Saturday, December 18, 2004

Dawdling Duty Doctor's Dilemma

Last night was my first tour of duty at the local GP on-call centre. (See "One Doc for 200,000 patients - cool. ") : Far from the shock-horror of the local and national newspaper stories, my colleague and I had a very relaxing time. We saw about 9 patients between us in the 9 doctor-hours that we spent there. I had a good study of War No More learning of the causes of war (always be wary of an autocratic leader with a character disorder seeking a diversion away from internal political or economic problems) and my colleague in the next room snuffled and sneezed every 10 mintues. I told him to go home (Stay Home If You Are Ill! - of which more later) but he wouldn't listen. Doctors.

Anyway, far from being rushed off our feet, we were underutilised and on a yearly basis this over staffing will waste a huge amount of money for this cash-starved PCT. Of course it is early days yet, and the laws of probability dictate that on other nights one doctor could be totally swamped. But in this case we could call on our back-up reserves.

Another factor is that we are using NHS Direct telephone service to screen calls. Whereas we used to get 40 calls, now we get only 10. So does this mean that the NHS Direct is doing its job properly then, screening off non-urgent calls that do not need to see a GP? Well, no, not necessarily. Apparently there are huge delays in getting through to NHS direct, so people are just putting the phone down, or going to sleep, (can't have been that bad, then) or dying while waiting (in this case, dial 999).

Should I, in a spirit of altruism, tell the PCT about this so they can save money? This will mean that GPs will be busier in the evenings and my name will be mud among my colleagues.

Decisions, decisions. A health service is a complex system. Why, the decisions implicit in this page alone will take up at least 100,000 hours of manager time to sort out, which woud cost more than paying one doctor to do nothing for a year.

I have decided to just send the PCT a link to this page. They will not follow it, or if they do, they will not act on it, so our cushy number will be unaffected, and my consicence will be assuaged. Nice.

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