The Good Doctor Blog: Time to honour and respect the elderly

THE NHS has a new survey to assess GP services called the Friends and Family Test. It is based on the idea that if you felt you could recommend your GP to your friends and family, that GP must be good. It is not difficult to see how controversial this assumption is.

People may be liked or disliked for all sorts of reasons. A GP with a healthy attitude to prescribing and referring may be deemed uncommendable by those who are convinced they deserve a prescription or a referral despite lack of a medical indication. Those who are convinced they merit a sick note and whose GP thinks otherwise may equally think their GP is uncommendable. Conversely, a GP may be deemed commendable for the wrong reasons.

Over the festive season, there were ideas mooted in Whitehall regarding what happens to the elderly over weekends. They are more likely to be admitted to and poorly managed in hospital, partly because hospitals are understaffed during weekends. It was mooted that GPs should be phoning their elderly patients at the weekend to see if they need anything!

The greatest problem of old age is loneliness, and that often becomes medicalised. This makes me wonder whether there is a more appropriate friends and family survey that should be carried out. The NHS/social services should be asking our elderly: How often do your friends and family pop in to see you? There are examples of wonderfully caring friends and families that I see every week. But alas like many GPs and social workers, we all know a huge number of elderly who are ignored by their families and have no friends.

It never ceases to amaze me how often my elderly patients, when offered the befriending service, having complained of loneliness, have turned down the offer. It is an issue of trust. An elderly person would rather be visited by someone they know and trust, such as a friend or a relative, than by a stranger. Family members are the obvious candidates. The state can never replace family. The state can offer care, but love is a different matter. We are all aware of how often the institutionalised elderly get abused by those who care for them.

What is needed is not more medical or social services. We need more love, from families for their own. This week we have seen an assault on our Judeo-Christian values in Paris. The Ten Commandments teach us to “honour you father and mother”. Honour encapsulates respect, care, and love for one’s elders. Ironically, those who perpetrated the Paris atrocities are better than us at honouring their elderly. A sobering thought?!

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