Friday 31 May 2013

Spiral Notebook: Money for old rope

pret_coffee.jpgI paid, as usual, for a coffee with a credit card. No big deal. In fact quite the opposite. A tiny one. £2.10. Used to be the case that the rule of thumb was anything under £10 was cash but now everything's plastic and no-one raises an eyebrow.


I don't carry change so much except for specific pre-planned purchases.

The clang of metal and the bias in the pocket veers me leeward - an excuse that hardly goes down well with the chuggers and the tramps.

In Egypt, the policy is a no-no. Virtually no ATMs worked and the hand-held card readers kept suggesting it was me, rather than their dodgy network, that was significantly underfunded.

This led to an embarrassment episode in which a shopkeeper was taking me round the streets to half a dozen cash machines in the shoes that I was checking for size and was planning to purchase.

He was thinking - if this guy doesn't pay I'm left with his sweat-stained cast-offs. I'm thinking - I've got an afternoon shift in a shoe shop looming.

We tracked one down in the end, and the relief was enormous. Wads of cash still feel good in the hand.

Action and Emergency

■ A&E is under pressure. There are now more than 21million visits annually, a rise of 50 per cent in a decade and a rise of a million in the past year.

Many factors have been cited - the ageing population, obesity, the growth of chronic conditions. The Queen's Speech pointed a finger at another reason - health tourism.

(One can only imagine flight-loads of foreigners with grumbling appendixes and creaking joints, their cries of pain disguised amid the general groans of anguish from the returning Brits crammed painfully on a Monarch flight.)

The lack of out-of-hours GP care is another oft-quoted reason but one of the lesser promoted causes is the inaccessibility of GPs within normal surgery hours.

Obtaining face-time is akin to winning a T-shirt on Radio KAOS in Los Angeles - the first 10 callers get through ("first time caller, doc, long time sufferer") - the rest have to languish another day in discomfort.

This ludicrous lottery was set in train by Tony Blair's 2000 reforms. In 2005 he confessed to astonishment surgeries had sidestepped his targets by, effectively, abolishing appointments and opting for a free-for-all.

A member of the public, Diana Church, had confronted the Prime Minister with the revelation: "You have to sit on the phone for three hours trying to get an appointment because you are not allowed to ask for the appointment before that."

The upshot, then as now, is people who miss out head needlessly towards A&E clogging the system. And those who miss out frequently find their condition worsening until A&E becomes essential.

■ Follow Giles Broadbent on Twitter @MediaGulch