7 February 2008

Rt Hon Alan Johnson MP

House of Commons

LONDON

SW1A 0AA

Dear Sir

GP Patient Surveys (Ipsos MORI G85129) and my GP

I visited my GP last Friday about a long running problem I have with my skin. This is hardly life threatening, but it is irritating for me, and embarrassing because it is unsightly. He suggested an appointment with a specialist. I asked him if he could recommend a team or a place, according to his experience. I thought he might know something of the social structures and ethos: a team that would accommodate my quirks and still know what its business was all about - the kind of thing that enhances and supports good practice. I was also asking for a small human relation to be opened for me, as it is not so easy to take my crumbling body to a stranger without a word of warmth from my GP.

He said he couldn’t give me any help because everything had changed so much, he no longer knew the scene. He could, however, give me information from the computerized system. This information turned out to be of waiting times: 30 days here, 50 there, 24 somewhere else.

I told him straight out that this does not constitute information, and certainly not the kind of information I would consult a GP to get. The ‘information’ that the computer system gave me does not indicate whether the waiting times are because of popularity or inefficiency, because of short staff or an epidemic, or because they reflect canny management and skill at manipulating statistics. It is not unheard of to wait for an appointment only to receive a letter postponing the actual date for another few weeks. Where once a real human being may have sat with a diary and an idea of the reality it represented (and know something of the ways and whiles of a patient), we now have a computer that knows nothing except it’s own certainty that someone else will get the blame for not living up to its prediction.

Once, more than a decade ago, I studied computer systems designers as they made a huge automated system in the water industry. The best outcome of this research was that it cured me from my naivety about computers and computer system designers, and glued me to the truth of science and technology – it is a by-product of human relations. In short: the information, and the choice that this kind of computerized system pretends to give me are worthless unless they are well established within the human networks that the practice actually depends on.

We laughed, my Gp and I, and I gave in. I chose a hospital nearby. Upon leaving the surgery I was then asked to fill in a form because I had received a referral. This form, complete with bar code and an elaborate long number simply wanted to know whether my doctor talked to me about a choice for my specialist appointment (Yes or No), how old I was, and was I a man or a woman.

Yes, he talked to me. He even made good eye contact in spite of the demands of his computer. But No - this does not constitute choice, nor information, not even if it is correlated with my age or my sex.

The only possible purpose of this survey that I can think of is a pernicious policing one. Even if it is a totally unintended consequence, this form could easily have a surreptitious intimidating effect. It simply reminds us that Big Brother is watching. There is no other useful function that the form can serve as far as I can see, except as an alibi for the company concerned to justify its government funding.

The technology and the research form have lost their relationship to the reality of the work they are supposed to serve. What possible good can ever come of that?

Yours faithfully

Janet Low