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Much as I’m sure that Post-its columnist Dr Steve Brinksman is an excellent and committed GP, I can’t help feeling that many of his observations about NHS primary care are perhaps a little rose-tinted and utopian. They certainly don’t bear much resemblance to my own experiences.
In February’s column (page 7) he talks about one of the privileges of being a GP as ‘the opportunity to follow through the “cradle to grave” ethos that the NHS was founded on’, knowing his patients from a young age onwards throughout their lives. I can’t remember the last time I saw the same GP twice at my practice. Perhaps what he’s describing is normal in small towns or predominantly rural communities, but in inner city practices – such as the one in Birmingham where he works – surely this is the exception rather than the norm?
Then in the write-up of the service user conference (DDN, March, page 8) he describes general practice as an environment that ‘aims to be’ non-stigmatising. I’m glad he felt the need to qualify that. I’ve no doubt that there are GP practices that are like this, but it strikes me that they must still be fairly few and far-between. I’ve certainly never experienced one. The general air of hostility, suspicion and barely concealed contempt usually starts with the reception staff, very often continues with the GP and almost always continues in the pharmacy afterwards.
I think the experiences detailed by participants in the conference’s Right to treatment workshop (DDN, March, page 10) are probably much more representative of general practice as a whole, with people describing attitudes of ‘you’ve brought it on yourself’ or how medical professionals hate to have their opinions challenged.
I know the NHS is facing great challenges in terms of funding and resources, and I know its staff are often over-worked and over-stressed. I also know that attitudes are probably slowly improving. But I do think we’ve got a very long way to go before most people get to experience anything like what Dr Brinksman describes at his own practice.
Name and address supplied
Professor Howard Parker acknowledges the harm reduction benefits of e-cigarettes (DDN, April, page 18), but also says they do not have a scientific clean bill of health.
E-cigarettes deliver nicotine in aerosol form without the hazards of tobacco smoking. As nicotine has minimal health impacts, they can dramatically reduce harm to smokers. With the rapid growth of the e-cigarette market, we are seeing a consumer-led health revolution that requires no NHS resources.
However, the UK government, along with the US and others in Europe, is gearing up to classify e-cigarettes as medicines, which would bring heavy regulatory burdens, costs and restrictions. It would be appalling if, in the name of safety, regulators smothered the e-cigarette market in red tape, tipping the balance back in favour of smoking cigarettes.
Gerry Stimson, emeritus professor, Imperial College London
Professor Stimson will be writing about e-cigarettes in the June issue of DDN.
Close to home
Your last issue touched on issues that are very close to me. Going to prison for a drug offence took me away from my children and broke up our family (DDN, April, page 8). My two children were taken into care and my daughter still does not forgive me.
I attempted suicide twice and did things I am very ashamed of. I still find it hard to live with myself and my children will never forgive me for the pain I made them go through. I am not in touch with their father any more.
I now volunteer as a women’s support worker and it gave me some hope to learn that the Prison Reform Trust are working with these other organisations to make sure that women who are not violent have the chance of getting support to reform and stay with their families. The only time I was violent was to myself.
If I had had the support your authors talked about, my life would be very different.
Name and address supplied