More nonsense. GP practices with small uneconomic lists of patients are liable to close because the income is unsuitable for replacement GPs to apply for these practices when vacancies occur. It would be better if the Commissioner offered large practices money for an additional partner to share work at the main surgery and to staff the small branch surgery. Offering the larger practice nice up to date premises for the branch practice would help. the Board are talking a lot of flannel about providing high quality care. It cannot be provided without investment.
I would not trust the CQC. I read some years ago of a Cardiologist at a Midlands Hospital who had 5 beds of which only 4 were equipped for cardiac emergencies and he complained to his Hospital managers who did nothing. So he reported the problem to the CQC which simply referred his complaint back to his Hospital managers. After this, the cardiologist's good name was publicly rubbished by the managers so he had to leave and it was only the Employment Tribunal which behaved correctly by finding that instead of putting right the problem the cardiologist had pointed out to the Hospital Management they had instead damaged his good reputation and the Tribunal awarded him substantial damages against the Hospital. If the CQC had done their job properly and investigated the complaint and found correctly that anyone in the fifth bed might die if in emergency cardiac failure, the problem could have been put right with the cardiologist keeping his job. So I would not trust the CQC one inch. They ought to be ABOLISHED!
Well you cannot win both ways can you? Marked up for one thing and down for another.
I do wish more incentives were offered. I have seen GP practices closed down because NHS England so incompetently offered local larger practices no incentives to take on smaller branch surgery premises. NHS E ought to have offered money for taking on an additional partner and found nicer premises for the branch practices. This has happened in North Brighton in isolated pockets of
population with small blocks of older housing developments where NHSE thought it would work if they contracted the branches to a private healthcare firm but this firm was obviously no better than any NHS GP would be at making a decent living out of small lists of patients and so backed out at a suitably opportunity leaving these generally low income patients without cars with no local access to a GPs and no transport to get further afield to another GP. This stands as a very strong argument for getting rid of commissioners altogether and using the money on recruiting more doctors and nurses, shortening waiting times, improving premises and accommodation and improving the care of the patients.
Mess is the correct word. Severe underfunding of the NHS and the competition imposed upon it are drivers toward bankruptcy instead of profit. Mr Blair (for all his Iraq War faults) increased NHS funding to equal the EU average healthcare funding level and so radically reduced the waiting times for hospital appointments and operations. But the Tory led Coalition and now the Tory Government have reduced NHS funding to way below the level of all nearby EU countries. This has starved the NHS of GP trainees and Hospital staff. It is not clear why the Government has done this. It is true that the crashed banks in 2007 absorbed more than £1261bn of public money for recapitalisation and quantitative easing to get them barely into a position to lend credit again. But this was the Banks' fault for having lent our nation's wealth to people all over the world with no prospect of repayment. But we remain the sixth richest country in the World and therefore I suspected that the Austerity Programme is ideological rather than fiscal. Therefore we must all holler at the Government that it has to fund the NHS properly. It is after all paid for and therefore 'owned' by our taxpayers. It would help the fiscal situation if all earnings and profits made in the UK were properly taxed.
I think that if the GP knows the patient has died and knows the cause of death then it is reasonable to issues a death certificate. If the GP does not know the patient has died and the cause of death, then it would be improper to issue a death certificate. This job must be performed by the Coroner's Office to establish the cause of death so they can record the cause. Some causes of death are often obvious (killed in battle, traffic accidents, fire etc) but consider our friend's partner in Brighton found dead but looking quite happy, on the bedroom floor. It took time and post mortem examination to find out what had killed this 50 year old, and the cause was an occluded coronary artery which was unexpected because, although he loved food, he had been a teacher and a ballroom dancer, always on his feet. May he rest in peace.
To Vinci Ho I reply that the banking sector has absorbed more than £1,261 billion of public money first to bail them out and second to help them lend which they don't much even after all this help, and especially after their having lent the nation's wealth to people the world over with no prospect of repayment. Our Banks are not profit machines but debt machines. I am now retired. So I can take up arms, figuratively speaking, against the the commissioners whom I regard as clinically and commercially incompetent, and what the Secretaries of State have done, by severely underfunding the NHS and imposing competition on it, is to create a health market which drives towards bankruptcy instead of profit. We are the sixth richest nation in the World and we need to ask ourselves whether this is the best way to run our taxpayer funded NHS.
Being a chap of a retiring nature of course I don't trouble my GP unless I have to. The Pharmacist told me the GP wanted to see me about a blood test so I phoned to make an appointment but the receptionist fobbed me off telling me the GP would phone me which he hasn't. So I am paying a private firm to do the blood test and will send my GP the results, politely of course. If he (in a very large group practice) is inundated with patients wanting things they can't have, he should tell them. There is a burgeoning complementary health sector and people of no faith in orthodox medicine with its carefully conducted trials can go to this complementary sector of course and we do know that the placebo effect does sometimes work. Perhaps there should be a notice on the GPs' door saying what they do and don't provide. I have been an official friend to GPs and then consultants for most of my working life, now passed, so I am not unsympathetic to their situation.
This report links to a report about patients forging their own sick notes. Since having a sick not does not appear to make any difference to the DHSS now it has abandoned using doctors to assess claims for sickness benefit and is using unqualified staff to assess ability to work who can obviously make more mistakes than doctors can, I would suggest that it is either waste of time writing sick notes or that the patient should write their own because the DHSS do not appear to appreciate the difference between the genuine and the forged so why bother?
I should have thought that if a doctor did his or her best for a patient with up to date clinical evidence and guidelines, they should not be prosecuted. If it is not clear then a hearing may clear up the doubt. If the doctor wanted to injure or kill someone then intent would have to be proved. It is rare for a doctor to be prosecuted. I have read of doctors having to drive sick patients to Hospital because the ambulance service forecast it would get there too slowly (due to financial cuts). Failure to visit may be solved by taking sufficient details from the patient or relative and being experienced in assessing urgency. I am sure if the doctor had to do an urgent visit, the waiting patients at the surgery would understand the wait. The doctor has the choice of an urgent visit or calling the ambulance if it can get there faster than the doctor. Ambulances are currently having to be waited for, for longer periods than used to be the case, due to the Government's severe underfunding of the NHS. Try not to get caught by the failure of the Government to fund the NHS properly. I know it is not easy.
Long ago in the 1970s, I knew an Islington GP who had a habit of visiting his at risk patients weekly and so he did not get called out by them at night. He said his younger partners did not copy his habit and were always being called out at night. There is some merit to this habit. But the reason why currently A&E are feeling flooded by emergencies is the severe underfunding of the NHS by this Government which has robbed A&E and all other parts of the NHS of staff. The Government wastes 15% of the NHS budget on the administration costs of the expensive, wasteful and disastrous commissioning system and this money would be better spent on recruiting and training more doctors and nurses, shortening waiting times and improving patient care. Tony Blair increased NHS funding to the EU average healthcare level of funding and got waiting times radically shortened but this Government has reduced NHS funding to the bottom rung of the EU league table, below that of other nearby EU countries. That is why there is so much stress in the NHS at present coupled with rocketing waiting times.
We already pay for the NHS through our taxation but this disgusting Government is underfunding the NHS so that while Tony Blair got NHS funding equal to the EU health care average funding, this Government has so underfunded the NHS that we are now at the very bottom of the EU healthcare funding league table. Instead of threatening to go private as is understandable, please join the campaigns to restore the NHS to a properly funded public service. There is a nationwide Labour Party Event on 26 November which will have stalls all over the place supporting the aim of a properly funded public NHS. Please join these stall or at least visit them and show your support. NHS commissioning has increased the administration charge on the NHS budget by over 200% (from 5% to 15% +) and this money would be better spent on recruiting and training more doctors and nurses, shortening this Government's increasing waiting times and improving the care of the patients.
So has public engagement been left out. Our local West Sussex commissioners' public engagement is not ready because they have only just stated discussing it. They may start discussing it today.
I am rather concerned that if local hospital departments or whole hospitals are closed down, whether the GPs will get more A&E and Maternity demands to deal with in their surgeries. I know they will be prepared but what is more important is the time taken to deal with these additional demands and will they be paid for this extra work?
I read about a cardiologist in West Midlands whose NHS Trust insisted on having 4 cardiology beds with only three of them equipped with the necessary cardiology equipment. He complained first to his Trust which did nothing and then to the CQC who simply referred his complaint back to his Trust. He then suffered great abuse and bullying with insulting announcements against him and his relief came from the Employment Tribunal which ruled that instead of following his specialist advice that all 4 beds should be equipped and that patients in the unequipped 4th bed were at great risk of death, the Trust instead set about threatening the cardiologist and blackening the cardiologist's good name and so the Tribunal ordered the Trust to pay substantial compensation to the cardiologist. I therefore count the CQC as grossly clinically and procedurally incompetent and it should be SACKED.
What makes a GP Practice vulnerable please? Is it isolation or is it a list of patients not large enough to provide a decent living? NHS England I find grossly incompetent because it has closed down a whole tranche of small GP practices in isolated pockets of population in North Brighton. NHS England asked local group practices whether they would be willing to take on these smaller practices as branch practices but got not interest from these group practices and you cannot do things like this. To persuade a group practice to take on a branch practice, you need to offer money for an additional partner to share between branch and group practices, and decent up-to-date premises. Going empty handed will get one nothing and NHS England should be sacked for its sheer incompetence.
This news about NHS cuts was on the Guardian Front Page two days ago on Saturday 19 11 2106.
This contradicts NHS England's Sustainability and Transformation Plan (STP) which many fear would close down local A&E and Maternity Units (both receive urgent and emergency patients) when speed to the A&E or Maternity Unit is of the essence. I was held up for an hour on a main road here in Worthing because of a traffic accident attended by three ambulances, four Police Cars and two Fire Engines many of which we had to let through by driving up onto the kerb. When we were allowed to proceed, it was clear that the roof of a burned car had had to be cut off to free the injured passengers. That is why we need nearby A&E and Maternity Units and if the STP causes deaths or increased morbidity by delaying getting accident and emergency patients to Hospital, the politicians who authored or introduced this STP will in future be unelectable. This note is a WARNING to them. Ambulance services obviously require to be adequately served with vehicles and adequately staffed. The last Labour Government increased the funding to the NHS to near the EU average per capita funding and reduced Hospital waiting times down from 1-2 years to 2-4 weeks but this Government had reduced NHS funding so that its per capita funding is now at the bottom of the EU per capita league table which is again increasing waiting times and the time it takes to reach hospital. The Government's Austerity Programme is misdirected because the Pubic Sector did not cause the Public Deficit: the Banks did. I vote that the Banks should share the cost of deficit reduction since they caused the deficit, and we should follow Bank on Dave's advice to establish local banks offering 5% to investors and charging 7% interest to borrowers such as local businesses and giving the profits charity in order to undercut the main Banks whose reckless and criminal misconduct with their investors' money practically bankrupted their banks. They ought to have lost their banking licences.
The people of our nation are awarded by our illustrious Government the lowest per capita health spending amongst our close European neighbours, and thus is why the supply of new GPs is drying up in this previously noble self recruiting profession. The latest threat is the NHS England's Sustainability and Transformation Plan which may close down A&E, Maternity or even your whole Hospital. A&E and Maternity are the very last things I would close down because they deal with the unexpected accidents, trauma, and emergencies of the type of which these departments are used.
Why do some people suffer from urinary tract infections? Would drinking plenty of water wash out the potential infection causing bacteria? Or is it too dangerous and requiring antibiotics?
I have just been reading about antibiotic resistance. It blames patients for asking their GPs for them, for colds, coughs and influenza which are most commonly of viral origin. I have never been given antibiotics for these infections but only for bodily interior infections cause by accidental injuries. I want to know what the effect of including antibiotics in farm cattle feed has had in generating antibiotic resistance because then it could get into the human food chain? I would suggest becoming vegan to evade this potential source of resistance. When we walked to the farm or factory it probably did not matter what we ate but, if we now drive to a sedentary job, it very much does matter what we eat and, as we need to reduce our consumption of refined carbohydrates, sugars and animal fats to ward off diabetes type 2 and obesity, a vegan diet seems doubly sensible. Debate, please.