Cybermedicine came to the UK yesterday, with the launch by the prime minister of an official NHS website to answer patient queries, thin the crowds in the waiting room and - within a couple of years - offer online consultations with a nurse or doctor. Tony Blair stood under a hot air balloon Christmas decoration in a shopping centre in Bootle, Merseyside, and with the help of Sarah Brookfield, an NHS Direct nurse co-ordinator, the notorious technophobe checked out his cold and flu symptoms by clicking on a user-friendly do-it-yourself diagnosis program.
The software established that Mr Blair did not have meningitis and concluded that he was suffering only from sneezing, a runny nose, a mild temperature, a sore throat and aches and pains. What else can you expect when you come north?
He was advised that he need not see a doctor unless he was an infant or a pensioner but a trip to a pharmacist might be useful. So off he went to Boots, only to find his way blocked by a posse of buggies. "I'm surrounded by babies," said the father-to-be with a hint of a blush.
The website is an extension of NHS Direct, the telephone support service staffed by nurses who advise patients as to whether they should see a doctor or tuck themselves up with hot lemon at home. Mr Blair's involvement yesterday was an indication of the importance the government attaches to the initiative which is designed not only to give patients quick answers but to take some of the load off hard-pressed GPs.
Returning to the baby theme, the prime minister sang the praises of NHS Direct which was established in the face of opposition from the British Medical Association but which is popular with the public who want instant advice.
"There are few more worrying situations than for a parent to wake up to a crying and sick baby in the middle of the night," said Mr Blair. As his audience of shoppers laughed, he departed from his text to add: "That's what it says here."
The website launch was one of three significant developments to increase the scope of NHS Direct announced yesterday. The others are the extension of the telephone service to 65% of the country, and publication of a substantial healthcare guide which is designed to become a basic self-help family bible.
Both the guide, which will be sold in pharmacies for £1.99, and the website offer step by step advice on what to do if assailed by the 20 most common sets of symptoms that present to NHS Direct at the moment.
There is the coughing adult, for instance. The guide and the website ask if there is also a blue tinge to the lips, severe shortage of breath or severe chest pain. If so, dial 999. If not, but the cough developed after peanuts or other such food "went down the wrong way", call NHS Direct. If the cough is associated with green phlegm, wait and hope it goes away, and if it does not, call NHS Direct.
The government denies that new technology spells the demise of the family doctor. "All of these NHS Direct services are a complement to and not in competition with family doctor services," said Alan Milburn, the health secretary. While a majority of those who phone NHS Direct are told to stay home and keep warm or give their children Calpol, a significant number are diverted swiftly to hospital. About 20% of those who phone need more urgent care, and some are serious cases. In 2,000 cases, ambulances were called, which undoubtedly saved lives, said Mr Milburn. About 35% were advised they did not need to see a doctor.
Next spring the website (www.nhsdirect.nhs.uk) will be available from computer terminals set up in public places such as pharmacies, GP surgeries and libraries. Mr Milburn said the integrated telephone helpline, website and guide put Britain ahead of the world.
Within a couple of years, patients will be able to have a personal consultation with an NHS nurse or doctor via video links and the computer screen.
Health sites are the second most accessed on the internet after pornography, according to Bob Gann, the director of NHS Direct online.
"There's good information out there and bad information out there," he said. What was on the government site would be good quality and would lead to other good quality sites. The US government's health site, healthfinder, already does this.
Ian Banks, the GP who put together the guide, said he was not alarmed by the informed patient who goes to the surgery armed with an internet printout. "I have no problem with my patients being better informed but the information has to be good information. There is an awful lot of rubbish out there."
He believed that only those who did not need to see the doctor would be deterred from making an appointment. "I'd like to have longer to talk to my patients who really need to see me," he said.
