The end of the NHS. (Read 194974 times)

Sloper · September 30, 2014, 04:57:43 pm

Quote from: Oldmanmatt on September 30, 2014, 03:46:27 pm

Quote from: GCW on September 30, 2014, 03:00:13 pm
Cameron tells GPs they must work weekends.

Er, how is this even vaguely possible within five years?????

Increasing the role of the Practice Nurse to include basic diagnosis?

As in "yes dear, you've got a cold dear" and " No dear, antibiotics won't help" or possibly even "No, dear, little Jaden won't have rabies because your Bull Terrier torn his face off"...

+ a simple advice sheet 'you're fat beause you eat too much and don't exercise' should cover a significant proportion of patients.

Perhaps if we started charging people for frivolous attendances say £100 (no charge if there's a real need) we might start allowing GPs to actually practice medicine again?

lagerstarfish · September 30, 2014, 06:11:51 pm

or see/speak to a triage nurse before being allowed near the GP to ask for some more benzos and a sick note?

webbo · September 30, 2014, 07:34:38 pm

I'm not sure how introducing lower grade practioners would work in a complaint averse NHS.
The number of complaints where we get a request for a patient to have a different nurse/ social worker because they are the wrong gender,they where the wrong shoes or part their hair on the wrong side seems to take up half my working week.

tomtom · September 30, 2014, 07:57:42 pm

Can someone explain in one reasonable length paragraph why 10 years ago I could see a GP within a couple of days (and I knew who they were) and now I get an appointment with 'my GP' (the new one allocated to me after the other one and the one before left) two weeks after calling? I'm not blaming anyone (especially Gp's) - it just seems like something that worked in fashion is now ferked...

Sloper · September 30, 2014, 08:17:20 pm

Quote from: tomtom on September 30, 2014, 07:57:42 pm

Can someone explain in one reasonable length paragraph why 10 years ago I could see a GP within a couple of days (and I knew who they were) and now I get an appointment with 'my GP' (the new one allocated to me after the other one and the one before left) two weeks after calling? I'm not blaming anyone (especially Gp's) - it just seems like something that worked in fashion is now ferked...

Hmmm the cynic would say the change to the GP contract and structures introduced by Labour, or is it more complex than that? GCW, answers please.

Webbo, time the NHC stopped dealing with every complaint as if they have a currency just because they're made, cf whistleblowing.

Oldmanmatt · September 30, 2014, 08:28:54 pm

Quote from: webbo on September 30, 2014, 07:34:38 pm

I'm not sure how introducing lower grade practioners would work in a complaint averse NHS.
The number of complaints where we get a request for a patient to have a different nurse/ social worker because they are the wrong gender,they where the wrong shoes or part their hair on the wrong side seems to take up half my working week.

I think " Suck it up Princess" as a standard reply should just about cover it...

webbo · September 30, 2014, 08:37:41 pm

Quote from: Sloper on September 30, 2014, 08:17:20 pm

Quote from: tomtom on September 30, 2014, 07:57:42 pm
Can someone explain in one reasonable length paragraph why 10 years ago I could see a GP within a couple of days (and I knew who they were) and now I get an appointment with 'my GP' (the new one allocated to me after the other one and the one before left) two weeks after calling? I'm not blaming anyone (especially Gp's) - it just seems like something that worked in fashion is now ferked...
Hmmm the cynic would say the change to the GP contract and structures introduced by Labour, or is it more complex than that? GCW, answers please.

Webbo, time the NHC stopped dealing with every complaint as if they have a currency just because they're made, cf whistleblowing.

If what you are saying is the NHS should stop believing every compliant has validity. I would love someone to implement this.
I have a current situation with a client with an extensive forensic history including robbery with violence,kidnapping, wounding and so on. Who complained because he turned up for an appointment at the wrong time and date due the appointment letter having a date and time that didn't match. He didn't bother to ring to say the letter did not make sense, before that was delt with. He then complained because he had not been allocated a female nurse because he can not trust men.
All this rather gets in the way of providing care for other patients and people wonder why there are waiting lists.

Sloper · September 30, 2014, 08:49:00 pm

Yes, that is exactly what I am saying, some complaints have inherent value, i.e. fluid balance charts not being completed, prescribed drugs not being administered, allegations of sexual misconduct, others as you say are horseshit and we should not spend millions investigating them as if they have some inherent currency.

When I was investigating allegations of serious misconduct against solicitors our fuckwit cvnt of a director decided that every lunatic who complained about a global masonic conspiracy and bent solicitors was to be taken as seriously as those cases where we had real concerns. Of course dealing with the fucking twats (and I include senior Law Society managers here too) meant that you actually didn't have any time to deal with the cases which needed proper investigation.

It drove to to the very edge and beyond until I resigned.

webbo · September 30, 2014, 09:05:02 pm

How I wish I was in a position to tell them to shove it.

GCW · October 01, 2014, 07:55:06 am

Quote from: tomtom on September 30, 2014, 07:57:42 pm

Can someone explain in one reasonable length paragraph why 10 years ago I could see a GP within a couple of days (and I knew who they were) and now I get an appointment with 'my GP' (the new one allocated to me after the other one and the one before left) two weeks after calling? I'm not blaming anyone (especially Gp's) - it just seems like something that worked in fashion is now ferked...

The contract changed so that workload tripled. The financing dropped exponentially.

Sloper · October 01, 2014, 08:08:08 am

When was this? The last significant change in GP contracts I can recall (from general reportage) was in 2004.

GCW · October 01, 2014, 10:11:06 am

2004 and 2014.

Sloper · October 01, 2014, 11:42:17 am

What's the deal with the 2014 contract?

<inference being that the inability to get an appointment <2014 is a consequence of the 2004 contract>

rich d · October 01, 2014, 11:56:46 am

To get referred to a physio I had to go see my GP first. Total waste of an appointment as far as I could see.

[/quote]
The contract changed so that workload tripled. The financing dropped exponentially.
[/quote] why did the workload triple? Is it different Px expectations, more Pxs, more health issues etc or a reduction in number of GPs?

GCW · October 01, 2014, 03:13:22 pm

That was my point a while ago about it being back to front.

Yes, patient load and demand has increased significantly. But there has been an enormous increase in the non patient contact workload- hospitals asking us to do a lot of their work for them, paperwork etc etc.

GCW · October 02, 2014, 03:07:02 pm

Jeremy Hunt admits there is a lack of GPs to cover the current workload.
Trainee GPs are to be forced to stay in the uk once qualified.

Bound to help recruitment and allow 7 day cover, eh?

GCW · October 02, 2014, 03:12:29 pm

Peverley sums up the general mood.

Jaspersharpe · October 02, 2014, 03:58:42 pm

Fucking unbelievable. The tax thing is presumably because the practice has to be run as a partnership which is the worst way to run a business (and one I always advise clients to avoid).

You're getting fucked from every side.

Sloper · October 02, 2014, 04:08:42 pm

What's preventing them from being a LLP or even a Ltd Co?

As for requiring trainee GP's to stay in the country, not good, they should be free to leave, but if they want to leave they have to repay the costs of their training not met by tuition fees.

My view is that we're going to see fewer patients being seen by a real doctor, which from what GCW says as to the fuckwits he deals with, isn't actually a bad solution.

GCW · October 02, 2014, 04:40:58 pm

Quote from: Jaspersharpe on October 02, 2014, 03:58:42 pm

Fucking unbelievable. The tax thing is presumably because the practice has to be run as a partnership which is the worst way to run a business.

Yes, but at present there isn't an alternative.... Unless a private company starts taking over practices and re employs us as salaried GPs who purely do the legwork.

GCW · October 02, 2014, 04:43:49 pm

Quote from: Sloper

As for requiring trainee GP's to stay in the country, not good, they should be free to leave, but if they want to leave they have to repay the costs of their training not met by tuition fees.

UK doctors pretty much pay their fees, as far as I know. Plus they will have had to work for 6 years in the uk to finish GP training. Then they will be forced (not sure how??) to stay longer.

Everything is just making GP less attractive. It's all going to implode soon. Secondary care cannot work without GPs as gatekeepers. Maybe that's the plan?

GCW · October 02, 2014, 04:52:22 pm

Quote from: Sloper on October 02, 2014, 04:08:42 pm

What's preventing them from being a LLP or even a Ltd Co?

There are quite strict rules on this. You'd need to get NHS England to agree a new contract. Effectively, you pretty much can't.

tomtom · October 02, 2014, 06:28:21 pm

Thanks for the answers GCW. Sounds like you're getting shafted from all sides

Quote from: GCW on October 02, 2014, 04:43:49 pm

Quote from: Sloper
As for requiring trainee GP's to stay in the country, not good, they should be free to leave, but if they want to leave they have to repay the costs of their training not met by tuition fees.

UK doctors pretty much pay their fees, as far as I know. Plus they will have had to work for 6 years in the uk to finish GP training. Then they will be forced (not sure how??) to stay longer.

Medical degrees cost c.25k per year per student to run... (According to the internal figures I've seen) The govt still pays the shortfall between their 9k contribution and the main cost...

GCW · October 02, 2014, 06:57:44 pm

Fair enough. Although they will pay their tax.

The main thing is the fact it will put people off.

Sloper · October 02, 2014, 07:55:50 pm

Not if they fuck off to Australia they won't.

How could the NHS stop a partnership assigning the rights under a contract to a LLP / Company? The contractual rights are property of the partnership and I would be surprised if they could not be transferred, after all a retiring / dead partner cannot be a new event.

Ohh and if salaried doctors earn more than partners then their salaries are too high, sorry but a partnership is a business and if it isn't worth the candle then it needs to change or close.

If that sounds brutal, that's the real world, sorry.