The whole financial ‘system’ is based on ‘creating’ debt through high street banks’ fractional reserve banking, QE by central banks and derivatives. This can only work if there is a continual increase in productivity to service the newly created debt. For most industry/business this has been achieved by ‘offshoring’ and automation of factories and services.
The big difference between healthcare and just about all other services, whether private or public is that despite the Govt/DoH attempting to do the same as above healthcare is still extremely labour intensive. It will remain this way until AI and robots become more advanced. This is additionally compounded as people live longer and medical advancements continue. Finally Joe Public will have to willingly accept AI and robots.
In terms of bureaucracy it is becoming more like being a family physician in the states, trying to get approval from HMOs and insurance companies. Over there it is far far worse. Could be the future for GPs.
Where is the evidence that this is likely to happen?
Doctors frequently do not enjoy the job anymore, because of the previously documented issues, So the prospect of staying on longer does not appeal. Far better to reach the maximum pension pot and retire or move on to non-NHS ways of earning an income / adding new pension / savings / investments.
One of the biggest problems is that nurses and doctors, whether in primary or secondary care frequently disagree on who or what is the appropriate service / person to manage a problem (one also has to look at what clinicians are contracted / paid to do). Then take a look at what the Royal Colleges think. Then look at what NHSE / DoH / Government think. Then take a look at what patients think... OMG!
So if they had to shut one site due to a lack of GPs isn’t that going to increase the workload and stress for the remaining GPs at their other sites. That then leads to more of those GPs resigning until Hull has no GPs at all!
Latest National News reports that hospital waiting lists are rising at a very rapid rate due to Consultants not willing to work extra sessions because of the new NHS pension limits decreasing their take home pay. This shows the difference between GP and Consultant contracts. If GPs had similar contracts GP waiting time would rise in a similar fashion when Practices were forced to take on new patients.
How progressively correct!
Do hospital consultants have their pay linked to an ever expanding workload of additional clinical standards that have to be documented like GPs, or is it just GPs? if so why is it just GPs that are continually being told to perform more work just to achieve the same income? The job is already unbelievably stressful.
If the partnership model goes NHSE will find that there will be even more locums / agency / chambers GPs setting their own rates, just as already takes place in the nursing profession. NHSE may try to regulate GP locum pay, but lack of supply and market forces will stop this. They have unsuccessfully tried to keep agency nursing pay down, attempting to get nurses to work on ‘bank’, if not salaried. They have been partially successful in keeping most agency nurses inside IR35, but the daily rate of pay has had to rise in order to keep agency nurses interested. The same will apply to the majority of GPs.
So the result will be zero continuation of care and patients will hate it! Of course in the long run the job of a clinician will become less desirable leading to fewer people training...this will increase the scarcity of clinicians...this creates a cycle where market forces force up pay and workload...repeat...
Like it or not the use of cheaper services is growing, for obvious reasons. From employing Noctors to telephone consultations, with or without video, to automated prescriptions with use of AI..This will increasingly spread to involve hospital out patients as well. There will be no going back. Telemedicine is growing in use across the world and will become normal routine Medical practice in a few years time.
Not saying that I agree with all the guidelines, but why is secondary care not financially remunerated according to guidelines, like primary care?
Agree with above comments.
There is also no analysis of how much extra time / resources are required to deliver the latest guidelines, which never reduce the workload for GPs.
The only way to prosper financially nowadays is to do limited NHS work and try to live off this income.Then look at where you can easily earn private medical income, which unfortunately may not be standard General Practice. Then form a Limited company, or possibly an LLP for the new private income.Try not to take dividends from the company to let the profits build. After a few years liquidate the company, pay the tax due, which will be a lot lower, to release the profits. Then invest this money, although it is difficult to find high yields with minimal risk. Then continue the cycle forming another company.
There you go...
Are we not a country of free speech anymore?
We need to drastically reduce the work load of GPs.
GPs are happiest with continuity of care looking after no more than 600 patients, as it is impossible to deliver the higher modern standards of care with any more. Payment should be per consultation, utilizing their full hospital experience. GPs have to be able to access nearly all investigations without referral. They should choose who they wish to work with and most importantly there HAS to be co-payment for numerous reasons, but obviously not for all patients. e.g. Canada
Research shows that the happiest professionals are those that have a skill that is in high demand and can charge a relatively high amount per hour worked. They also need to have control over their working hours and prefer self-employment. Interestingly they tend to be happiest when working by themselves, not with others. Guess who these people are?
Plumbers and in particular those working on boilers and heating.
“June 1, 2018
It seems plumbers are guaranteed not to get that sinking feeling every time they go to work…
A survey has revealed that Britain’s plumbers are the happiest professionals in the country. In fact, 55% of plumbers said they were ‘very happy’ in life.
It seems tradespeople are way ahead in the happiness index because builders were next on 38%.
The survey was commissioned by Boundless, an experiences company with a 94-year heritage.“
“Those in the public sector are less happy than counterparts in the private sector”
Need to move to Canadian / Oz model with 600 or so patients per GP with Co-payment...loads of time to cover everything..and higher income
As policenthieves said, it is what always happens with new technology. It will become far more disruptive if and when this service spreads across the UK. No difference to how automobiles replaced horses. Do not forget that it is not just GP services, but also hospital services that are increasingly being delivered virtually. If not already doing it, GP and hospital care will eventually be forced to deliver their services in the same way.
The really scary bit is when AI becomes more advanced. The virtual delivery of services does not threaten jobs, just how those jobs are delivered. However AI will certainly threaten jobs and is definitely coming!