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The waiting game

Una Coales

  • LMCs consider radical motions calling for industrial action at GP crisis summit

    Una Coales's comment 16 Dec 2015 8:19am

    @10:40 pm even US doctors are recommending Canada and New Zealand. In America residents earn the same as BASIC pay of junior doctors without the supplement! Tax is slightly less at 15%, as is cost of living. I can see where the government got the idea to scrap junior doctors supplement! But the upside is starting pay for US family physicians is $200,000/yr. With social media and a global economic market, UK GPs are quickly learning where they are a respected asset and not a state salaried workerbee who may be unable to afford to get on the property ladder. Have a read of US doctors describing working life across the pond to a UK doctor. https://www.reddit.com/r/medicine/comments/2h1vwi/uk_doctor_thinking_about_moving_to_usa_i_have/

  • LMCs consider radical motions calling for industrial action at GP crisis summit

    Una Coales's comment 15 Dec 2015 5:12pm

    https://youtu.be/0pLWKWXBBxw To think it will almost be 2 years since I spoke up at the annual LMC conference demanding we put leverage (industrial action, undated mass resignation etc.) into the 87 pages of LMC motions to negotiate a fair contract. Better late than never, although we sadly lost some GPs to an early death while waiting for a trade union to behave as one and methinks too many young and old GPs have now made their plan Bs, voting with their feet.

    Surprisingly in America, doctors are now shunning family practice as $200,000/yr is TOO LITTLE! Gobsmacked. And 2 states in the U.S. take GPs with MRCGP and USMLE without doing a US family medicine residency programme. Interesting times. Watch this space!

  • Half of GPs willing to resign NHS contracts in protest at state of general practice

    Una Coales's comment 14 Dec 2015 10:17am

    @Peter have faith in our younger Generation Y GPs. Resignation and voting with one's feet are picking up momentum in protest to high membership fees, high indemnity fees and/or a unilateral financially unviable government (Capitol) imposed 7/7 state contract for (district sector) GPs. http://blog.networklocum.com/2015/12/09/why-i-resigned-from-the-rcgp/

    Most GPs are now female, and we know how to do maths! Women juggle and manage household budgets, childcare, mortgage repayments, taxes, council tax, road tax, car insurance, student loan repayments, etc. and are quickly seeing that a salaried GP job pays too little after all the outgoing expenses are taken into account and the pressures of a GP partnership are rapidly becoming a sentence to an early grave from heart failure or sudden cardiac death. Again reminded of The Hunger Games...

    Just as nearly half of junior doctors, who have completed their 2 year foundation years, are looking elsewhere for work, career change into real estate, banking, private GP work, cruise ships, etc., so too are Generation Y GPs who may not have been granted a ballot on mass resignation, so instead are voting with their feet. Meanwhile the Capitol continues to bestow CBEs to 'leaders of GPs'. And leaders are keeping state sector coalfaced GPs in tow with slogans such as Put Patients First.

    As Generation Y GPs watch their colleagues end their lives due to being overworked or under the harsh Draconian grip of the GMC regulator who seems to abide by 'guilty until proven innocent' conditions, and are not allowed to stage a revolt (no ballot from their 'trade union'), it is no wonder we see so many fleeing each sector. The average age of a female GP leaving the NHS is 34 (presumably after their second child). Young male GPs are emigrating outside of the Capitol to lands on the other side of the world. Older GPs are dropping their tools as they approach 50 and willing to accept a smaller pension in exchange for their liberty.

    I have a lot of faith in Generation Y GPs who seek professional autonomy and financial independence despite all the obstacles placed in front of them to destroy the last vestige of general practice. I wonder who will be left to work as state sector salaried GPs for 65 million people, with only approx. 4,000 EU GPs on the GMC register and many IMGs blocked by the CSA and/or visa changes. The way of the world...

  • Half of GPs willing to resign NHS contracts in protest at state of general practice

    Una Coales's comment 10 Dec 2015 3:29pm

    On Tuesday 15 December, the Parliamentary Health Select Committee holds ita 4th oral evidence session of its inquiry into Primary care. The witnesses are Maureen Baker CBE, chair of the RCGP, Steve Field CBE, former RCGP Chair and currently chief inspector of general practice CQC, and Chaand Nagpaul CBE, chair of the BMA. Enough said.

  • Pulse named top business magazine for second year running

    Una Coales's comment 10 Dec 2015 11:02am

    I second that! Well done!

  • Half of GPs willing to resign NHS contracts in protest at state of general practice

    Una Coales's comment 10 Dec 2015 10:58am

    When oh when will the doctor's trade union, the BMA, ballot its GP members on mass resignation from a financially unfeasible and unfair contract? How many GP partners have to end their lives or work to an early grave before poor GPs are balloted? Well done Pulse on taking the initiative. Another Christmas approaches and many GP families must celebrate without their father, mother or spouse. RIP burned out GPs. For the rest, keep making your plan Bs.

  • 13 doctors died while GMC 'failed to act' on suicides risk, review finds

    Una Coales's comment 30 Nov 2015 4:58pm

    @4:33 pm I am sorry to hear you are now facing a FTP. Please put pressure on your medical defence org to represent you with an experienced lawyer/barrister. I can't fathom how much pain and suffering you are under right now. I don't think I would have personally made it had any of the malicious complaints made against me been advanced to an FTP. The months of waiting and the shame are unbearable.

    Please seek counselling and let your friends and family know. You will need all the strength in the world to get through this. We GPs do not have the professional linguistic capital of barristers and most certainly are not in a position to self represent when our MDO turns us down at their discretion. I wish I could wave a magic wand and make this FTP go away for you. No doctor should have to endure this inhumane process. In my opinion criminals may be treated better in a court of law than doctors at an FTP.

    Pray to God to give you and your family the strength to endure and yes the evidence may be collected to find you guilty rather than focus on an equal and fair process.

    And when you come out of this, which you will, ask yourself is it worth this high risk to continue to work in the UK as a doctor or maybe it will be time to emigrate or change careers. One GP emigrated to the US with his MRCGP, did a complete family medicine residency, worked in San Fran in semiprivate family medicine and has now moved to Hong Kong to work and sit the family medicine board there. You see, the world really is your oyster.

    Be strong through Christmas and the New Year and I pray that God will grant you a miracle. God bless you.

  • GP practices to reduce routine appointments on junior doctor strike days

    Una Coales's comment 28 Nov 2015 3:01pm

    We respect Dr Dean Eggitt for showing solidarity with the junior doctors strike by reducing routine appointments as hospital trusts cancel routine procedures.

    We GPs were never given a ballot against an unworkable contract.
    Instead we continue mourn more sudden deaths among overworked NHS GP partners.
    These GP partners will be remembered.

    More overworked NHS GP partners have died suddenly between October and November 2015 of heart attacks or heart failure. RIP and the BMA still has not balloted GPs on industrial action (work to rule, unsigned mass resignation, strike days, boycott cremation form signing, anything!) against an unworkable slave contract.

    RIP NHS GP partner Dr Brian Keighley died suddenly November 2015, aged 68.
    http://www.dailyrecord.co.uk/news/local-news/tributes-long-serving-former-balfron-6825789

    RIP NHS GP partner Dr Mukesh Patel died suddenly of a heart attack October 2015, aged 59.
    http://www.granthamtarget.co.uk/Popular-GP-59-died-hospital-following-cardiac/story-28062631-detail/story.html#AGMeT8pMHZPQK3it.01

    RIP NHS GP partner Dr Jenny Wess died suddenly of heart failure October 2015, aged 52.
    http://www.newsnorthwales.co.uk/news/153794/overton-on-dee-gp-s-death-leaves-husband-and-children-devastated.aspx#.Vllh5W0s5FE.facebook

    RIP NHS GP partner Dr Hameed Khan died suddenly of a heart attack October 2015, aged 68.
    http://www.guardian-series.co.uk/news/13336986.Tributes_to__kind_and_compassionate__GP/?ref=fbshr

  • GP trainee died by suicide after fearing GMC suspension

    Una Coales's comment 26 Nov 2015 11:29am

    Deepest condolences to James and his family. Fear of GMC suspension, fear of loss of GP training number, fear of joblessness, fear of loss of medical career, shame, isolation, and a harsh interviewer are all too much for anyone to bear, let alone a junior doctor, a top GP trainee.

    The GMC must reform and ensure they arrange counselling and support for any doctor they are investigating or putting under restrictions that may affect employment and pay. Only doctors who have been investigated by the GMC can understand the enormous stress, pain and suffering endured for months on end while their lives and careers are in limbo and in the hands of the regulator. It is no wonder some doctors who care too much, end their lives.

    Dr Halcrow's last poignant words were 'I'm sorry'. What more could he give to show remorse and sorrow over an alcohol problem that appears to have been addressed but a harsh interviewer set an unrealistic target expecting him to abstain even from social drinking. Even the criminal courts do not make such an incredible demand! Rest in peace James. I wish someone had advised you not to self refer but take a sabbatical, get help and counselling, and return to training when ready. As long as patients are safe, the GMC need not be involved in my opinion.

  • GP trainee died by suicide after fearing GMC suspension

    Una Coales's comment 26 Nov 2015 11:29am

    Deepest condolences to James and his family. Fear of GMC suspension, fear of loss of GP training number, fear of joblessness, fear of loss of medical career, shame, isolation, and a harsh interviewer are all too much for anyone to bear, let alone a junior doctor, a top GP trainee.

    The GMC must reform and ensure they arrange counselling and support for any doctor they are investigating or putting under restrictions that may affect employment and pay. Only doctors who have been investigated by the GMC can understand the enormous stress, pain and suffering endured for months on end while their lives and careers are in limbo and in the hands of the regulator. It is no wonder some doctors who care too much, end their lives.

    Dr Halcrow's last poignant words were 'I'm sorry'. What more could he give to show remorse and sorrow over an alcohol problem that appears to have been addressed but a harsh interviewer set an unrealistic target expecting him to abstain even from social drinking. Even the criminal courts do not make such an incredible demand! Rest in peace James. I wish someone had advised you not to self refer but take a sabbatical, get help and counselling, and return to training when ready. As long as patients are safe, the GMC need not be involved in my opinion.

  • Junior doctors to stage full walk-out under BMA plans for industrial action

    Una Coales's comment 16 Nov 2015 2:41pm

    Your support and that of fellow dentists is very welcome Dr Healy. The BMA ballot for strike action for junior doctors closes in 2 days. They have my full support.

    It begs the question, when will NHS GPs be given a ballot on industrial action (have been asking since 2014) or are they to keep stumm and work 7/7, continue to burnout, to emigrate, to retire early until there are no NHS GPs but fast tracked science majors, noctors, pharmacists covering GP posts?

    Without GPs seeing the bulk of NHS patients, how can junior doctors be shielded from the huge deluge of patients descending on hospital A&Es and clinics when there are no GPs to field and treat the majority of patients at an incredibly fast 10-minute per consultation pace.

    Without IMGs, general practice recruitment plummets. Without GPs, the NHS struggles and cracks. Shame the RCGP did not offer IMGs an exam with 2 examiners per station and videos for fair appeals. Shame the BMA did not give GPs a ballot on strike or work to rule action. You reap what you sow.

  • 40% of GPs to quit within five years

    Una Coales's comment 27 Oct 2015 7:15am

    Decades ago, my uncle in America was one of the last of the dying breed of general surgeons who could operate from head to toe, from C sections to hip replacements. The general surgeon was made obsolete. Now it is upper or lower GI surgeon, hand surgeon, etc.

    In my opinion, GPs are being made obsolete as a profession by the government. When I was chair of the GP section of the Independent Doctors Fed, they were battling with private health insurance companies who wanted to bypass the role of the private GP. Private GPs make their bread and butter on being able to advise patients on the names of the best specialists and to write referrals for them as well as general practice consultations. PMIs told their members to call and a nurse would screen calls and triage as to who would see a physio or a consultant specialist, thereby bypassing the private GP all together. This is the future for the NHS, private medical insurance companies trying to maintain a profit for their shareholders by cutting costs and then only allowing their members to be seen by a few of the consultants the PMI chooses, ie the cheaper.

    Private consultant gripes were that these PMIs were reimbursing the same amount for grommets as they had done 20 years ago and that if you did not work in one of their private hospitals, they would reimburse only a fraction of your independent clinic and equipment fees, which may muscle out competition in my opinion.

    Clearly doctors will need to be trained somewhere but with no NHS, who will offer specialist training? Or will our doctors have to seek training abroad and come back to work here as salaried doctors for private health insurance companies? In the meantime there will be a heavy reliance on EU consultants and junior docs from the poorest EU countries to work insane hours for below minimum pay when you actually add up the real amount of hours they work and not the ones managers clock. There is nothing the BMA can do when the monopolistic employer is the government for a public sector job, working for a public sector NHS.

  • Jeremy Hunt’s letter to BMA on the junior doctor contract

    Una Coales's comment 09 Oct 2015 9:03am

    The government gave cast iron assurances that MPIG (Minimum Practice Income Guarantee) would exist forever. It has been stripped away. The government gave cast iron assurances that student loan repayments would be income based. It has changed the terms 'retrospectively' this year. In 1946, Labour Health Minister Bevan gave cast iron assurance legislation to the BMA that GPs would never become salaried civil servants. This government is now trying to make all GPs salaried civil servants for super practices by stripping away sustainable income from GP partnerships. And now in 2015 you are asked to believe that the government is giving junior doctors cast iron assurances their income will not be reduced after announcing a new contract which reduces pay and increases working hours? Conclusion: never trust a politician!

  • ​Let us know what you think of our new-look site

    Una Coales's comment 24 Sep 2015 7:14pm

    Hate it! Too much scrolling. Font size too big. Looks like a paper li. Are you trying to cut costs by adopting a newer cheaper format? Keep the old. This is giving me a migraine to navigate. Thumbs down.

  • GP commissioning champion among heavyweights vying for RCGP presidency

    Una Coales's comment 18 Apr 2015 12:42pm

    @Peter Howe I stand corrected. I was an RCGP faculty officer as treasurer for 3 years but not a central College executive officer.

    Current power lies with the Trustee Board chaired now by the chair of the TB, Colin Hunter. http://www.rcgp.org.uk/about-us/governance-and-constitution/trustee-board.aspx

  • GPC challenges decision to open all new GP contracts to competition after legal advice

    Una Coales's comment 27 Aug 2014 5:44pm

    While the old boys rant about matters they have no control over, ahem unilateral government contract, government in control of both the law and the public purse strings, our young GPs are already transitioning and those who must remain in the UK are now doing part NHS and part private Nuffield, BUPA and BMI healthcare as semiprivate GPs. Accept that change is happening.

  • Doctors who harm patients to face tougher sanctions, GMC proposes

    Una Coales's comment 22 Aug 2014 4:41pm

    I managed to speak up for our 96 fallen comrades @8:52 and @9:00. Your anonymised case was heard internationally on Sky news! I asked why no apology to you after an 18 month investigation and you were found innocent! Forgot to mention more carrots, not more sticks. Anyway I think the 96 number of suicides will stick in the public's mind as if for some reason a doctor's life has no value? There should always have been an external public enquiry not yet another internal partial review!

  • Doctors who harm patients to face tougher sanctions, GMC proposes

    Una Coales's comment 22 Aug 2014 10:34am

    Keep the comments coming! Sky News has invited me to debate 'against' this sanction of a forced apology vs CG arguing 'for' at 1:30 pm today!

  • Become a partner? Not if I can help it

    Una Coales's comment 21 Aug 2014 7:01pm

    Sorry typo 'one of your GP surgery partners...'

  • Become a partner? Not if I can help it

    Una Coales's comment 21 Aug 2014 6:59pm

    I am so sorry to hear of the death of one of your surgery partner @8:26. Thank goodness you are rethinking your work situation.

    Based on what has happened to American internist Dr Annette Bosworth, I shudder to think of what is next for NHS GP partners! She was investigated by medicaid and the state medical board for fraud for 3 years and became homeless! She was cleared but now lives in a RV donated by her Christian church with her 3 children. Her crime? It may have something to do with setting up a sole practitioner practice treating state medicaid patients in a state with 2 major health providers and refusing to work assembly line style.

    I feel the govt may wish to tender out the NHS to private and NHS MD lobbyists. Money and power talk?