Why the doctor patient relationship needs to change

Return to topics

Medical practice in Britain has changed out of all recognition since I graduated in the ‘70’s. When I was first in practice the health service was held in almost reverential esteem. Dissatisfaction with the NHS now seems to be the norm. Reports of complaints, formal inquiries and litigation are daily news.

Most immediately in 2023 delay at every stage is potentially calamitous for individual patients.

Why has this come about? I suggest there are many contributing factors.

Most obviously the pandemic has placed huge demands on an already overstretched organisation. But many complaints were already circulating before Covid struck.

More recently staff strikes have added to the pressures.

Medicine is a very expensive business and is growing more so as new developments offer new remedies. Part of the problem may be lack of funds. We have entered a cost-of-living crisis and the nation is having great difficulty in balancing the books. But the statistics about numbers of patients treated in comparison with numbers of nurses and doctors are not encouraging in comparison with similar western countries.

Another factor is the inefficient structure of the Service itself. There is a shortage of many skilled staff. Expensive equipment stands for long periods underused – with no one available who is trained to operate it.

Many of the ‘workforce’ of health professionals are demotivated and understandably weary. The ‘team’ structure which worked so well in earlier times, providing mutual instruction and support, has been destroyed by the European Working Time directive and Government changes.

Expectations on the part of patients are changing too.

The public is now so familiar with immediate communication and the rapid delivery of Amazon parcels, for example, that the rigid hierarchical structure of the health professions, and particularly their booking systems, no longer fits the times.

Re-organisation of the NHS requires a national debate. Some of this will take a long time to change. But there’s a lot that can change, even without a massive influx of funds.

Return to topics