Doctor, doctor – I think we’re on the verge of a major global catastrophe

It would seem like the shortage of GPs and hospital beds has put GPs under pressure to hand out antibiotics like sweets


Some 2,500 years ago on the Aegean island of Kos, there came into being a sacred text that survives to this day. The passage of time has modified the Hippocratic Oath, and our doctors no longer swear it by Apollo the healer. Yet in essence it remains much the same, and one thing everyone knows it includes is the promise to do no harm.

On the newly published evidence that British GPs are more than ever misprescribing antibiotics, that bit of the oath probably needs rewriting as follows. “I promise to prescribe antiobitics to everyone with a cough or sniffle, in spite of my knowledge that a) they are entirely useless against viruses; and b) that doing so may hasten the day when mass antibiotic resistance renders easily curable ailments lethal. I know it sounds barmy, but if risking a return to the dark ages is what it takes to hurry the snivelling wretches out of the surgery, so be it.”

For several years, Sally Davies, the Chief Medical Officer, and her counterparts elsewhere have warned of a doomsday scenario, comparing the threat from resistance to that posed by climate change.

Despite her portrait of a dystopian back-to-the-future in which ailments that have been minor since the discovery of penicillin become deadly again, a survey of four million NHS patients finds that GPs now prescribe antibiotics to slightly more than half of those who present with a tickly cough, a cold or some other trivial bacterial bug.

As one of the planet’s leading hypochondriacs, it is not my way to defend a profession that has treated me with little more than contempt. On countless occasions, I have asked a GP to refer me to a specialist, and with one exception (what proved a benign growth on the scalp), they have refused.

At 21, imagining myself in the latter stages of congestive heart failure, I demanded to see Magdi Yacoub about a transplant. After a thorough examination, the doctor did promise to refer me, though only to a psychiatrist. On another occasion, I presented with all the classic symptoms of pre-eclampsia. Again, the doctor declined to investigate further.

Sensing the dwindling of your interest, such as it was, this seems the moment to conclude a potted personal history, brought up only to establish that I am by no means instinctively opposed to medical treatment even where none seems necessary. Yet even I have never sought antibiotics for a cold. What in the name of sanity would be the point?

However bemusing it may strike you that many GPs show less common sense in this field than an overtly deranged writer, it is here that I feel obliged to defend these glorified plumbers. They may often be arrogant, and sometimes incompetent, but by and large the general practitioner is neither malevolent nor a fool. Generally, with apologies to the late Harold Shipman, doctors do not set out to defy the Hippocratic Oath by doing harm.

The only logical explanation is that, under crushing time pressure, they dole out the pills like Smarties (a placebo that would do just as much good) as simply the quickest way to get one patient out and the next in. The root of this potential disaster lies less with overworked doctors and ignorant, drug-hungry patients than with an overstretched NHS that cannot match the supply of GPs to the demand that has grown along with urban populations.

This problem is political, and hints at a danger to Conservative re-election hopes. A nastier and more cynical opposition leader than Ed Miliband would be on his knees nightly praying for a really vicious flu season. If that exposed the shortage of GPs and hospital beds in brutal clarity, it could well do for him what the Winter of Discontent did for Mrs Thatcher, and shatter confidence in the Government severely enough to trump an embryonic economic recovery in the electorate’s mind.

Happily, in the absence of the funds and/or political will to invest in producing more GPs, there is a solution to this conundrum. It is being trialled at my local practice in west London. With this urban surgery, as with so many, it is virtually impossible to get an appointment, regardless of the symptoms, within a fortnight.

That will bode ill for the Government if there is a major flu pandemic this winter. But since a cold or middle-ear infection almost always vanishes within a week, it does represent a brave rearguard against the overprescription of antibiotics.

God or (in this case Apollo) knows what Hippocrates of Kos would have made of a medical philosophy built on denying any treatment at all back in 5th-century BC Greece. Here in 21st-century Britain, it may be the best chance that we have of avoiding Sally Davies’s apocalypse.

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