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Gold, incentives and meh

Realist

  • Cannabis debate leaves GPs facing a prescribing conundrum

    Realist's comment 23 Aug 2018 1:48pm

    Umm...what is wrong with simply looking at a reliable source like Cochrane and drawing your own evidence based conclusions? If there is no evidence for the thing you are looking for there is no evidence to justify a prescription. Cannabis is no different from any other of our drugs in this respect.

  • Vast majority of GPs support charges for non-NHS work

    Realist's comment 21 Feb 2018 1:49pm

    My experience of charging patients in GP abroad is that it empowers the patient as much as the doctor. We need to get away from "free at the point of access" and start talking about "good quality means-tested healthcare". Co-payments do not result in absent healthcare for the poor - they finance it. In case you have not been paying attention this is how prescriptions work in England already.

  • The real conspiracy of NHS England

    Realist's comment 10 Aug 2017 6:37pm

    Direct Democracy: An Agenda For A New Model Party
    Co-author J. Hunt?

  • This LMC vote does not mean GPs support co-payments

    Realist's comment 24 May 2017 2:09pm

    In case you have not been paying attention we already have a co-payment system in the form of prescriptions. This has not led to a collapse of healthcare for the poor because they do not pay. I have come across people (JAMs) who have not collected their meds until their pay cheque arrives but on those occasions it has been a personal choice between their meds and another lifestyle factor which they prioritise. They are making a resource based decision for themselves - it just happens to be with a different lens to mine. The wealth of evidence (i.e. the rest of the world) shows that a system which allows patients to supplement a basic healthcare provision works better than the NHS (although is less resource efficient). Co-payments are a way of increasing patient choice and effectively increase the private spend that goes into a country's healthcare. As a profession we have a responsibility to call time on a health service which is not serving our patients and start looking for long term sustainable models. The obvious thing to do is look at another country that is managing better and see if we can mirror that here. All options need to be on the table - we must not cling on to blinkered ideology if it is not working. Co-payments can be means tested and that protects those who cannot afford them.