Princess Diana’s funeral was in the era before mass out-of-hours services, and I was on the rota to cover my practice that weekend. Our receptionist, Judy, brought in a portable telly on the Saturday morning. It was eerily quiet – no appointments booked, the phone didn’t ring once and not a single home visit was requested. Judy and I watched the entire coverage without interruption.
I mention this to illustrate quite how discretionary much of “urgent” general practice actually is. The stuff that genuinely requires immediate attention – heart attacks, strokes, that kind of thing – crops up only rarely. The vast majority of patients that come during an “out of hours” period could quite easily, were there to be something sufficiently compelling for them to do instead, wait till another time.
The only other day of comparable quietness always used to be Christmas Day. I worked quite a few of them in my early years in practice. There would be occasional patients with pressing problems, but most people stayed tucked up at home with the presents and turkey and their gathered family, stoically ignoring coughs and belly aches and sore throats till at least Boxing Day.
Those patients who were compelled to seek medical attention were usually deeply grateful to find someone giving up their own Christmas to be available to help. And there was a sense of quiet satisfaction for me. Being of service to someone with a life-threatening or scary illness makes missing a special day with loved ones feel worthwhile.
When the kids came along, though, I tried to preserve Christmas for my own family. I got round it by offering to work New Year’s Eve instead. There was always some colleague without young children – and therefore able to contemplate actually staying awake till midnight getting uproariously drunk – who was glad to make the trade.
Time moves on, children grow up and last year I found myself once again free of ties for 25 December. My wife and I decided to volunteer as drivers for a local charity that puts on a Christmas lunch for the lonely elderly. But as we got near the day, I started to get increasingly frantic round-robin emails from the out-of-hours service. They had no medical cover for the whole of Christmas Day. Could someone, anyone, please help.
So in the end, my wife ferried a bunch of excited widows and widowers to and from their festive party, and I went to the out-of-hours centre to do my first Christmas duty for some 20 years.
What a difference a couple of decades make. Patients came in an unending stream – earaches, funny rashes, a spot of diarrhoea. I genuinely didn’t see anything that couldn’t have waited. Not a single person made any comment about the fact that it was Christmas, so much so that at one point I had to double-check I hadn’t got the day wrong. And far from there being any thanks, the only expressed emotion was from a couple of punters who got so fed up at having to wait a while to be seen that they thought they’d have a go at the harried reception staff.
I came away feeling I hadn’t made a jot of real difference to anyone. It would have been better to have done some OAP chauffeuring instead. I suspect it says something about our society – how we expect everything to be available instantly at all times, and how we’re losing the notion of anything being special or sacrosanct. I resolved not to squander the day in such a way again.
I wish all New Statesman readers a very happy Christmas when it comes, and I hope it’s a healthy one as well. If by some bad luck you are taken ill, you will always find doctors and nurses and ancillary staff there to help. If you’re really poorly – God forbid – then they’ll be only too pleased to be there for you. But if you are more of a “walking-wounded” then a smile and a word of thanks will almost certainly make their day.
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This article appears in the 08 Dec 2020 issue of the New Statesman, Christmas special