Patients' attacks on family doctors rise: GPs and teachers face increasing risk of assault at work

ONE IN 12 family doctors in London has been assaulted over the past two years while on duty, and two in five have been threatened with violence by patients or their relatives, according to a survey published today.

The leader of Britain's GPs said the increasing number of attacks could be linked to rising public expectations of the health service generated by the Patient's Charter.

The survey of nearly 2,000 GPs came out less than a week after Dr Gerry Flack was shot three times at Bilting, Kent.

Dr Ian Bogle, the chairman of the British Medical Association's family doctor committee, said patients often expected more of their doctors than they could give. Patients' verbal abuse of the 'effing and blinding' variety was also a daily hazard faced by doctors and staff.

'There is a strong possibility that the advent of the Patient's Charter has exacerbated these problems. The charter has certainly heightened public expectations beyond what general practice and primary healthy care can deliver,' Dr Bogle said yesterday. 'It has certainly increased the tendency of patients to complain.'

Patients had been known to resort to violence if the doctor refused to give them a sick note or treatments that were 'simply not available', but there were risks outside surgeries too. Many attacks and muggings occurred when doctors were making home visits on ill-lit housing estates.

The BMA has been pressing the Government to help GPs by scrapping the rule that requires doctors to wait a week before removing from their list a patient who has assaulted them. The doctors also want training in 'non-confrontational' ways of defusing tension and aggressive behaviour in surgeries.

Virginia Bottomley, Secretary of State for Health, has agreed to set up a working party of Department of Health officials and members of the profession to report by the autumn on steps to stem the rising tide of violence against GPs.

According to the BMA survey, two- thirds of GPs in London fear that the Government's proposals to concentrate London's hospital services on fewer sites will worsen health care, already poorly-resourced in some inner- city areas. Only 29 per cent of the 2,000 GPs believed the plans would benefit patients.

Despite the Government's promise that no patient should have to wait for more than 18 months for a hip replacement, one in six doctors in London says he or she experiences delays of more than two years from the time of GP referral to the operation.

Mrs Bottomley pointed out that the Department of Health was spending pounds 43m this year on building up primary health care facilities in the capital. She added: 'Although London has many good GPs, its primary health care facilities have for too long lagged behind what is commonly available in the rest of the country.'