I think the plan is for each GP's prescribing system/appointment system to export enough data that you can just use the NHS app for your needs. i know I can book appointments through it. Obviously doesn't help when the GP is still sifting through paper records. But those are few and far between.

Hm, I'll check that out. If that is the plan then all GP websites should be required to advertise the NHS app instead of the hundreds different private booking companies.

NHS.uk is brilliant, but yes, individual GPs (and I think the different NHS regional bodies, whatever they’re called), are a hodgepodge.

Because most GP surgeries are private companies.

Impossible! Only America could have such a thing!

It's the worst of both worlds, what people have described as a "playing at shops" market: the surgeries are private, so they're all little businesses with inefficiencies and poor IT, but they look and feel like a poverty-striken government service. Many have Squid Game appointment systems (rush the phone at 8am precisely and hope you get a slot). The user does not acually pay money at the point of service.

NHS dentistry is a lot more .. honest about "we don't have any NHS appointments, but you can have the same service from the same person at a higher price, in which case we do have an appointment".

The worst of both worlds would be all of those problems + a bill that bankrupts you at the end. Which is, for what it's worth, what the US is like. The US medical system is also ludicrously oversubscribed and has insane wait times for lots and lots of routine health things.

> The US medical system is also ludicrously oversubscribed and has insane wait times for lots and lots of routine health things.

The number of doctors per capita in the US increased a lot for decades[0], but stalled over the past 10 years. I wonder if the blame lies at the AMA's feet.

For what it's worth, my personal experience with routine medical care hasn't been too bad in three (very different) states, though it's unclear to me what my expectations should be. It seems like the US is worse than average for primary care wait times and better than average for specialist wait times among developed countries[2].

[0]: https://www.cdc.gov/nchs/data/hus/2020-2021/DocSt.pdf

[1]: https://www.statista.com/statistics/186092/active-physicians...

[2]: https://www.oecd-ilibrary.org/sites/242e3c8c-en/1/3/2/index....

I have known GPs to try that too, although it is much rarer and I do not know anyone (even in London) who has been completely unable to find a GP (one person did have to ask the NHS to find her one willing to take her though).

NHS practices are private businesses, which are contracted to provide NHS services.

That's why there's the complex business of 'partners', which buy into the "business".

Ahh, so another thing that can be blamed on the privatisation of organisations that shouldn't be privatised.

Not privatised. GPs have always worked like this, since the foundation of the NHS. They were never nationalised in the first place.

IIRC GPs refused to be NHS employees, so the government compromised and agreed to pay existing private GPs to treat NHS patients.

The thing that's changed in recent years is who "owns" the practices. Traditionally they were owned by the senior GPs, they became partners (owners) in the practice they ran.

Now increasingly as older GPs who are partners in prentice's retire they sell their practice to privet equity backed groups. GPs don't want to buy into a practice anymore.

The result of this is significantly worse care and service as the PE backed groups try to extract profits from the system. It's an attractive deal for PE, guaranteed income based on patent list size, and an opportunity to cut costs to make a profit.

> GPs don't want to buy into a practice anymore.

Why is that?

I think GP practises were always privately owned?

Doctor's practices have always been private businesses. It was the NHS that pseudo-nationalized them by making the government the only paying customer (more or less). The doctors recognized the dangers and didn't want it, so Bevin famously had to "stuff their mouths with gold".

>This should all be standardised and nice, why isn't it?

The prevailing opinion in government is that services are better when they are organised locally.

This is obviously wasteful and results in duplication and hundreds of organisations (e.g. councils) all doing the same thing in a different way.

It's absolutely wasteful.

The disadvantage of the opposite is that if everything is nationalised into one giant org, it could become too big and become an unmanageable and slow monolith (which is why it was decentralised back in the 90s).