Sorry, folks. No season of mists and mellow fruitfulness this year. More a season of murk and mildewed hopelessness (with apologies to Keats).

I, for one, have entered a death spiral of my own in terms of compulsive news consumption this month. I’ve learned, the hard way, how many hours it’s possible to squander on each spasm of the Westminster snafu. Each moment of thinking it cannot get any worse. Each realisation that oh yes, it can. Each empty promise to myself that I’ll close Twitter, switch off the news and turn my attention, just for a moment, to something more edifying. Each bleak reminder that behind all this are empty food cupboards, hungry kids, cold homes, struggling businesses, soaring mortgage rates and a record seven million languishing on NHS waiting lists.

I try to lighten the mood. As our democracy smoulders, it’s been a good month for char-black humour. There was Liz versus the lettuce and the passionate defence of tofu. Then came new chancellor, Hunt, attracting his second, live, four-letter cuss-handle on the Today programme. And finally the promise of self-immolation by a senior Tory if Johnson were to deliver on his Cincinnatus comeback. But as I sit here typing at dead of night, because I spent all day watching the circus, the overriding feeling is one of deep existential weariness at the state of the nation. I suspect I am not alone in that.

The elastic has snapped
Of the numerous important news stories all but drowned out by the turmoil in government, there was one that landed, with barely a whisper, on the day Prime Minister I’m-a-fighter-not-a-quitter Truss quit. This was the publication of a report by the Commons Health and Social Care Committee, chaired until six days earlier by one Jeremy Hunt MP, on the future of general practice. An attempt to address to the crisis within primary care – responsible as it is for the delivery of up to 90% of healthcare in this country – the committee’s findings are a sobering read.

Arguing that this is a bona fide calamity-in-waiting for the NHS, the report doesn’t pull its punches. “The elastic has snapped,” it states, with patients “facing unacceptably poor access to, and experiences of, general practice.” On the one hand, this is down to more appointments, fewer doctors, plummeting morale, dissatisfied patients, and an ensuing exodus of GPs, who are leaving the profession almost as fast as they’re joining it. But it is also about the loss of something more fundamental.

The human relationship between doctor and patient, once hardwired into general practice, is, according to the MPs’ report, now in critical decline. Long sidelined by policymakers as something of a museum piece, continuity of care has fallen victim to the emphasis placed upon access to a doctor, any old doctor. It’s like “phoning a call centre or booking an Uber driver,” says the report balefully, adding “it is unacceptable that one of the defining standards of general practice has been allowed to erode in this way.”

The report cites the growing body of evidence linking continuity to better health outcomes, lower hospital admissions, even lower mortality, as well as to happier doctors, less likely to burn out and quit. The point is that it’s not just nice to know your doctor. It’s that knowing your doctor, and your doctor knowing you, saves lives. In its conclusion, the report calls for continuity to be enshrined in the GP contract by 2030.

So there it is, in black and white, and it should have been on every front page that dank Thursday as the government consumed itself from the inside.

I get exercised about this because my latest book is a documentary study of a doctor, so I have lived and breathed these issues with her for more than two years.

Based on many months of observation and conversation, A Fortunate Woman tells the story of a remarkable female GP working in a remote rural valley. The book is, at one level, a portrait-in-miniature, a love letter to a landscape and a community. But it also tells a much bigger story about what it means to be a doctor today; it’s about the nature of medical vocation, the process of care and how fundamental the doctor-patient relationship is to both.

This month, to my astonishment and delight, the book was shortlisted for the Baillie Gifford Prize for Non-Fiction. What started as a small – at times I feared parochial – project has grown and gathered momentum. And to feel that this doctor’s story resonates beyond the valley where it unfolds, that its message is important and timely, well, that’s been a ray of light at a dark time.

Falling leaves
I live in the thickly wooded valley where A Fortunate Woman takes place and many of the conversations that formed the spine of the book’s research were undertaken on long walks with the doctor whose story it tells. We haven’t seen each other for a couple of months, but this morning, a Saturday, she and I pull on our walking boots and set off for a stroll through the woods, while our teenagers sleep.

We talk about work, medical and literary, lament the chaos in government and our shared addiction to the news on every platform. But as we walk, the irrepressible beauty of the autumn woods cuts through. Leaves crunch beneath our feet. A low sun dapples the path ahead. And our spirits lift, a burnished reminder that, in spite of it all, Keats was right: the world continues to turn.

Polly Morland is a writer and documentary maker. She is the author of several books, including “A Fortunate Woman: A Country Doctor’s Story” (Picador 2022) which has been shortlisted for the Baillie Gifford Prize for Non-Fiction.

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