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Letters: Patients unable to see their GPs face to face can find that their illness is misdiagnosed

Although Covid infection levels are falling, it is still difficult to book an appointment to be examined by a doctor - Lynne Cameron/PA
Although Covid infection levels are falling, it is still difficult to book an appointment to be examined by a doctor - Lynne Cameron/PA

SIR – Two weeks ago, I rang my local surgery at 8.30am, as a large swelling had appeared on the inside of my knee. The surgery gave the date as January 2021 in its recorded message and said it had closed and was operating from another surgery in a neighbouring village, with reduced appointments. I finally got through there at 4pm and was told by the receptionist there were no more appointments for that day and I should try again the next day at 8.30am.

I told her I was not prepared to sit on the phone all day again. She said there was a link on the website to request “e-consult”. There wasn’t, but I found it myself via a search engine. It took some time to complete the online form with all my personal and medical information and it suggested I include a photo of the problem, which I did.

I was called two days later by a physiotherapist who obviously had not seen the photo or details. I described the problem, and he diagnosed bursitis of the patella and told me to elevate the leg and apply ice packs.

After a week, nothing had changed and, fortunately, I was able to speak to a retired orthopaedic surgeon who lives locally. He came to my home and diagnosed a cyst, which may need surgery. How I will see a GP in person to get referred to a practising surgeon is anybody’s guess.

Amanda Malas
Hartley, Kent

SIR – Face-to-face GP appointments have continued throughout the pandemic in our part of France, as have annual cancer monitoring and any investigative MRI scans, X-rays or ultrasounds. Masks are worn and appropriate sanitising is carried out.

Following these procedures, you either walk out with the results in your hand or receive them within 24 hours. Consultation times for GP and hospital appointments have been slightly extended to reduce the possibility of queues. Why the disparity between France and the UK?

Christine Clegg
Saint-Aubin-le-Cloud, Deux-Sèvres, France

SIR – The NHS is not, nor has it ever been, a Covid-only service (Allison Pearson, Features, May 5). GP appointments have been available throughout the pandemic.

It was right, to cut the chances of catching Covid and protect our patients and workforce, that some NHS appointments had to take place online. However, appointments continued to be conducted in person, and patients who need to see a doctor face to face should always be given this option.

More than half of appointments are still face-to-face, and this number is increasing every month, as the restrictions placed on our lives to reduce Covid transmission are lifted.

As a GP I know that online appointments are not for everyone, but they are welcomed by millions and are widely available. Video consultations help people to describe symptoms quickly, and allow a clinician to triage a patient to the right service. In January, there were more than two million online consultation requests submitted to general practice and about 155,000 video consultations.

In a recent independent survey, the majority of people reported receiving appropriate care, and more people than not said they would be happy with future consultations taking place remotely. However, everyone working in primary care remains committed to ensuring face-to-face appointments continue to be offered. They are at the heart of what we do.

Dr Nikki Kanani
Medical Director of Primary Care
NHS England
London SE1

SIR – My GP surgery, while refusing to offer anything like a proper caring service to patients, is more than happy to provide my wife and me with letters on surgery notepaper confirming that we have been vaccinated (required by the Israeli embassy to accompany requests to enter the country). But the surgery will charge me £30 per letter. Nice work if you can get it.

Brian Gedalla
London N3

Soldiers betrayed

SIR – The Armed Forces Covenant has been breached by successive governments. The latest example is the recent (now collapsed) trial in Northern Ireland (Letters, May 6).

One wonders why this has to be, and the only explanation is that it is for political reasons. This must cease, otherwise we will no longer have any Armed Forces.

Jack Marriott
Churt, Surrey

SIR – The trial of two elderly ex-paratroopers in Northern Ireland was nothing short of a national disgrace.

These men have been hounded for years. We sent them into danger and they did their duty. We owe them our thanks and support, not the stress we have caused.

I understand that there are more prosecutions (or should I say persecutions?) in the pipeline. Thousands of pounds have been spent and a very honourable government minister has been lost. I am ashamed – for our country, our government and our legal process – that we allow this to go on.

Patricia Reeves
Newport, Isle of Wight

Porn via social media

SIR – The news that two thirds of teenagers are watching pornography on social media (report, May 5) is distressing.

Ministers must confront social media companies through robust new duty-of-care legislation. However, they must not stop there. Given the massive proliferation of online pornography, its degrading content and its accessibility to young children, age-verification checks for those seeking to access commercial porn sites are essential.

Such controls have been approved by MPs and peers, so there is no excuse for delay. Through combined action, both on social media and pornography providers, the UK can truly claim the mantle of “world leader” in online safety.

James Mildred
Chief Communications Officer, Care London SW1

Made in China

SIR – I was delighted to see that my bag of ice cubes had “Made in Britain” proudly emblazoned upon it.

Depressingly, my tube of toothpaste was (just visibly) “Made in China”.

Why?

Richard Booth
Ringmer, East Sussex

French fishing rights

SIR – The French seem to think they have a right to fish in Jersey waters and land their catches in France without impediment. However, the French refuse fish caught by Jersey fishermen from the same area, on the basis that the water is not up to standard.

The former Bay of Granville agreement wrongly permitted the French to issue licences to all and sundry, with no control by Jersey. This has been corrected by the agreement reached by the UK with the EU and subsequently approved by the government of Jersey.

The French can fish our waters if they can prove they have the right to, in accordance with this agreement. They seem unwilling to do so.

Edward Trevor
St Helier, Jersey

SIR – I am a customer of Électricité de France. Whatever the rights and wrongs of fishing permits, the threat to disconnect the supply of electricity (report, May 5) to Jersey is shocking.

It is not only a form of bullying but is also a type of collective punishment – illegal under international law. Article 33 of the Fourth Geneva Convention forbids it.

I won’t renew my EDF contract.

Tony Hambro
London SW1

The Bard at his best

SIR – In 2016, I saw an RSC production of King Lear (Letters, May 4). The props included rocks with anti-Brexit slogans, which I felt was an arrogant display of the company’s political view.

I decided to avoid future RSC wokefests. Instead, I bought a BBC DVD set of 37 Shakespeare productions from about 40 years ago. The plays feature the best talent of the 1970s and 1980s, they are in period costume and the words can be heard clearly. I now have hours of pleasurable viewing.

Don Webber
Bembridge, Isle of Wight

Golf on the wild side

SIR – While seconded to the 4th (Uganda) battalion of the King’s African Rifles, I also enjoyed many rounds of golf at Jinja, beside Lake Victoria (Letters, May 5).

We always had two caddies – one was there to stop pied crows picking up the balls. There was also a club rule that players could move a ball without penalty if, as frequently happened, it landed in a hippo’s hoof mark.

Major Iain Grahame (retd)
Lamarsh, Essex

The demise of handwritten wedding registers

Signing the Register by the English painter Edmund Blair Leighton (1852-1922) - www.bridgemanimages.com
Signing the Register by the English painter Edmund Blair Leighton (1852-1922) - www.bridgemanimages.com

SIR – The registration of marriages solemnised in churches has now been changed in the most fundamental way since wedding registers first came into existence during the Tudor period.

While I applaud the inclusion of both parents’ names (report, May 4), I deplore the wretched nature of this new normal. The couple and their witnesses now merely sign a sheet of paper, which clergy send to the register office. The newlyweds then receive another piece of paper from the registry to say they are married.

No more registers, no handwritten marriage certificates, just dreary printouts. A true sadness.

Rev Michael J Maine
Cuckfield, West Sussex

Lincoln fought a civil war to preserve his Union

SIR – D A Glass (Letters, May 5) compares Scotland to South Carolina and asks what would happen if this state were to break away from the United States. We already know the answer. In December 1860, against the constitution, South Carolina was the first state to secede from the Union, and a bloody civil war followed.

The Acts of Union of 1707 said that “the two Kingdoms of Scotland and England, shall forever after, be united into one Kingdom by the Name of Great-Britain”, and that “the united Kingdom of Great-Britain be represented by one and the same Parliament” – although that ended with the Scotland Act of 1998.

I am not advocating civil war, but if Tony Blair had shown Abraham Lincoln’s determination to preserve his Union, we would not now be seeing the dismemberment of ours.

Nicholas Young
London W13

SIR – Ben Riley-Smith (report, May 1) suggests that Boris Johnson is prepared to take the SNP to the Supreme Court to stop a unilateral second referendum, but this would be a stopgap. There has to be some finality over this issue.

I believe the Government should agree to a new referendum, but on revised terms. First, a higher threshold must be met before change can take place. In 2014, only 44.7 per cent were in favour of independence. Countries with written constitutions typically require a two-thirds majority before it can be amended.

Secondly, no further referendum should be allowed to take place for a set time. If the SNP had stuck to its commitment in 2014 not to revisit the issue for a generation, much angst and division could have been avoided.

These arguments apply to any referendum on a constitutional question. Had a two-thirds majority been required in the Brexit vote then Britain would still be part of the EU, a result that might have been more easily accepted within the UK, including in Scotland.

Stephen Parkinson
London EC1

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