There are many things great about living in Britain, but right now I’m rather glad that the political campaign season is short. The endless run up to the US Presidential election seems like an eternity. The five weeks since the dissolution of parliament to the UK General Election are thankfully whizzing by. 

As a General Practitioner I’m used to being at the centre of political debate. I naively went into medicine to try and help people. I felt the NHS was there to solely safeguard the health and wellbeing of the nation.

In my very first week as a doctor, I was asked a question – the answer of which has remained with me ever since. My first consultant was a tall, bespectacled proctologist. Spending all day delving into the nether regions of the populace, he was well placed to provide political commentary. After all, he did spend all of his days staring at arseholes. Running to keep up, he asked me, “Dr Piccaver, what is the role of the NHS?”

Dr Matt is fed up of lazy NHS promises.

Dr Matt is fed up of lazy NHS promises.

Fresh out of medical school, I replied “To look after the sick, and protect the health of the population” I replied, as if in exam mode.

“Nonsense my boy” he might have replied. “It’s to get the next government elected”.

With three weeks till polling day, the NHS is right at the heart of the campaign. The closest we have to a national religion, more people visit their doctor than sit in the pews, and the electorate are rightly aggrieved when their beloved NHS is under threat.

For those of us working in the NHS, we get the feeling it is dying on its arse. Legs in the air, the final flickers of life visible, before it gets crushed by a heartless, private, insurance based system. Time and time again, the NHS proves to be one of the best systems in the world, caring for people regardless of ability to pay. Clinics held on old prefab units and Nissen huts, or former Victorian workhouses, containing some of the planet’s greatest healthcare professionals. A whole system held together by committed staff working unpaid overtime all because we care.

The Tories want to spend an extra £8 billion over the next five years. A tiny proportion of the £100 billion it takes to run the NHS. They want seven day access to GPs, and same day appointments for all over 75s. Around a third of GPs are set to retire in the next five years. Seeing endless lines of the “well-derly” at the expense of seriously ill people who aren’t old enough to see the doctor that day does not make sense. With fewer doctors working, this just won’t work.

Labour want to create an extra 8,000 GPs. It takes 10 years to train one, no one wants to do it, and we don’t  even train enough doctors in the UK to meet our needs anyway.

The Lib Dems have also plucked the figure of £8 billion from somewhere, but they also want to be nice to mentally ill pregnant women. A noble sentiment, but perhaps not the most pressing problem the state faces. UKIP also feel than can magically create another 8,000 GPs from fresh air, but also want to charge migrants for the use of the NHS. In some cases, this is already meant to be happening, but my priority as a doctor is to treat the sick person in front of me. Each day I’m grateful that I can look after the sick and vulnerable without having to present them with a bill before they see me.

In general, the main players in this election want more GPs, open longer, and seen more quickly. In case they haven’t noticed, we have a shortage of GPs, which will only get worse in the next few years. None of their sums seem to add up. It’s going to take more than a spoonful of sugar to make this medicine palatable. 

Spending my early days in colorectal surgery has prepared my well for this election campaign. I can recognise an arsehole spewing forth shit when I need to. My only problem is, what can I prescribe them to make it stop?

  • The Case For Prevention

    The NHS spent £114 bn in 2014/15 and employed 1,388,000 million staff in
    2014, thats one NHS staff for every 47 of us assuming population of 65
    million. And we are heading towards the USA level of spending on
    lifestyle diseases. The USA spends $158 billion on just one lifestyle
    disease Type 2 Diabetes(estimate 90% of total spending on
    diabetes)compared to £9 billion in the UK. So when you see a patient who
    is overweight, what is your reaction? Do you want to – a. say please
    take better care of yourself the NHS needs your help b. give them a
    stick based on carrot and stick principle. c. Ask them to speak to
    grandparent for healthy eating advice or if the havent got one, adopt
    one! d. Keep quiet and give them a diet plan. e. Other?!

    • Matthew Thomas Piccaver

      Hi there.

      A little complex but depends on condition/case etc. Give patients basic info, sign post to more detail and let them make own decision. We’re all guilty of “salad avoidance” but people should play a full role in their health decision making. No stick or carrot – just “here’s the facts and you’ll use them when it is right for you”.