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'Inner City General Practice'

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'The Photographer`s Story'

Mike Abrahams photographed the primary health care teams based at Earle Road Medical Centre, Liverpool.

"The primary health care team is the first port of call for anyone who's ill, with GPs, practice nurses, midwives, district nurses, drug counsellors and health visitors.

"I photographed in an inner city practice, in Liverpool 7. It's quite a deprived area, with housing problems, poverty and drugs. But Liverpool's such an easy place; people were generous with their time and always hospitable.

"Each doctor has around 2,000 people on their books, so the practice of three GPs would have 6,000 patients. The regulars they know. Others only go once every two years.

"The most remarkable thing is the appointment system which is worked on a ten minute basis. That means each patient actually gets about seven minutes. So the old idea of the GP as a confidant of the family has changed.

"One doctor said that the bedside manner used to have a very important role, because there wasn't a lot the doctors could do. Now medicine has advanced so dramatically you get them into the surgery, solve the problem, and get on to the next. Still, they show incredible patience and tenderness.

"Every person who comes in has their own concerns. Some can be angry, or difficult. Some are hypochondriacs; others have absolute traumas to deal with. Doctors have to click from one to the next - see ten cases of coughs and colds then be alert enough to spot the unusual, complex illness in the next patient. I was amazed at how quickly they would pick up on things.

"I think the reason 95 per cent of us go to the doctor is to be re-assured that we're not going to die. But a lot of people expect the doctors to do everything, and don't see their role in their own treatment."

Community health professionals make over 100 million contacts per year with patients. Those most likely to pay a visit to the GP are under-4s and over-65s.

Each year in the UK, over 500 million prescription items are dispensed.

Deaths in childhood have dropped dramatically since the birth of the NHS; mortality among under-4s has dropped to one sixth of what it was in 1948.

Competition to become a doctor is more intense then ever, with most medical schools demanding straight As for undergraduate entry. General practitioners train for seven years, and can expect to earn approximately 55,000 pa.

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