The NHS is probably the best system in the world, despite being given a kicking

http://www.theguardian.com/commentisfree/2014/jun/30/nhs-best-system-in-world-healthcare

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The NHS may be "palpably fraying at the edges" according to Dr Mark Porter, chairman of the British Medical Association, but as a jobbing GP, I'd say it's not unravelled yet.

Undoubtedly, too many people pitch up at A&E. And when asked to account for their actions, a quarter say it's because they can't get access to their GP. Often that's true. Sometimes it's not. Unpublished data from a local study of A&E attendances that I worked on three years ago showed no correlation between GP opening times, type of appointments (booked as opposed to walk-in surgeries), and size of practice. Access to GPs is a problem in some areas but some patients don't even try to get an appointment.

People from countries that don't have GPs are used to having direct access to specialists or going to A&E. I have patients from the US who think it very odd that I can do a smear test, see their kid with a sore throat and treat their diabetes. It takes a while to prove my competence and earn their trust. NHS primary care is an unfamiliar model to many whereas A&E is universally recognised as a place you can go to get help.

And people get confused by the range of options now available. There are extended opening hours at GP surgeries, walk-in centres, and out-of-hours care for when surgeries are shut. Many people dial 111 for non-urgent health advice but call-handlers are not medically trained, and follow cautious pathways that often result in advice to seek medical help when simple reassurance would suffice.

Of course it makes sense to wait and see your own GP but some people like to call at 3am. I have just looked at the out-of-hours calls made by our patients this weekend. Almost all could have waited until Monday morning but they chose not to. And there is no issue about getting an appointment here; we operate a walk-in surgery every morning for anyone who wants to show up.

So A&E departments are overflowing because of a complex mix of reasons. But it suits the government to blame GPs and it suits the BMA to highlight the need for better resourcing. And while the government's got the boot in, why not throw in a random idea that when cancer diagnosis is delayed, the GP should be "named and shamed"?

But let's contrast this gloomy and scary picture with some other objective facts. Earlier this month, the Commonwealth Fund judged UK healthcare to be the best out of 11 countries studied. And in the most recent national GP survey, these were some key findings: 75% patients found it is easy to get through to someone at their GP surgery on the phone; 86% of patients were able to get an appointment to see or speak to someone; 83% of patients feel their GP was good at treating with care and concern; and 87% of patients have had a good overall experience of their GP surgery.

Honestly, the NHS is not perfect. It needs more money and there's no place for complacency. Good experience should be celebrated and shared. Bad experiences should be used to improve the service by working with the provider and patient advocacy groups. But politicians, doctors' representatives and patients who rubbish the system in a nihilistic way should temper their remarks. It's probably the best system in the world. Where's the evidence that other countries do it better?