‘Zoom medicine’ just won’t work for the elderly – seeing a GP face to face is important

Yes, there are some positives we’ve learned from the pandemic, but when it comes to healthcare the patient must come first, writes Janet Street-Porter

Zoom is one of a number of communication apps that have seen usage increase during lockdown

The Queen might be a new recruit to Zoom (under the tuition of her daughter Anne), but would she be happy discussing health issues online?

Zoom, FaceTime and WhatsApp have kept us in touch with friends and relatives during lockdown, making isolation a bit more bearable. But social media and technology can’t replace physical contact.

Older people are the biggest clients for the NHS and this government (for all the pronouncements and promises) has not been our best ally.

At the start of the pandemic, the decision to release patients from hospitals to care homes without being tested for Covid-19 was not only shortsighted, it proved fatal. Thousands died unnecessarily. As the weeks turned into months, residents in care homes were isolated, stranded from view, cared for by staff who couldn’t get the right equipment to protect themselves.

This government still hasn’t solved the crisis in funding social care, years and years after the Dilnot report. It hasn’t stepped in and stopped the BBC withdrawing free TV licences for the over-75s. But it handed out £10 vouchers to Nando’s. Not only does Boris Johnson have a “woman” problem, he seems to have an “elderly” problem too – but boomers are the generation who are not going to go away and shut up.

Now, the news that Matt Hancock thinks “there must be a compelling reason” to see a doctor in person signals another misstep from the disaster-prone health secretary, who told us the track and trace system would be world class (the original app was scrapped), that testing was going brilliantly, when – after all this time – less than 50 per cent of results are back within 24 hours.

Under Hancock, decisions (like the latest restrictions in Greater Manchester and the surrounding areas) are blurted out on Twitter at 9.25pm. Is that the best way to communicate with an ageing population? He’s not ordering a takeaway, but screwing up the holidays, religious festivities and eagerly planned reunions for millions.

If Hancock thinks Twitter is the best way to announce decisions of national importance, then it’s not surprising he thinks that “Zoom medicine” is the future for local health centres. Instead of a friendly chat with a familiar face, does he expect older patients to dial a number and sit in front of a screen and discuss incontinence, piles and impotence? It doesn’t bear thinking about.

It’s easy to see where Hancock found his latest “Big Idea”. Since lockdown, only one in ten of us have been able to see a doctor face to face, according to a new survey by the Royal College of General Practitioners (RCGP). Before the pandemic, three-quarters of consultations took place face to face in the surgery.

During lockdown, phone calls replaced two-thirds of consultations – a system which might suit GPs because they can sit at a desk while you (the customer) has to hang around waiting to be contacted. My own experiences bear that out. To book a phone consultation, I must request one online with a fiendishly difficult password (or queue for ages on the phone), then explain why I need to speak to the GP (in an email which is read by receptionists so it’s not private).

I can ask for a time, but the doctor will call when it’s convenient for them and they never leave a number. So, if you’re not quick off the mark, you have to go through the whole process again.

I’m a tech-savvy 73-year-old, but don’t tell me the average eighty-something is finding the current system great. I can see why Zoom appeals to a cash-strapped health service. Fewer GPs can service more people. But the family doctor has always been more than a medical service.

In my previous home in Yorkshire, I would see the same faces over and over again in the reception area. Some might have been seriously ill, but for many of the older folk, the health centre connected them to their community. Their GP was one of the few people they might talk to that month.

The RCGP survey found that 90 per cent of the practices they talked to now offered video or online consultations – before the pandemic that service was offered by just 5 per cent. As for telephone appointments, 7 out of 10 doctors said they”‘increased their efficiency” – by that, I understand they might be able to talk to more people.

However, chat is chat –how do you talk about intimate problems or mental issues, how do you read body language and see signs of abuse? As for Zoom, are you supposed to strip off in front of a screen?

Hancock says he wants a “bureaucracy-busting push” to build on what he calls “the positive changes” resulting from the pandemic. The NHS is overloaded with managers, has a disparate and uneconomic ordering system and an inefficient IT system. Yes, there must be better ways to streamline the service.

At the centre, though, are the patients – the customers. Their needs must come first, not those of doctors or health workers. Of course these modern-day saints do wonderful work, but patients need a system that is tailored to their requirements, not those of box-tickers determined to bring down costs and sod the consequences.

In Yorkshire, I had the same GP for more than a decade. Gradually, as doctors’ pay increased, their hours changed along with the role of medical support staff, it became harder to see him. Moving to Norfolk, I initially saw one doctor for about 12 minutes and he started asking why I didn’t give up HRT and my arthritis medication. Not surprisingly, I have budgeted to see a private doctor about personal and intimate issues. I am lucky I can afford to do so.

But for ordinary pensioners, the removal of the right to see a regular doctor – even if it is one from a pool of staff – and replacing it with a chat on the phone or online is disgraceful. Patients with several health issues and long-standing conditions are entitled to ask for the same person with whom they have built up a relationship.

As for ordering medication over the phone, it’s a recipe for disaster. Our elderly are being overprescribed opioids like Tramadol for longer than ever, to keep them quiet and away from the surgery.

Start campaigning now to ensure you don’t lose the right to see your GP face to face.