Do you think we'll ever go back to routinely seeing GP face to face?

[Makeitgoaway]

It's long seemed a terribley inefficient process to me, both for the GP and the patient. If it's something mild and routine, the prescription or advice can be given over the phone, as now. If it's something more complex the GP has refer us on anyway, usually without much of an examination.

An example, I was suffering with a very painful foot. I knew I needed physio but I couldn't access that without first waiting 3 weeks to see GP, taking up a valuable appointment and then waiting again for the appointment I really needed. GP didn't even ask me to take my shoe off so there was nothing that couldn't have been done by phone. A physio would have been far better placed to diagnose the issue anyway.

Another, I needed antibiotic cream for impetigo. Pharmacist had diagnosed it but couldn't give me anything that would help without a prescription, which I needed to see a GP to get.

If it was something GP did feel they needed to see the patient for, an appointment could be arranged at the initial telephone consultation and I'm sure in many cases that would be necessary but it must be possible to cut out a huge number of unnecessary face to face GP appointments?

I regularly had phone consultations before this - with the doc and the nurse practitioner for an ongoing condition. They didnt need to see me - they and I knew when symptoms were flaring and it ws dealt with speedily over the phone. I much prefer it that way, although with any 'new' illness I'd still rather a face to face consultation where necesary.

The national insurance system was originally supposed to fund the NHs but is now state pensions (or just an extra non-ringfenced tax?). The German insurance system is interesting as it is a mixture of an obligatory state insurance scheme and private (but is not funded centrally). We don't seem to have enough money to fund the NHS the way it was conceived (underfunding aside). As a taxpayer I would personally be happy to pay an extra health tax if it was ringfenced, as long as this didn't lead to inequality of access or a US style insurance system not everybody can afford.

National Insurance predates the founding of the NHS by several decades. It started off paying for sickness and unemployment benefits, was expanded to pensions, then other benefits, and eventually any part of the welfare system created in the 1940s

Ah ok, sorry. I got mixed up. What I mean is it doesn't seem to now be ringfenced but a health tax could be sold to people that way (If it was).

Our GP services have been a million times easier to access since they shut the surgery.

We used to have to wait ages for even a phone consultation, but now everything is same day (as long as you are flexible on time) and they will make you a F2F appointment if they think it's needed.

I hope they don't go back to the old system

My GP has always had a good triage system. You call in the morning and give a bit of info as to what it’s about, then one of the GP’s calls you and decides whether you need an appointment or not. Because of this it’s much easier to get face to face appointments if you do need them. I think it’s a shame more surgeries didn’t do this anyway.

NIC needs scrapping completely. It's just another tax. Monies aren't ring-fenced etc. It's not "insurance" as you don't have to pay in to get the benefits out of it. Huge numbers of people never pay a penny into it yet still qualify for the same "benefits" as someone who's paid in thousands over their working life. Now would be a good time to scrap it and increase income tax instead so that everyone with a high enough income to pay income tax would pay towards the NHS, pensions, etc. Either that, or keep NIC but have it on exactly the same rules as Income tax, i.e. payable on ALL taxable income, not just wages. So many people have good incomes that are derived from not working, i.e. property income, investment income, pensions, foreign income, but who pay too little into the pot because they only pay income tax.

"as you don't have to pay in to get the benefits out of it"

That's not true for the state pension.

Nor for contributions based JSA, both of which are quite important in their way.

And you are overlooking employers NICs.

And increasing taxes for the elderly and infirm disproportionately.

Because I get such awful hayfever over the counter meds do absolutely nothing. If I am to function for six months of the year I need a combination of drugs only available with a prescription. However, they're all on repeat and accessed through a repeat prescription request. Not everyone asking for antihistamines is time wasting

I had assumed the pp was referring to new people with hayfever, not existing patients with repeat prescriptions. If I had hay fever symptoms I'd just head to a pharmacy and buy antihistamines, at least in the first instance.

I think GPs do have to tread a careful line thinking everyone is time-wasting because clearly lots of people aren't. However, there are a lot of people who just seem needy of attention. An example is checking in for a flight. I go to the desk, check in the bags, pick up boarding passes, go (assuming no online check-in). But there is always somebody asking question after question and spending at least ten times the amount of time I spend. Extrapolate that to the GP and I can see why they'd want to limit patient contact.

However, it's become the norm in the NHS - once you get care it's excellent but it's a complete PITA navigating access to care. Primary care is not working at all.

It is not about getting rid of the time wasters or accusing them it’s is about re directing people. online consultation services have proven an excellent tool to do so. It has the functions to redirect people to find advice and also consult with a clinician.
We must see this as one positive that smart intelligent technology has finally been embraced in what was an old fashioned creaking system of bad habits