MATT Hancock, the Health Secretary in England, has informed a meeting of the Royal College of Physicians in London that "Zoom medicine" is to be the new norm, and that, in the post-Covid age, GP consultations will be remote. Before Covid, 75 per cent of GP consultations were face-to-face. At the peak of the pandemic (thus far), this fell to 15%, and has since risen to about 30%. Professor Martin Marshall, Chair of Council, Royal College of General Practitioners, has predicted that the remote to face-to-face consultation ratio might settle at about 50:50. Dr Richard Vautrey for the British Medical Association has said that "the suggestion that all appointments going forward will be remote must be approached with caution". The issue was discussed on BBC Radio 4's Any Questions and Dr Carey Lunan phoned into Any Answers to draw attention to the many disadvantages of remote consulting. I think it would have been helpful if she had stated that she is Chair of RCGP Scotland.
The medical profession must be much more robust in telling Mr Hancock not to dictate how medicine is to be practised. The idea that a Zoom consultation should be superior to a face-to-face encounter is preposterous, chiefly because remote physical examination is impossible. Once again, the sanctity of the medical consultation is coming under attack. We must put this attack in historical context. In 2005 when GPs handed out-of-hours care over to health boards, they gave up power as well as responsibility. As a result, a third party entered the consulting room, the poltergeist within the computer screen – the Quality Outcomes Framework (QOF) – dictating how GPs should work. Now that Mr Hancock wants to digitalise primary care, the big tech companies are itching to manage our data. Zoom medicine will be the QOF on steroids.
Medicine is fundamentally a "hands-on" profession. No medical students will contemplate a career in general practice because they will not wish to spend all day staring at a computer screen. If no GPs are trained, general practice will collapse. If general practice collapses, the public hospitals will come under enormous pressure and they, too, will collapse. The only winners will be the patients who can afford to consult their physician in the private sector, who in turn will be delighted to see them, in person.
Fortunately, north of the Border, health is devolved. We don't need to go down Mr Hancock's dreadful path.
Dr Hamish Maclaren, Stirling.
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