Being fairly ancient, I recall the "Birmingham 13", 13 GP's who refused to join the NHS at its inception fearing both the loss of the direct link to their own patients, the interference of government and the loss of autonomy. It is a shame that they are probably all dead and cannot see how right they were all those years ago.
Our current crop of GPs have got themselves into a fine mess. What businessman in his right mind, invests thousands in premises and hires staff to service just one customer. This is a business model that would be laughed at by the Dragon's Den.
Remember too, that these are the same GPs who refused to back the Junior Doctors when they were in trouble.
I have no sympathy for any of them. The service they provide to patients who have to wait weeks to get an appointment is awful. Our ability to catch cancer as early as our European counterparts is embarrassing. And now they are moaning about a situation that they have allowed to develop.
What a mess we have made of our profession. Nobody comes out of this with any credit.
Pregabalin ought to be a controlled drug. So very many of my patients, ( I work in substance abuse), are hooked on Pregabalin. One growns in despair at the stuff GPs seem to be handing out like smarties. In addition to the crack, heroin and cannabis that my patients buy off the street are all the goodies that the GPs throw at them therby adding to the medical and social problems; the pregabalin, the Zopiclone, the Diazepam. The list seems inexhaustible.
The great flaw of the independent contractor model is that you put vast amounts of money into a business that has but one customer. Try running that business proposal past the Dragons' Den team and just watch as they all declare that they are "Out"!
The NHS is not sustainable in its present format. It is going broke. The only question is, how many of us will it take with it.
Am I alone in believing that the BMA is not fit for purpose. They signally failed to win for GPs, they failed even to support the Junior Doctors and now it is the turn of the Consultants to get pasted.
This continued fracture of our profession serves neither GPs, Juniors or Consultants. The cowardice shown by the BMA leadership merely cements our profession's misery for the future.
The whole point of any industrial action is to "hurt" the employer. Lincolnshire LMC won't take industrial action "because of patient safety ". Twaddle. How will refusong to do ECGs or 24 hr blood pressure monitoring help patient safety. No, they won't resign because it will cost them money. These highly intelligent people have invested all in businesses that service just one customer, the NHS. Imagine the gwarfs of derision that would face any applicant in "The Dragons Den" were they to ask the "Dragons" for cash toward a business proposal that had one single customer. That customer is playing hard ball. It is too late for these GPs. Their business model was insafe fr the outset. Their only course of action now is to resign enmass and form a direct commercial relationship with their patients. Then, perhaps, we will get a system of General Practice that is responsive to patient demand and lead by doctors rather than Civil Servants.
It is this unrealistic demand for more and more of the nation's wealth, with no consideration for looking to where savings could be made, that give our profession a bad name. Of course it is good politics in support of a more left wing "Corbinista" government, but we are years away from a general election and we have no business playing party politics as the Junior Doctors have discovered.
How about offering 5 ways to reduce expenditure so we can do some core work well?
1. How about saving a quarter of the NHS budget by accepting people make mistakes and things don't always go to plan and limiting compensation to cases where doctors have acted maliciously.
2. What about accepting that prolonging life of the body when the mind has long ceased to exist is both cruel and huge expense. Approaching old age fillse with fear, not because of death, but because theedical profession, (and I do not hold myself blameless in this), will keep me alive long after life has ceased to be a pleasure.
3. How about using Brexit to get rid of the Specialist List and so allow easy transition from hospital medicine to General Practice. How about accepting that GPs are NOT Consultants working in the community. It is all very well wanting to offer a Rolls Royce service but how about being realistic and accepting we only have the finances to run a Ford Fiesta? How about, just for once, we put our country and our patients above our desire to be "consultants?
4. How about we get tid of uneccassary bureaucracy that diminishes our productivity? Get rid of CQC, NICE, CCGs, and the rest. Lets get rid of QofS and QUALs that cause a practice to offer cervical smears to the local convent in order to meet a target.
5. Let us acknowledge that the introduction of the computer into tje consultation has halved productivity. Before computers, average consultation times were 6 to 7 minutes. Now we run at about 14 minutes.
GPs have benefited enormously from the new contract introduced under Tony Blair's government. Now we are reaping the rewards as it proves impossibly expensive to maintain a system WE created.
I am one of those doctors to whom Prof. Clare refers.
I fully completed the post graduate training for General Practice but entered prison medicine. Ended up as the Senior Medical Officer for an HMP. Took a career break following illness but found, upon my return, that I was not considered suitable for General Practice. I was told that my experience as a prison doctor didn't count towards GP.
The GMC said that they would be delighted to place me on their GP List once I had undergone retraining. Health Education England said that they would be delighted to retrain me, but only after I was on the GMC's GP List.
The only other route is to go back to being an FY1. I am 61 y/o.
When I was a medical student, there were two GPs who helped me train. One had been a Surgeon and the other a Pathologist. Neither required 3 year's retraining, yet both were hoghly successful GPs.
Now the British population has been given the worst of all worlds, no access to a GP. When you can't afford a Rolls Royce, wouldn't it be better to make do with a Ford rather than nothing at all.
Mr Hunt has got the measure of the BMA and the medical profession. He knows we might whinge but we haven't got the guts or the motivation to do anything. We have really failed ourselves and our patients. End of story.
Need something more assertive.
And where is the BMA and the medical profession in all of this? Muddling through with genial incompetence is just not good enough. If the NJS is to ne saved, it is going to take more focused and enthusiastic leadership than the BMA has shown.
I would be interested to hear from colleagues how many of them find a computer in the consultation room a useful adjunct to a consultation and how many feel it is an intrusion which gets in the way of an empathetic dialogue with the patient and reduces productivity.
I ask because, being somewhat ancient, I recall happier times before computers when we could give the patient our full attention. I was particularly aware of this as I was a GP Trainee at the time and I and my fellow trainees were videotaping our consultations. I recall our regional trainer's video of himself when he had newly acquired a computer. His consultation time rose to 15 minutes and his eye contact time with the patient dropped to three minutes. I suspect. from my own visits to the GP, that matters have not improved.
I also note that consultation times have escalated from 7 to 14 minutes.
We are also distracted by the instructions given to us by this equipment which now tells us what to do in the consultation. So, the patient with the cancerous looking mole or suspicious lump discovers that we are intensely interested in his Blood Pressure and Cholesterol Level!
Any ideas how we drifted into this mess?
If this scheme requires "leadership", then you are on a hiding to nothing. The BMA is devoid of such qualities. If they did have leadership and vision, they would mobilise the entire profession and sort out all problems in one go instead of allowing the govt to attack first the Juniors, then the Consultants and then the GPs. After all, Juniors will one day enjoy the attentions of the CQC et al. Jeremy Hunts avowed intention is to privatise the NHS. (He has written a book outlining his vision). What better way to achieve his ends than to gently push out the doctors until, like the Dentists, they all decide to leave of their own accord. The BMA lacks the vision to see this. Meanwhile, we are stretched thinner and thinner and when mistakes occur our MDO premiums sky rocket. We need a BMA that sees the overall picture and has the guts to do what is necessary to save the NHS.
I worry that the BMA and indeed the medical profession have not got the skills to take on an experienced politian like Jeremy Hunt.
Remember that Mr. Hunt's stated onjective is the privatisation of the NHS. What better way to accomplish this end than by blaming the doctors?
The BMA leadership has shown it hasn't got the stomach for this fight when it failed to go through with its threat of an all out strike after the initial two half hearted attempts at the ber start of this dispute. That is when Jeremy Hunt knew he had won.
Next I worry that we are not a united profession. GPs, Consultants and Juniors are all fighting their own battles with no coordination, and yet don't we all have a common purpose?
This fight is already lost and yet so much could have been won had we had courageous leadership at the BMA. Are we ALL happy with the GMC, CQC and Indemnity costs and blame culture. No we are not. And yet the BMA contests each of these and other problems individually and without coordination.
A short, (2/52), all out strike would have removed Hunt and sorted out all these troubles and preserved the NHS.
What a shame we have such spineless leadership.
I am helping a pharmacist to become a prescriber in her own right. I work with nurse prescribers. All of which takes pressure off the clinics.
Why not go further and employ junior doctors to run clinics?
By splitting ourselves into seperate groups, (GPs,Consultants and Juniors) and refusing to support one another, Jeremy Hunt has us beat. He knew he had beaten the Juniors when the BMA flinched the first time they were due to implement a full strike. Having won that battle, the GPs will be a push over.
Please stop griping until you really want to win.
We have a GMC taking more and more power to itself and decimating medical education in the process. It actively encourages complaints that leave us all stressed and vulnerable. It has given us the absolute nonsense of revalidation and still all we do is gripe.
We have the CQC veing an infernal and costly nuissance and all we do is gripe.
The Juniors look to a return to the silly and dangerous practices of my youth, and all we do is gripe.
The Consultant contract has changed and we do nothing.
It is getting embarrassing not to mention lonely as more of our best colleagues leave this mess that we refuse to sort out.
Could you imagine any other trade union accepting such body blows with the dithering, ineffectual response the BMA has shown. I really do ask, whose side are they on.
In short, we need to acknowledge the damage being done to our profession and act in unison. But please stop this griping. Put up or shut up.
Only if we allow it! We accepted all these evils. We accepted CQC.We embrace QOFs and QUALYs just as we accepted working silly hours as juniors. We accepted the GMC taking control of training. As a profession, we have about as much backbone as seaweed in the tide. If we supported a more robust leadership in the BMA we could have all this sorted within 6/12. But we will continue to accept ever increasing costs and impositions while those that can, leave for happier climes. What kind of leadership is that?
The service was a waste of money to begin with. Diet and exercise do not work in the long term. I made the mistake of allowing a wretched Prof. of endocrinology to "cure" my hyperthyroidism. Following a dose of radioactive Iodine, my weight balooned to 24 stone. Hypertension and Type 2 DM followed despite diet and exercise. Couldn't lose any weight. Underwent a Mini-Gastric-Bypass in September 2014. Now only 14 stone, no diabetes and no hypertension. 45 minute operation and the NHS saves thousands and I live to pay even more tax. Oh well, every silver lining has a cloud!
Dr. Annesley is correct in saying that junior doctors are losing public support. The problem is that public support has not helped junior doctors one jot. Furthermore, the BMA's campaign could not have been better designed to lose public support or better guaranteed to fail. The junior doctors should have gone on all out strike from the start and this issue would have been sorted within a week or so. The junior doctors will indeed fail, not because of how the public might feel, but because they have been badly led by the BMA.
I think you are forgetting Jeremy Hunt's book. Just like Mein Kampf it illustrates his beliefs and intentions and just like MK, nobody believes he could be so crazy. He wants to privatise the NHS. This means breaking the medical profession by getting us to consider ourselves as individual groups, (GPs, Consultants, Junior Doctors etc.) rather than as a whole. His stratergy is working and, in fighting, (or in most cases acquiesing), our own little corners, we are playing straight into his hands. It is not ill treatment that is driving doctors abroad, it is lack of hope that our proffession has the political will to defend our profession. Spain is my exit statergy. The BMA leadership give me no confidence that they have the will to oppose this awful man and this awful burden of regulation, red tape and unrealistic expectations.
Stop pussy footing about. You said months ago that you would hold tw limited stikes followed by an all out strike. The BMA chickened out. You have no credibility left and you are back to "considering all options ". Jeremy Hunt knows you won't go on a all out strike. You have lost. Accept the new contract because the BMA won't let you go on strike.