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July 5, 2001
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UK Doctor Gets Patients More Time

Sanjay Suri
India Abroad correspondent in London

An Indian doctor has taken the lead in a radical overhaul of the British medical system under which doctors agreed to give patients twice as much time as before.

Doctors voted unanimously at the annual conference of the British Medical Association to give patients at least 15 minutes consultation time. That followed stinging criticism from Dr Chand Nagpaul who practices in north London. The British medical system has become so efficient that it has no time left for patients, Dr Nagpaul said at the conference.

"We demand an end to the disgrace that the public are subjected to sub-standard care due to this conveyor-belt processing of patients at brutal speed," Dr Nagpaul said. "We unfairly resent patients for bringing a shopping list of problems, rather than sympathising with their plight, expecting them to present illness in conveniently packaged seven-minute units," he added.

Last week, Dr Nagpaul said he could not find enough time for a young woman with bladder cancer. "I had to end the consultation because I was running 40 minutes late and had ten patients in the waiting room. I felt terrible," he said. "It should not be like this but this is what doctors have to do.

"How can you show compassion in seven minutes to a patient with a life-threatening illness or in the same time listen sensitively to a patient with depression ?" he asked the delegates.

"We can't go on working like this with the added risk of getting it wrong and with the intense fear of serious complaints and being publicly vilified by the Government and the media alike, when in fact it's the system not us that is at fault."

Statistics showed the UK had the lowest number of GPs per head of population in western Europe, he added . "The single greatest deficiency in UK general practice is the scandalously short consultation times our patients endure, averaging seven to eight minutes. We short-change our patients, with shortcuts and hurried examinations, in a maddening pace which barely allows time for exchanging pleasantries."

Dr Nagpaul said that in America doctors could not be insured for less than a 15-minute consultation because of the risks of missing an illness. The "brutal speed" at which doctors now dispose of their patients is leading to many mistakes in diagnosis, he said.

These views found immediate support at the conference, which voted to double the average consultation time for patients. But this was being seen as a mixed blessing. Double the time for a patient will mean twice as much waiting time to see a doctor. The waiting period for consultations with specialists runs into months and on occasion into a few years.

Dr John Chisholm, chairman of the BMA general practitioners' committee, said that the NHS needs at least 10,000 more doctors if patients are to be given at least 15 minutes. "We need to be embarking on urgent, constructive, radical, flexible and fruitful negotiations, committed to finding solutions on behalf of our patients."

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