read in the Telegraph today that Jeremy Hunt, the Secretary of State for Health, is condoning, and even recommending, consultations with GPs by e-mail. 
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My dismay at GP 'e-consultations' recommendations

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The British Medical Association's head of IT, Chaand Nagpul, however reportedly told the Telegraph that both patients and GPs would prefer that consultation times increase from 10 minutes to 20 minutes. As a clinical negligence solicitor, I have seen over the years, how the restricted time that GPs have to spend with their patients, has lead to numerous diagnoses of potentially life threatening conditions being missed. Telephone consultations are now commonplace and it is impossible for the GP, as highly trained as they are, to make an accurate diagnosis, or to prescribe the correct treatment or medication, via this method in all cases. E-mail consultations are surely a step in the wrong direction.

An unwell patient is not capable of, or qualified to, make a correct diagnosis. This is why we seek the advice of our GPs if we are unwell or feel that something is wrong. How though, can a GP, without examining or speaking to us, be expected to make an accurate diagnosis, on the basis of our unqualified description of our symptoms, committed to eternity to the internet? How many of us would tell a GP that we have problems with our toilet habits, or require a repeat prescription for our antidepressants and by the way, think that we may have found a lump in our breast in an e-mail?

Clearly there is a place for telephone consultations, and I myself have benefited from these (travel medication) when it is really not necessary for me to take up my GP's consultation time. I would not however want to do anything more than re-order a non-problematic prescription (such as an asthma inhaler) on this basis.

The vast majority of people do not seek an appointment with their GP unless there is something that they need to discuss with a medically qualified individual. When a patient has symptoms of meningitis, colon cancer or breast cancer, a GP who gets to see that patient face to face, is expected, and in most circumstances will, recognise the symptoms and refer that patient appropriately. This cannot be the case when a GP only has the benefit of a telephone call, or even worse, an e-mail correspondence with the patient.

GPs already have a minimal amount of time in which to assess patients. Telephone appointments have their place but are not a substitute for a personal consultation when the patient considers this necessary. The proposal that GPs should offer e-mail consultations is fraught with problems.

It is of note that Mr Jeremy Hunt, Secretary of State for Health, has no medical qualifications and no experience of dealing with ill patients.

GPs are highly qualified and have trained for years to try and indentify health problems in their patients at the earliest opportunity, and to refer them to the appropriate specialist if necessary. To expect them to discharge the duty of care that they rightly owe to their patients by e-mail, is surely to leave them open to increased allegations of negligence, and the costs that flow from such allegations?

No-one is infallible and I and my colleagues have a number of clinical negligence cases against GP's who have failed to discharge their duty of care. However, over 99.9% of GPs go into practice with the best of intentions and wanting to serve their patients to the best of their ability. I fail to see how they can demonstrate that ability through an e-mail or on-line consultation with a patient.

Kym Provan
Senior Associate

Head of South Coast Clinical Negligence team       

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