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This week Cicero wants to start with a challenge.
If anyone would like to let Cicero a topic on which they
would like to hear Cicero’s thoughts, let him know. You can pass your
suggestions via the technology on this set or through Cicero’s very own Twitter
feed @cicero_speaks. Go on, you know you want to.
And now to matters more life and death.
Last week Cicero had to go the doctor’s. Don’t worry Cicero
is ok, merely a minor physiologically irritation. And thank god for that, given
the time and trouble it took Cicero to get time in the doctor’s diary. Two days
it took and endless phone messages telling Cicero to hold on ‘but we are
experiencing high call volumes today’.
And even when he did finally manage to speak to the Gorgon-esque
keeper of the doctor’s diary, it was to be told that there were no further
appointments left. And for reasons unbeknown to Cicero it would appear that the
Gorgons who man the calls and desks of our doctors’ surgeries today do not feel
able to book a next day appointment.
Now this is a Catch 22 situation. You can’t get a same day
appointment because the chronically sick who understand the system are quick
off the mark and book all the appointments. And the Reception Gorgons won’t
book a next day slot until it becomes the same day even though they have plenty
of free spaces on that day. Ridiculous.
After this episode two thoughts occurred to Cicero and in
the expectation that these might resonate with others he has decided to share
them.
Thought number one.
If the GP practice was run as a normal business, and there
is no reason why it shouldn’t be, it would segment its customer base and
develop treatment strategies accordingly. Clearly the number one priority
treatment strategy would be for those who are seriously ill and who require
access to medical help quickly. But it occurs to Cicero that those who probably
have the most difficulty accessing the system are the time poor, in other words
those who don’t have the time to queue at the door of the surgery first thing a
la January sales or hang around waiting on the telephone, and infrequently
unseriously ill. And these are the cohort of people the NHS needs to give some
sort of priority to because a) they don’t cost the NHS a lot of money and b)
they fund the system through their taxes.
And so Cicero would like to propose for these people a Gold
Card NHS Membership to allow immediate access to their doctor after those with
imminent clinical need.
Thought number two.
Cicero calculated that at best Cicero’s surgery was open for
60 hours maximum per week. And given that there are 168 hours in a week, this
means that the facility is used for about 35% of the week. Now this is a very
expensive resource and proper businesses would never allow such a high level of
investment to stand around idle for 65% of the time. This is a nonsense.
Especially since we now live in a 24x7 society. And an ill one too seemingly.
Surely it is not impossible for doctor’s to open their
facilities to the ill on Saturdays and Sundays. In business we call this
‘sweating the asset’.
It staggers belief that our doctors have a facility that is
in use for so little time and yet can’t see everyone they need to in a speedy
and timely manner, yet think it ok to be closed for so much of the time.
When did GPs start to act like trade unionists and stop
regarding what they do as a calling?
Cicero lives in hope that such ideas might be listened to
and acted upon by the relevant Royal College of Doctors. He does expect to be
disappointed however.
But what do you think?
Sis felix. Et sis fortunatus. Semper.
