The importance of time

I read David Cameron's pre-election promises regarding the NHS with relief. Relief that I am no longer a GP, relief that I will not have to keep on working in an ever-demoralising work environment, relief that I will not be an NHS patient in the near future.
 But I also worry. Once I had great pride in our NHS services. Through goodwill of frontline workers and healthy clinician-management relationships we used to provide a fantastic service. I worked in a hospital that had social workers and occupational therapists in the Emergency Department, where patients wouldn't be sent home unless they were proven fit to be independent, and were never sent home in the middle of the night. Then I saw the advent of 4 hour targets, the hospital was financially penalised for breaches, and suddenly clipboard bearing idiots with no other focus than meeting these targets were deciding who was admitted and who was sent home.
 Political involvement in the NHS is destroying it. Many think this is the underlying aim, with the ultimate plan to sell off NHS contracts to private providers. I suspect there is some truth in this.
 The NHS was set up to provide us with what we need, and instead the politicians make empty promises based on winning votes from the well, rare users of the NHS who think convenience and speed are more important than complete care.
 The two things that really, really annoy me are the demands for appointments of convenience, and the desire to be seen the minute any symptoms starts.
 Now wanting an appointment at a convenient time I do understand. Pill checks, BP reviews, routine stuff, you don't want to have to book a full day off and ring repeatedly from 7am only to be told there are no appointments. But most practices have moved away from this, most have appointments open up to a month in advance. If you are organised you can easily book an early morning or late evening appointment. Most of the disappointment comes not from lack of appropriate appointments, but from people only remembering a day before and then wanting the earliest or latest slot when it was booked by someone who was organised. Should the NHS really have to fund millions of pounds worth of extra doctors hours because you only remember your 6 months worth of pills are running out on the last day?

 Jeremy Hunt famously let on that he took his own children to A&E because he couldn't wait for the out of hours service.
 First of all let me remind you that when the GP contract was renegotiated in 2004 there was an amazing set up where local GPs co-operated to share out of hours cover. The government believed they could provide this service cheaper by opening it to private providers. Existing GP co-ops that bid to run services were not selected and the resulting sparce cover is the result.
  But my key point, and the aim of the title, is that time is a crucial part of making a diagnosis.
 Recently a visiting friend had an infected insect bite. A sensible friend they shared my reluctance to take antibiotics unless strictly necessary and decided to keep it clean and dry and watch for any signs of deterioration. 30 minutes later they had a fever and flu-like symptoms.
 Had they been Jeremy Hunt-like, and wanted seeing immediately, it would have been too soon. Symptoms develop with time. And while some things do need seeing immediately (meningitis and septicaemia, chest pain, acute shortness of breath to name a few), most things benefit from having a chance to develop.
 So please don't think that being seen for a sore throat in half an hour is a good thing. It only means you'll be sent away to come back again in a few days if it's no better. Time is a diagnostic aid, and sometimes all the treatment you need.