Editor-At-Large: Mess with my GP's practice, Mr Lansley? Over my dead body!

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The Independent Online

Andrew Lansley is fast shaping up as my least favourite government minister. Obsessed with cutting costs in the NHS, his latest wheeze is to commission a report that proposes all GP patient appointments could be handled by call centres which would also issue repeat prescriptions.

If I asked you to nominate your least favourite experiences in modern life, I am sure that dealing with any call centre would be right up there in the top five. The rise in our collective blood pressure and the increase in the number of stress-related ailments can probably be put down to having to speak to call centres and all the anxiety and impotent rage that generates.

Gas leak? You'll be talking to someone in a call centre miles away who has never heard of your street. Want to know about train connections from Swindon to Ashford? You'll be chatting to someone in the Third World who probably thinks Paddington is a new chocolate. Credit card been rejected? You might be upset and even humiliated in front of a snooty shop assistant, but you'll be in meltdown after trying to remember your security catchphrases with a call-centre teenager who goes through a pre-determined script asking for your first car or your auntie's maiden name, like zombie robot. Want a cab? The call centre for one of the biggest fleets of taxis in the UK is based in a remote bit of Scotland. Really useful when you're explaining the location of a tiny mews in west London.

With an ageing population, it's not rocket science to work out more GP appointments and repeat prescriptions will be needed than a decade ago. The trouble is, the NHS is top heavy with chief executives and managers with pumped up salaries, nice pensions, company cars, and objectives (i.e. boxes they have to tick to qualify for chunky bonuses). The NHS at this level of bean counters is just another career option after many years sitting behind a desk running factories, pension funds and local government. They don't think about patients as living breathing quirky human beings – we're merely "customers". Add to that toxic mix the fact that the Department of Health is run by civil servants with a similar mindset, and you have a recipe for disaster. OK, the days of Doctor Finlay's Casebook are long gone. But most of us have a very intimate relationship with our local doctor and their hard-working support staff.

When I visit my GP in Yorkshire, the receptionist is always welcoming. The building is a sort of drop-in centre, and has replaced the village hall or post office as the place people sit and chat long before and after being seen by the doctor or a nurse. When I call up for a prescription, I'm never made to feel like an irritating pensioner with a lot of pills to be processed. Civility and courtesy are the norm, and not because they're on a list of targets.

Andrew Lansley has not the slightest interest in this aspect of NHS care. He is all about streamlining and rationalisation, and has proposed combining practices to make huge consortia which will mean longer journeys for patients and less personal contact. Small is definitely better when it comes to providing GP services, and an integral part of that is dedicated backup staff – pharmacists, secretaries and receptionists.

The report that recommended call centres (and would have meant tens of thousands of redundancies) was written by the Foundation Trust Network, made up of NHS managers, and welcomed by the Department of Health. When the proposals were made public in Pulse magazine at the end of last week, the outcry was instantaneous; the report was trashed by the British Medical Association. Suddenly, the Department of Health changed tack and claimed it was only one of "several options" it was considering, but it definitely would not be going ahead with plans to use call centres.

Lansley says his plan to hand GPs the right to handle their own budgets and directly commission services will cut out layers of NHS bureaucracy. That will only work if they have a dedicated support staff. Not managers, but front-office people. Patients aren't interested in the spurious concept of "choice". They expect to be seen as quickly as possible, and they want a welcoming face at the front desk, not a disembodied voice at the end of a phone line.

I'm still not convinced Mr Lansley understands what providing a service really means.

Has Gillian bitten off more than she can chew?

Reality television is merciless, and yet there are individuals who think they can use it as a vehicle to persuade us that they are not evil witches or raddled loafers after all. Who on earth would submit to several weeks of constant filming with the ever present possibility of public ridicule, all in the company of fellow guests who openly sneer at your trials and tribulations? We now know Gillian McKeith is that naïve. The self-declared "holistic nutritionist" has made a career out of telling us what to eat and how to improve our bodies in prime-time television series such as You Are What You Eat. Scientists have derided her qualifications and dismissed her advice as "mumbo jumbo", but that does not stop her flogging books, pills and potions, via her website. Years ago, I visited a so-called nutritionist and left an hour later and £150 poorer with a chart of food combinations to eat, along with a bottle of oil to dribble on everything. After a week, I was full of wind and hadn't lost a pound. I poured the oil down the loo and put the chart in the bin. I immediately felt better, and have never consulted a dietary expert since. If you're worried about your diet, have a drink with a friend – and watch Gillian making a complete fool of herself on Celeb. You'll soon feel better.

Vintage is the way to go, Kate

Will That Wedding be good for business? Most of the souvenir mugs will be made in China, but there will be other benefits closer to home. I was filming at a jewellers in Hatton Garden last week, and they already had orders for copies of the engagement ring. Thomas Goode, the swanky china shop must be hoping to get the royal wedding list, and there is plenty of speculation about who will design the frock. Burberry has just reported a 50 per cent rise in profits, and Kate is a customer. Will it be lucky? Rather than commission a small dressmaker or pricey designer, why doesn't the bride do the right thing in a recession and wear vintage? Plenty of old royal frocks could be recycled, chiming with the 1950s trend.

Chocolate fountains make me sick

If the coalition really wants to deliver no-frills government, they could ban one of the most wasteful and useless inventions of the past decade – the "team building exercise". These away days started in the late 1990s, and now no self-respecting government department or local council can manage without them. The Department for Business, Innovation and Skills spent £4,700 on an event last May which involved making chocolate and creating packaging, with a free chocolate fountain thrown in. A departmental spokesman said "it was an exceptional event involving 40 people, and followed the restructuring of a team". Once we just did our jobs and tried to get on with workmates. Now we have to be "helped" to team-build. Are we any more productive as a result? No, but the consultants who prove this dubious service are cashing in big time.