Primary care in the Emergency Room

Dispatches from the Emergency Room by Teri Reynolds describes the experience of an emergency room physician (Accident and Emergency doctor) working in Oakland County hospital in the US. She describes in vivid detail the consequences of a system of healthcare that leaves people without access to comprehensive primary care.

As the coalition accelerates New Labour’s conversion of the NHS from a public service to a competitive market we will see people who require care that cannot be provided profitably left stranded like those that frequent Dr Reynolds’ emergency room. The coalition plan to use personal health budgets and GP commissioning to hand over responsibility for rationing care for populations down to individual patients and groups of GPs. It is patients who will suffer the consequences acutely once their money has been spent. If you or I as a patient are given money for our diabetic care but chose to spend our personal budget on scans for our more symptomatic back pain and headaches (shamelessly promoted by private healthcare providers) presumably we’ll be left to the same fate as Dr Reynolds’ patients with only A&E departments willing or able to provide care.

The NHS is there to care for those who cannot care for themselves. My consulting room is full of people who are not only physically or mentally unwell, but they’re also illiterate, uneducated, destitute or intoxicated, abused and isolated -just like Dr Reynolds’ patients.

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