The doctor won't see you now

Tried to see your GP lately? Maureen Plantagenet nearly gave up in frustration. Then she complained - and the trouble really started...

On a recent holiday to Sardinia, I dislocated my collarbone. The Italian doctor told me I would need physiotherapy. I was in lots of pain and needed to have the joints manipulated back into place. So on my return I tried to book see my GP for a referral.

The Monday after my return was a holiday, and the surgery's answerphone said I should call NHS Direct, or 999 in an emergency. Either my surgery didn't "do" out of hours or its answerphone wasn't working again, like the time it answered, "the mailbox is full, goodbye", and went dead. So I called NHS Direct who suggested I visit casualty.

Rather than brave the queue, I decided to wait until Tuesday and try to see a GP. I rang at 8.15 when the half-hour slot for booking appointments opened. I was 11th in the queue, but by the time the receptionist answered, all appointments had been taken.

I rescheduled my own work appointments to Wednesday and stayed home to try again during the afternoon booking slot. But once again, by the time my call was taken, all appointments had gone.

On Wednesday I tried once more, but the same thing happened. I complained to the receptionist, who suggested I call one of the doctors between 3.30 and 4pm. So I rang at 3.30pm and keyed in the option to speak to a GP, but the recorded message said patients could only call GPs between 12.30 and 1pm.

It took three more 0845 calls to find one multiple option with a human on the end. She offered me an appointment within 48 hours, but by then I was so stressed and had missed so much work that I went to casualty. The wait took three hours but at least I got to see someone. The admissions nurse said her own GP was almost impossible to see, because he had changed his system to internet bookings only. She had no idea how patients without computers coped.

As the time dragged on the patient ahead of me lost his rag. He'd been trying unsuccessfully to see his GP all week and was by then feeling so ill that he decided to go to casualty. He told me he'd been waiting for five hours and the stress was too much. After 15 more minutes he sprang to his feet and said he'd had enough and left. Where he went I don't know. Home to die perhaps.

Answerphones, obfuscation and hours spent waiting - it's all very stressful. Can doctors really say that a multiple-option answerphone is an appropriate way of dealing with worried, sick people? Surely it can't be right that I had to take two days off work in case one of the four phone calls I made to surgery resulted in an appointment? And when, after two days, I had failed to book a slot, is it best practice for casualty to mop me up?

If people can't get to see a GP because their workload has increased, then end the requirement for GPs to refer. Why do you have to go to a GP if you have a skin lesion when you can go straight to a dermatologist? If these highly paid GPs are so put-upon that they have to meter their time out by recorded announcement, it's time they spent less of it writing letters of referral.

My surgery's appointment system was so user-hostile that I complained to the practice manager in writing. Last week my cholesterol results came in, and I rang the results line to hear them. To my surprise the receptionist told me there was a note on my file saying I had to make an appointment to receive the results in person. I called my primary care trust, which confirmed I had a right to receive my own information on the results line like any other patient. The GP responded by arranging an instant appointment for me with the practice nurse. I went, the nurse printed my totally average results off and handed them to me, and I left.

Two days later I got a letter from the surgery excluding me on the grounds that it couldn't offer me the sort of service I wanted. The letter also claimed the doctor-patient relationship had broken down. What relationship?!

More than 30 per cent of patients can't book an appointment three or more working days in advance, and "urgent" access means 48 hours. Unfortunately, there will be no improvements for at least a year. From next July, PCTs will monitor access via patient surveys, with mystery callers ringing surgeries to see whether doctors are fiddling their waiting time records, on which they claim additional payment.

But why wait a year? My PCT tells me that my concerns about GP appointments are echoed at a national level. Echoed? Patients are shouting from rooftops!

Do doctors care? Not a lot. Mine didn't think twice about excluding me, even though I have a serious heart condition. Doctors know full well that patients find the changes they've made to the appointments system unworkable. But they weren't devised for our convenience. They were devised to extract as much money as possible out of the new contract.

GPs need to ditch the answerphones, extend availability, employ more staff and make patients feel valued. They're rapidly spending their quota of goodwill among the British public and it's high time we let the Government know. The system isn't working, so fix it, or build a new one.

The Government's response to the GP crisis

* Tony Blair was confronted over GP appointments during a BBC Question Time broadcast during last year's election campaign.

* An audience member told Mr Blair that at her practice no appointments could be booked more than 48 hours in advance.

* This was in response to a Government target that all patients needing urgent appointments should be seen within 48 hours by a GP, or 24 hours by a practice nurse.

* Tony Blair was caught off guard by Mrs Church's question and promised to investigate.

* The Department of Health later issued guidance saying GPs were expected to offer advance appointments as well as seeing all patients requesting urgent appointments within the target 48 hours.

* A Department of Health survey in July last year reported that less than 1 per cent of patients were unable to get an appointment within 48 hours.

* But a patient survey carried out by the Healthcare Commission in September found this figure to be nearer 12 per cent.

* Random checks are now to be introduced by the Government to ensure GPs are not fiddling appointment times.