2. Matthew Parris uproar: summary and excerpts from his article

Having bought and read the article, and having it in front of my, I will summarise the main points (I don’t thing I’m breaking the law here):

If family doctors did not exist, we would not need to invent them
Next week family doctors are about to strike (yes, he does use the word strike)
We pay GPs more than airline pilots, but they are really just glorified gatekeepers: a portal to specialist medical care
GPs have receptionists, so the NHS uses GPs as its receptionists.
Question: are we paying too much for these receptionists?
We really don’t need to pay these GPs all this money to deal with coughs and colds; we can just get rid of the middle man, and use a variety of lower grade professionals (community pharmacists, nurses, receptionists, maybe ‘an American idea’ physician’s assistants) to route the patients to the specialists.
Gone is the time when the GP could have a grasp of the whole of medicine and its advances; they cannot keep up
The concept of the personal doctor is dying, about to be extinct
Referral rates are rising and ‘in some practices’ they are reaching 50%
‘It’s nice if you mechanic knows you and your car but, on the whole, if a tyre needs changing there’s much to be said for going straight to a tyre centre.’

I will end by quoting the last 2 paragraphs and hope Rupert does not mind:

“Nurse-led primary care, too, is plainly on its way and expanding fast, with (the research is clear) excellent results. Walk-in and appointment clinics are becoming more common, especially evening clinics. Sexually transmitted disease, family planning, coughs and colds, eye, ear nose and throat … in all these fields specialist practices staffed by nurses and pooled doctors, rather than personal GPs, are where we’re going.

“The only question is how fast. Let’s hope next Thursday’s strike prompts us to speed this thinking up. Decades ago, at the bookshop Foyles, you had to get a little chitty from a person in a booth before you could get your purchase. One day we’ll remember the GP surgery in the same way, with the same amusement that the archaic practice lingered so long.”


Matthew Parris has a flowing prose, and the texture of the article is far better than I have reproduced. However, the content and basic message is as outlined.

When I looked at the online article an hour ago, there were over 200 comments. The latest one read:

As I was meandering through a completely unrelated medical story and its background I came across Wittgenstein’s 7th Proposition that I thought is perfect for Mr Parris’s peroration:

whereof we cannot speak, thereof one must be silent

One Response to 2. Matthew Parris uproar: summary and excerpts from his article

  1. As a journalist M Parris may revise his views on British GPs but he made a very important and timely point about much needed global healthcare reform in his Times article. It is not about ‘how hard’ individual British GPs work but one may see how the gatekeeping system is failing – the following example is from the Netherlands so does not ruffle any British feathers:
    A Patient’s Journey
    Sir Karl Popper, swans, and the general practitioner
    BMJ 2011; 343 doi: http://dx.doi.org/10.1136/bmj…. (Published 3 October 2011)
    Cite this as: BMJ 2011;343:d5469

    Best wishes

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