Skip to main content

Main menu

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • BJGP LIFE
  • MORE
    • About BJGP
    • Conference
    • Advertising
    • eLetters
    • Alerts
    • Video
    • Audio
    • Librarian information
    • Resilience
    • COVID-19 Clinical Solutions
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers

User menu

  • Subscriptions
  • Alerts
  • Log in

Search

  • Advanced search
British Journal of General Practice
Intended for Healthcare Professionals
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
  • Subscriptions
  • Alerts
  • Log in
  • Follow bjgp on Twitter
  • Visit bjgp on Facebook
  • Blog
  • Listen to BJGP podcast
  • Subscribe BJGP on YouTube
British Journal of General Practice
Intended for Healthcare Professionals

Advanced Search

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • BJGP LIFE
  • MORE
    • About BJGP
    • Conference
    • Advertising
    • eLetters
    • Alerts
    • Video
    • Audio
    • Librarian information
    • Resilience
    • COVID-19 Clinical Solutions
Out of Hours

Self-service

Saul Miller
British Journal of General Practice 2014; 64 (618): 43. DOI: https://doi.org/10.3399/bjgp14X676564
Saul Miller
GP, Belford, Northumberland.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info
  • eLetters
  • PDF
Loading
Figure
  • Download figure
  • Open in new tab
  • Download powerpoint

Saul Miller

‘Sorry.’

I nod my head as I concede defeat. A woman in Lycra has beaten me. I’m not the only one in a rush, clearly.

As she turns to start unloading, we both realise I need to take a step or two back, to give her space.

‘Sorry.’ I repeat, retreating.

It would not feel so bad if she had beaten me with 6 items or less, but this is a queue for baskets and hers is fully loaded.

Frustration rises like a spring tide. I cast my eyes around again. It is opening time on Sunday morning and I was expecting no delay.

Then I spot the self-service checkouts.

I hesitate, caught between the certain mild inconvenience here and the uncharted territory over there. Her basket sways me. That and the sight of an assistant supervising the do-it-yourself checkouts.

‘Morning!’ I greet her warmly. I might need her onside.

Several others are busily serving themselves but there are plenty of these checkouts free: the till operators in aisles 1 to 15 must sense their uncertain future.

I place the basket in its allotted place and press the cheery screen to start. A recorded female voice instructs me firmly but encouragingly. Even so, I am soon stuck.

‘You have to put your bag in here to load it’, the smiling assistant tells me, gently guiding me towards correct behaviour.

The till seems satisfied and we carry on. By the time I leave the place though, the patient assistant has needed to correct my actions several times more. Any gain I might have made over the position in the queue I gave up has been lost. Still, I do not mind: I will be quicker next time. Besides, I am impressed with the way they have deconstructed the checkout process so they could halve the number of people involved in each sale, almost.

The small shops in town already struggle to compete on price. And no one values expertise from shopkeepers now. Already, 0.1% of businesses in Britain have a greater turnover than the rest put together.1 With self-service meaning fewer staff and further reductions in wage costs, big supermarkets like this one will further increase their advantage.

This is where general practice is. We are caught in a closing vice, ever bigger hospital trusts on one side and big business — that same 0.1% — being helped into public service provision by a conniving government on the other.2 The problems for every other small business are the problems we face, especially the power of the competition to tilt the tables in their own favour, by whatever means. Federation, a proposed solution, is an if-you-can’t-beat-‘em-join-‘em strategy to resist that vice. Without government support, there seem no stay-small alternatives.

And whatever the problems with the nationwide 111 helpline,3–5 the drive to deconstruct medicine, to unbundle it into its constituent algorithms, will continue. Corner shops thrive on their relationships with their customers but for big supermarkets loyalty is just another commodity that can be dissected, dehumanised, priced.

Personal continuity weakens but the self-service consultation is still some way off. Perhaps it will be a good solution for Sundays?

  • © British Journal of General Practice 2014

REFERENCES

  1. 1.↵
    1. Department of Business Innovation and Skills
    Business population estimates for the UK and regions 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/254552/13-92-business-population-estimates-2013-stats-release-4.pdf (accessed 26 Nov 2013).
  2. 2.↵
    1. Maude F
    (Nov 19, 2013) The Independent, We need a vibrant ecosystem of providers but I expect G4S to emerge stronger after review. The reward will be savings for taxpayers. http://www.independent.co.uk/voices/comment/we-need-a-vibrant-ecosystem-of-providers-but-i-expect-g4s-to-emerge-stronger-after-review-8950258.html (accessed 27 Nov 2013).
  3. 3.↵
    1. Iacobucci G
    (2013) NHS England announces inquiry into ailing 111 service. BMJ 346:f2923.
    OpenUrlFREE Full Text
  4. 4.
    1. Iacobucci G
    (2013) Reliance of 111 on non-clinical staff has increased pressure on emergency departments, MPs say. BMJ 347:f4717.
    OpenUrlFREE Full Text
  5. 5.↵
    1. Kmietowicz Z
    (2013) NHS 111 led to more ambulance dispatches, finds study. BMJ 347:f6811.
    OpenUrlFREE Full Text
Back to top
Previous ArticleNext Article

In this issue

British Journal of General Practice: 64 (618)
British Journal of General Practice
Vol. 64, Issue 618
January 2014
  • Table of Contents
  • Index by author
Download PDF
Download PowerPoint
Article Alerts
Or,
sign in or create an account with your email address
Email Article

Thank you for recommending British Journal of General Practice.

NOTE: We only request your email address so that the person to whom you are recommending the page knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Self-service
(Your Name) has forwarded a page to you from British Journal of General Practice
(Your Name) thought you would like to see this page from British Journal of General Practice.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Self-service
Saul Miller
British Journal of General Practice 2014; 64 (618): 43. DOI: 10.3399/bjgp14X676564

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Self-service
Saul Miller
British Journal of General Practice 2014; 64 (618): 43. DOI: 10.3399/bjgp14X676564
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Mendeley logo Mendeley

Jump to section

  • Top
  • Article
    • REFERENCES
  • Figures & Data
  • Info
  • eLetters
  • PDF

More in this TOC Section

  • Books: A Layman’s Guide to Psychiatry and Psychoanalysis
  • Can compassion help cure health-related disorders?
  • Nature works: why don’t we? How living systems can inform the design of effective primary care
Show more Out of Hours

Related Articles

Cited By...

Intended for Healthcare Professionals

BJGP Life

BJGP Open

 

@BJGPjournal's Likes on Twitter

 
 

British Journal of General Practice

NAVIGATE

  • Home
  • Current Issue
  • All Issues
  • Online First
  • Authors & reviewers

RCGP

  • BJGP for RCGP members
  • BJGP Open
  • RCGP eLearning
  • InnovAiT Journal
  • Jobs and careers

MY ACCOUNT

  • RCGP members' login
  • Subscriber login
  • Activate subscription
  • Terms and conditions

NEWS AND UPDATES

  • About BJGP
  • Alerts
  • RSS feeds
  • Facebook
  • Twitter

AUTHORS & REVIEWERS

  • Submit an article
  • Writing for BJGP: research
  • Writing for BJGP: other sections
  • BJGP editorial process & policies
  • BJGP ethical guidelines
  • Peer review for BJGP

CUSTOMER SERVICES

  • Advertising
  • Contact subscription agent
  • Copyright
  • Librarian information

CONTRIBUTE

  • BJGP Life
  • eLetters
  • Feedback

CONTACT US

BJGP Journal Office
RCGP
30 Euston Square
London NW1 2FB
Tel: +44 (0)20 3188 7400
Email: journal@rcgp.org.uk

British Journal of General Practice is an editorially-independent publication of the Royal College of General Practitioners
© 2023 British Journal of General Practice

Print ISSN: 0960-1643
Online ISSN: 1478-5242