Spent all day chairing a conference about primary care.It was mostly about the role of nurses, and was a lot of fun.
I get home to read that we will be expected to take back out-of-hours care with effect from next April. This seems to me to be a very rushed timetable, and I expect that is because out-of-hours being run by the private sector and "supervised" by the authorities has proved to be an unmitigated disaster.
This disaster need never have happened if we hadn't had to put up with an imposed new contract that was forced on a profession that was scarcely consulted with.
No, the out-of-hours imbroglio has its roots firmly in the hubristic arrogance of Tony Blair and his "Special advisers".
So they are turning to GPs to help them sort out their mess. And what a mess it has turned out to be. In the past, we used to cover all of our out-of-hours ourselves. This was when we were able to self-regulate as a profession and were treated like a profession. But GPs over the last 6 years have been bombarded by a series of Government inspired stories that were designed to undermine and denigrate a vital part of the workforce. We have been attacked and undermined at every turn.
Now, all of a sudden, the Government wants to hand it back. Maybe it was too hot a potato, but they were warned that moving it to profit-making organisations would cause problems.
I'm not really inclined to co-operate that much. Working with the Department of Health means that you need to sup with a long spoon. I don't trust them, and really don't much like them either. My trust will need to be earned.
The more we think about the latest White Paper, the more we are sceptical. The internal market needs to be abolished, and we can return to good old service of the public, not the shareholders.
There is precious little criticism of the latest nonsense from rank and file doctors. Where are they?
This whole problem has come from the so-called "special advisers" who have been brought in to fragment and privatise the NHS by stealth. They are well into their 10 year plan. I would like to see the "special advisers" quietly pensioned off, before they do any more harm, and allow decent civil servants to do their jobs properly.
Joke:
"What do you call a boatload of Special Advisers sunk at the bottom of the ocean?"
"A good start".
26 comments:
I think on the hospital side we are quiet because most of the white paper relates to general practice..
One thing seems obvious. If you are going to do your present work, and go back to out of hours, and involve in commissioning, you are going to need a considerable increase in numbers. How is this going to be achieved while maintaining quality?
Yet, it is a clever distraction as people were misled into thinking it was about GPs and the rest would be fine. As with most organisations, reward failures. When Private firms failed the OOH, let them run the hospitals.
But as Doctor Zorro have talked about in two blogs about consultants, many of them driving to their BMI hospitals in their Porsches cannot wait for the day when they are totally private.
For Child Psychiatry, can these places cope with the ever increasing number of Anorexia Nervosa? I cannot bear to think what will happen.
Did you vote NO for the new contract all those years ago?
Yes, I voted No.
I clicked on you in my favourites list on the off-chance, and you were there! I've just caught up with all you've written since your hiccup :-) Glad you're back. Love the bookshelves.
"that moving it to profit-making organisations would cause problems"
But your practice is a profit-making organisation. So what is wrong with profit? You couldn't run it at a loss.
JD
If we achieve nothing other than getting those evil folk in Coventry PCT out of the loop that will be a success
Frankly if I was running the country I would put everyone on Coventry PCT payroll up against the wall and shoot the lot of them
Moving onto the queues round the blocks in the filth and dirt of Orsett hospital to see some of the worst excuses for eye consultants in the Western World, I sure hope the commissioning GPs get out and see how crap the service the patients get is, and ask independant eye consultants from the best of the rest of the world what they think of the shit care at Orsett
Moving onto the TOTAL NON TREATMENT of prostate cancer in Sunderland, doing fuck all but dishing out morphine when its too late is not what we employ medics to do, again top candidates for up against the wall
Moving onto the total lack of care available for severe painful conditions out of hours when there are no out of hours GPs and A & E is probably the wrong answer, get some proper doctor staffed drop minors clinics
Moving onto actually doing something when someone has potential skin cancer, like chopping if off like the rest of the Western World, not a fucking 2 year wait
Moving onto some provision of care for people who move address frequently, the current non care made available to anyone who chooses to move address more often than the NHS likes is not sustainable
Moving onto actually being able to see a GP
True power to the patients, let them take their spend elsewhere when they see crap care, let the poor providers close
Status quo is crap, give the patients the decisions
Dear No-one,
I didn't think you'd agree with me. I don't think I work in a cocoon of excellence, you are either unlucky or I've got impossibly tinted spectacles.
Sherwin,
This is true, but I am not in a big organisation and I make enough to have a decent lifestyle and I'm happy with that. If I was private I could earn a bomb.
JD.
JD
Like most GPs you dont see it from the patients point of view much
Funnily enough I wrote a long thankyou letter to the GP of a relative recently, doesnt mean I am impressed with the care dished out by the hospitals or wider nhs for that patient
So dont feel I dont dish out praise when its due
But kidding outselves that current day medical care in the UK is acceptable is laughable
Go look at the queues to see the eye consultants at Orsett and so on if you think I'm looking through shit coloured spectacles
Go talk to an independant eye consultant who has looked at the results of their care for their patients
Go talk to the hospice docs in Sunderland about the prostate cancer deaths they see
These things are not hard to do
Go look at the queues to see the eye consultants at Orsett and so on if you think I'm looking through shit coloured spectacles
Go talk to an independant eye consultant who has looked at the results of their care for their patients
Go talk to the hospice docs in Sunderland about the prostate cancer deaths they see
These things are not hard to do
Go look at the queues to see the eye consultants at Orsett and so on if you think I'm looking through shit coloured spectacles
Go talk to an independant eye consultant who has looked at the results of their care for their patients
Go talk to the hospice docs in Sunderland about the prostate cancer deaths they see
These things are not hard to do
Go look at the queues to see the eye consultants at Orsett and so on if you think I'm looking through shit coloured spectacles
Go talk to an independant eye consultant who has looked at the results of their care for their patients
Go talk to the hospice docs in Sunderland about the prostate cancer deaths they see
These things are not hard to do
ok, no one, we get the point - you're pissed off over opthalmologists and urologists in your patch
sorry about the duplicates bit of a tech problem
re "pissed off over opthalmologists and urologists in your patch" oh no im more upset than that and its not "my patch" its the whole country
Oh come on, do you take us all for fools?
If GPs really disagreed with the Labour Government's contract, they would have all gone on strike and protested in the streets.
The reality is that GPs knew they were onto a great deal (no OOH responsibility for a very tiny pay cut) and jumped at the chance.
You only have to read the posts on PULSE to see what GPs really think about the OOH deal.
It is surely noticeable to all but the thickest that the areas of private involvement in the NHS in the last decade have uniquely combined high costs and poor service: GP OOH, darzi centres, PFI, LIFT centres, DTC's, etc etc...
It's not that I am against private work, indeed I make a very good living out of it, it's more that I am appalled at the wasteful and incompetent way these private hyenas feast on the flesh of the dying corpse that is the NHS.
I sigh, and pop off in my Jag to little Harley street, where people who are frustrated by the above bring me their cash. Those without cash must rue the day they voted for the suck-ups to American health corps who have control of new Labour.
Still only a few more years before I retire, toodle pip!
You were right JD!
http://www.wgrz.com/news/local/story.aspx?storyid=79438&catid=37
Why did my 'name' come out like that? It's not what I typed!
Why did my 'name' come out like that? It's not what I typed!
Why did my 'name' come out like that? It's not what I typed!
You aren't doing that well, Phil yerboots, if you can only afford a Jag. Hope it's not one of the new Tata ones with the appalling tandoori-coloured seats and rosewood dash. Round our way the consultants drive Rollers and Bentleys.
Something is wrong JD, I only pressed the post comment button once and look what happened!
Don't ask me...I'm not a techie.
Dear anonymous,
I quite agree that modern Jags are not what they were, what is? But I do have a soft spot for them, having had Jags for years.
As my NHS salary has been frozen for a couple of years, and they have my pension in their sights, I think that driving a car costing more than £50 000 would be financially imprudent, perhaps even a little bit vulgar.
Working in the NHS has always been hectic, and pressured, but used to have considerable corps de esprit. Now it's just power mad managers with their Blackberrys, no fun at all.
Still I hold all aces, as do my other colleagues. Health care cannot run without me and my ilk. I have 30 years of expertise In my speciality, and there are only a few hundred of us in the country. MTAS and the EWTD has screwed training so much that my skllls are in increasing demand. You can go to the local DTC and be bodged by a Rumanian, with a CCT printed on bog paper, or come and see me. It's like I said, we jobbing consultants, like JD, hold all the aces!
Must dash, patients are queing up at little Harley st!
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