliver to targets and to take on more and more patients? Ask any patient and they will tell you one thing though. In the end, a prescription might not be worth the paper that it is written on. What we really want from our family doctor is time, advice and a remedy for our ailments so we do not become a bigger burden on the NHS.