[fatdoc]

in this context.. though hard to reconcile.. i agree Sloper...

[GCW]

Teaching Assistants and Learning Mentors in education.

It isn't really comparable Andy. 5 years at Uni and then at least five years on the job training. If you look at previous experience, eg Nurse "Consultants", it becomes clear who ends up carrying the can.

[Andy B]

I wasn't meaning it was comparable, I was just giving another example of the erosion of a profession as Sloper had stated above my post. Unless of course you agree with Sloper that teaching isn't a profession.

[lagerstarfish]

it's more of a hobby where you get some of your expenses refunded, innit?

[Andy B]

I want my plywood back off you now.

[GCW]

Ah, I see. All fits with the conspiracy theory though.

[Sloper]

in this context.. though hard to reconcile.. i agree Sloper...

Any more of that and you'll be referred to a FTP hearing for re-education

I wouldn't be at all surprised if we start to see a bit of dog whistle politics about fat cat doctors and the outrage of a consultant surgeon with a merit award earning £120k + a private practice vs a health care assistant on £12.5k.

We say the introduction of PCSO's and the bollocks to count them as Police Officers, we've seen the assault on legal aid and the debauchment of the legal profession, medicine is perhaps the last bastion of professionalism for the fucktards (and I include the Tories in the appellation as well as Labour).

Still if representing yourself in a serious criminal matter is fine, how hard can it be to rely on Dr Google and a semi qualified tick box driven functionary?

My view remains the same, the NHS is a wonderful institution and certainly the least worst way of delivering healthcare, however it does need reform and it needs politicians to say it cannot grow in line with demand and it cannot do all things for all people all of the time (and quickly) for free at the point of service.

[GCW]

Your last sentence is the key. It can't remain a free service with unlimited access.

[petejh]

We say the introduction of PCSO's and the bollocks to count them as Police Officers, we've seen the assault on legal aid and the debauchment of the legal profession, medicine is perhaps the last bastion of professionalism for the fucktards (and I include the Tories in the appellation as well as Labour).

Still if representing yourself in a serious criminal matter is fine, how hard can it be to rely on Dr Google and a semi qualified tick box driven functionary?

Thing is, there are aspects of 'healthcare' that aren't dealt with very well by highly-qualified, expensively educated 'professionals'. Try going to your GP with non life-threatening but otherwise bloody disruptive musculoskeletal problems. Then go and see a semi-professional specialist. There's no doubting who's more useful, and there are plenty more examples in healthcare and other aspects of life where semi-professional people prove the most useful tool for the job. I honestly don't see a need for GP's in these cases, other than acting as continuity data filters. I do get the impression you're a little bit too far up your own arse regards the supposed worth of professionals in some areas of life.

Don't get me wrong, serious illness, disease, surgery etc. - I'd want the most highly-regarded professional there is. (edit) In your view do you regard nurses as professionals? Some of what they do makes what your colleagues in the legal profession get up to look like a load of trivial nonsense in comparison.

So if there are opportunities for semi-professionals to take the place of Doctors I'm not automatically against the idea. As always there'll be pitfalls and benefits. Avoid the former and milk the later.

[GCW]

I agree with a lot of that. Things like MSK issues should never come to see me until physio has been trialled first. The whole system is arse about face.

[mrjonathanr]

Sure. I very rarely see a doctor. I'm never out of the physio's.

The rub for me isn't the principle of specialisation.

It's who wants to introduce it. And to what end.

[Sloper]

I agree with a lot of that. Things like MSK issues should never come to see me until physio has been trialled first. The whole system is arse about face.

So as a doctor what % (roughly) of attendances on a doctor are a total waste of time?

MJR, you really need to grow up a bit if you think that Labour have an animus any different to the Tories in respect of the NHS, all recognise its flaws, everyone knows of the failures and there is a universal desire to make it work.

[GCW]

At least half of GP visits?  Dunno. I'll audit it this week.....

[mrjonathanr]

MJR, you really need to grow up a bit if you think that Labour have an animus any different to the Tories in respect of the NHS, all recognise its flaws, everyone knows of the failures and there is a universal desire to make it work.

 You assume without sound evidence.

 

[GCW]

No evidence, but probably true. Unfortunately.

[mrjonathanr]

You read that post as a defence of Labour? They have the same direction of travel, at a different pace.

[GCW]

Nope, as I've said before there is an underlying agenda. Doesn't matter who is in power, saying you have to pay for health is political suicide. Hence the plans to cause failure.

[mrjonathanr]

Nope....

I infer you think Labour would bring in private providers at exactly the same hurried pace as the current administration?

[GCW]

Hurried? Political changes resulting in private providers have been slowly implemented over the last 15 plus years. True, the Tories have been more aggressive in the rape of primary care, but it couldn't have been done without the foundations laid over the last number of administration changes. Infer whatever you like, but there is an agenda that isn't seen from outside.

I'm getting rather close to jacking it in and looking at doing something else, and I know I'm not alone. Primary Care is going to go bang in the next few years; 2015 if you believe some of the leaks.

[mrjonathanr]

I'm well aware that this has been slowly built up since at least 99 and probably back to the 80s if the information were there to corroborate it. Hurried refers to this administration. 

A shame you are feeling so disillusioned. if it were pay not principle you found inspiring, you'd be on the winning team, no?  Medicare is nearly here, surely?

[fatdoc]

You are both indeed traveling in the same direction. Once primary care fails.. Secondary care inevitablly will fall.

All caused by some very clever peeps over at least 15 years, for the system to be seen to fail, and politicians walks away... Like what we discussed earlier on in this thread.

It's a perfect, unstoppable, storm.

Unfortunately my retirement date is 14 years and six months away... ( earliest option )

Darn it... Be full shifts 7/7 ( we cover 7/7 but not fully shifted at present) in my 50s to look forward to. Now, I'm reasonably fit for my age... But I doubt I'll be able to Manage that in 10 years time... That will finally nail the coffin of the DGH... No one will want to work there, and the aging workforce will either get out as soon as they can... Or keel over.

Happy days, finishing annual 2 weeks summer family holiday tonight... Into a full week, full weekend, then full week. Deep joy... A few hundred mainly useless emails await, to be read after the all day clinical work. No doubt detailing loss of acticvity, targets missed, lack of achievement in cost improvement and increase in overspend. Sooo relieved I stepped out of trust level medical management, nearly killed me. Unfortunately that experience has given me the insight to see a really rather good healthcare system been set to explode. Such a waste....

[GCW]

A shame you are feeling so disillusioned. if it were pay not principle you found inspiring, you'd be on the winning team, no?  Medicare is nearly here, surely?

Pay not principle? You really have no idea, do you?

I'm sick of secondary care dumping on us. I get twenty letters a day from the hospital saying please give antibiotics for a sample I sent when I could do it myself, please repeat blood tests when I could do it myself, please refer to my colleague when I could do it myself etc. I'm sick of people coming in to get paracetamol on prescription just because they are on benefits and get free prescriptions. I'm sick of people coming in for a month's sick note because they hate their job/ life/ wife.

Don't start on the principle crap, I've worked my ass off in extra roles like the LMC and CCG just to get screwed over again and again, whilst the media pedals the rich GP shit you've clearly swallowed.

Yeah, I'll be far happier in France running a gite than earning whatever I am now and listening to people that have no clue (not aimed at you, just all the other parties that slag us off) moan about the crap service.

Last week I had someone that had gone book an appointment to get re-referred on the nhs because the cost of a hip replacement was "ridiculous". Err, that's how much it costs the nhs, it's just that you don't pay directly.

Go on, keep bashing us lot that do all the work until we all give up our shit salaries and worse pensions and you're left with nothing. Then there will be no way back and you'll have burned you're bridges for "pay not principle".

[mrjonathanr]

Don't start on the principle crap, I've worked my ass off in extra roles like the LMC and CCG just to get screwed over again and again, whilst the media pedals the rich GP shit you've clearly swallowed.

Woah .......  Can you really not follow the meaning of the post...? You're misconstruing or misunderstanding  the meaning, that to be motivated primarily financially rather than for other sources of job satisfaction, would position you better to enjoy a career in an increasingly privatised system.

Go on, keep bashing us lot that do all the work until we all give up our shit salaries and worse pensions and you're left with nothing. Then there will be no way back and you'll have burned you're bridges for "pay not principle".

I said -and implied- nothing of the sort   

You're criticising  the antithesis of what I wrote..... Why be hostile to a post which is sympathetic to your position?

(edit: last comment added)

[GCW]

Ok, the pay not principle bit was evidently misinterpreted. I took it to mean that I valued pay over principle, based on

if it were pay not principle you found inspiring, you'd be on the winning team, no?

.

Anyway, it's all rather academic as it's gone too far now for any repair job.

I'm sorry if I'm hostile, but the perpetual negativity gets rather tiresome.  Last few weeks, we've had GPs are rubbish because they don't diagnose cancer and don't refer enough. Next day, GPs are rubbish because they refer too much to the hospital. I could carry on, but what's the point?

[mrjonathanr]

I'll take some blame for the wording...it's easy to misread..