This site is intended for health professionals only

At the heart of general practice since 1960

pulse june2020 80x101px
Read the latest issue online

The waiting game

Una Coales

  • GP in £200,000 legal action against Daily Mail was 'unfair and unjust', lawyers claim

    Una Coales's comment 31 Jul 2014 8:03pm

    God bless you Dr Serrano. We are all side by side with you!

  • GP sues Daily Mail for £200,000 over 'insulting and oppressive' article

    Una Coales's comment 31 Jul 2014 6:41pm

    Dr Serrano Garcia is making a stand for our profession, which is under attack from many sides, the press being one of them.

    The High Court outcome will not be known until October. If he loses, he will lose it all. If he wins, he hopes he can show the press to treat GPs with more respect.

    This comes with an inordinate amount of prolonged stress. Dr Garcia has the total support of all of us. It is a God send a law firm has offered him no win, no fee. Dr Garcia has my utmost respect for being a great noble GP who is standing up for all of us!

    I only wish the BMA had taken on the tabloid on behalf of our profession...

  • 5,000 doctors a year considering leaving the UK to emigrate abroad

    Una Coales's comment 30 Jul 2014 10:14pm

    @1:22 agree. Have to add that when all NHS surgeries collapse, so will NHS hospitals follow suit and IMO this will lead to mass UNEMPLOYMENT of doctors as without surgeries or hospitals, where will future doctors find training and where will qualified doctors work?

    It takes time to build up a private practice list (~10 years) and there are not enough private hospitals or private GP surgeries to offer everyone a job.

    My advice is do not take out a mortgage or if you are paying a mortgage, consider selling. The immediate future is not secure. It is vital to think of a long term financial and career plan B. And I think those who already have, have emigrated to Canada, Australia, New Zealand, etc. Caveat, IMO the door to Australia will be closing in 1-2 years as they become saturated with ex pats from the NHS.

  • GP witch-hunt could boost morale

    Una Coales's comment 30 Jul 2014 5:42pm

    Don't worry, 6 years of UK med school at a cost of £100k in student government loans, will price out all future GP witches...

  • GP sues Daily Mail for £200,000 over 'insulting and oppressive' article

    Una Coales's comment 25 Jul 2014 8:45pm

    Thanks @10:55 pm. That is why I am 100% against a salaried GP service working for HMOs. I received so many emails from abused NHS salaried GPs, female salaried GPs weeping and saying they were stuck in a living nightmare, dreading going to work in the morning, signing off sick, etc. Better not to enter into a profits before patients model.

  • Revealed: Only 13% of premises applications approved last year

    Una Coales's comment 25 Jul 2014 8:28pm

    How many red flags that the NHS is being shut down?

  • Revealed: the GMC’s secret complaints files

    Una Coales's comment 24 Jul 2014 8:34am

    Vino, the GMC answers to the Parliamentary Health Select Committee. Dr Sarah Wollaston MP, a former GP, is now the Chair of the HSC. The other route is to write Niall Dickson directly to raise concerns about the handling of your complaint. I am sorry that your complaint of bullying was turned into a dossier against you.

    My sympathies as this is how I too felt the BMA handled my complaint of bullying and intimidation by the Chair of the BMA Council. After I resigned from Council, I was told that the BMA President had concluded that the Chair had not bullied me...

  • GP sues Daily Mail for £200,000 over 'insulting and oppressive' article

    Una Coales's comment 24 Jul 2014 8:21am

    Jo Clark-Wilson I too once believed in the judiciary until I witnessed the High Court Judge presiding over the controversial CSA case, say at the end of 3 days, that this was not his area of expertise, that he would allow an appeal, that another judge may rule differently. Why did this judge not excuse himself from day 1? Why did Indian doctors and sympathetic white doctors raise £175,000 for their one chance at justice only to be heard by a judge who admitted this was NOT his area of expertise? Why did he influence BAPIO's barrister by saying on day 1 that it would be an uphill battle for her? How is justice served when BAPIO were faced with raising another £200k but this time in only 3 weeks to be heard by another High Court Judge? Impossible.

    We can only hope for Dr Garcia that ge gets a High Court Judge whose area of expertise is libel.

    @9:51 I resigned both the BMA and RCGP and stopped paying optional membership fees as in both instances, I felt they served their own self interests rather than the interests of members, my personal opinion. There is another organisation called the Independent Doctors Federation and I have sat as the GP Chair and witnessed how they do lobby for their members, GPs and consultants alike and have taken on health insurance providers to ensure fair reimbursements for consultants, they have their own sympathetic doctor revalidation officer who understands portfolio careers and you get to pick your own GP appraiser, unlike the NHS in which you are at the whim of a randomly allocated appraiser and the local RO. And they provide free CPD, free BLS, free child protection updates and do not charge to attend their conferences or lectures. And on top of this they charge half of what other orgs charge as annual fees.

    The future for GPs is semiprivate, ie independent status and NOT salaried for HMOs.

  • GP sues Daily Mail for £200,000 over 'insulting and oppressive' article

    Una Coales's comment 23 Jul 2014 8:57pm

    Good luck Dr Jose Garcia. Many NHS GPs have been thrown under the Daily Mail bus, including myself and the fallout is devastating and for me, included a malicious GMC referral shortly after the article was published. My name was cleared by the GMC but the Daily Mail article remains forever on google. I had to face the shame of my own teen daughters whose schoolmates read the misleading Daily Mail article!

    I hail you and your legal team for taking on the Daily Mail and setting a precedent that I hope will stop sensational and misleading reporting that has bashed NHS GPs on an almost daily basis and as a result has contributed to the exodus of NHS GPs and soon the end of the NHS.

  • Over 2,000 hospital training posts should be axed to fund GP expansion, recommends DH review

    Una Coales's comment 23 Jul 2014 11:03am

    By axeing over 2000 hospital training posts, NHS hospitals will close faster as trainees were always needed for inexpensive service provision...without manpower, hospitals fold faster. Where do you think GP trainees spent 2 of their 3 years of GP training? Not in a GP surgery but rotating through hospital training posts to fulfill NHS hospital service provision.

  • Health unions ballot members on strike action over pay freeze

    Una Coales's comment 22 Jul 2014 9:44pm

    IMO the reason why the BMA is not joining the Royal College of Midwives and Unison in balloting its members for strike action, is because the 'old boys' are to be given 10 year pension protection from 2015 for anyone who turned 50 in 2012....the old pension terms allowed one to pension up to £1.8 million, the new pension terms means a cap of £1.25 million, a cap on annual pension contributions of £40k a year and a cash out date of 68 years if you are still alive. At the rate my white male GP friends are dying in their 40s/50s, the new middle age may well be late 20s/30 for white male GPs! Why bother to make a fuss when a nice cushy pension is around the corner for the 'old boys and gals'? My personal opinion.

  • Over 2,000 hospital training posts should be axed to fund GP expansion, recommends DH review

    Una Coales's comment 22 Jul 2014 9:32pm

    I say again, who wants to be a NHS state salaried GP on £57k when saddled with a £93k student loan to repay? The maths just doesn't add up. And be ready for what I predict will be US style HMO management, see more patients and faster, get scolded for not referring for expensive chargeable investigations, for inexpensive primary care management with diet and exercise advice that deprived the clinic of charging for meds and ixs...
    http://youtu.be/haXGD9r9gSY a glimpse into the future for UK salaried GPs...

  • Revealed: the GMC’s secret complaints files

    Una Coales's comment 21 Jul 2014 11:22pm

    The GMC website makes it too easy for a member of the public or colleague to complain online. It does not block access by first asking if you have approached the doctor or the practice manager or the senior partner or the CCG? It does not block access by first asking if you have approached the hospital medical director? Instead it encourages all to click online complaint referral directly to the GMC! And the GMC then replies that it has to investigate all complaints, no matter how trivial. Initial investigations do not last weeks, but months!

    If a left wing socialist doctor disagrees with a right wing conservative doctor and refers the doctor to the GMC, where do we draw the line? If a Muslim doctor disagrees with a Christian doctor and refers the doctor to the GMC, where do we draw the line? The GMC is supposed to be used to protect patients from harm, ie a Shipman, not to police doctors for having different political or religious views. I say this because a Muslim medical student has just referred a Christian doctor to the GMC without informing the Christian doctor he had done so.

  • CQC considers inspecting GPs on different nights

    Una Coales's comment 11 Jul 2014 9:55am

    Ramped up CQC inspections, looming revalidation interrogation dates, increased numbers of GMC scrutiny of doctors, incarceration for 'wilful neglect', pay cuts for NHS GP practices, little control over patient influx and demands on a cash strapped healthcare service, pandering to unreasonable patient (voter) demands of a 7/7 service from GPs and now hospital consultants, GP partners see a drop in drawings and stress over paying out staff redundancies, GP burnout on the increase, recruitment figures drop, medical students burdened with up to £83k in student loans, NHS pension age moved to 68 with less out for more in, and so on and so forth....One burning question....WHEN WILL THE BMA trade union BALLOT ITS MEMBERS on some form of industrial action (mass resignation, strike, OOHs boycott), ie the only leverage any trade union has to ensure fair pay and fair working conditions?

    Why were NHS workers conspicuously absent from a strike march of up to a million public sector workers (teachers, firefighters, etc) asking for a humble £1/h increase in pay at the same time Cameron is on £142k and MPs face a 11% pay rise from 2015 or £74k?

  • Pulse scoops two gongs at medical journalist awards

    Una Coales's comment 10 Jul 2014 5:36pm

    Well done Nigel, Alex and the entire Pulse team of journalists. You have been a great honest voice for NHS GPs and the comment boxes allow for a great sounding board, well moderated too! Keep up the good work.

  • Revealed: Sixty GP practices across the country facing imminent closure

    Una Coales's comment 08 Jul 2014 8:39pm

    @4:41am GP registrar,mI am sorry you were up so early. I hope all is well.

  • Dead GPs should be allowed to return to practice

    Una Coales's comment 08 Jul 2014 8:36pm

    Dead GPs are depriving ghost patients of much needed 7/7 appointments...

  • Revealed: Sixty GP practices across the country facing imminent closure

    Una Coales's comment 08 Jul 2014 10:31am

    @4:53 I am pleased to read young GPs are seeing the light. My parallel female GP activist in the States is a Dr Pamela Wible MD who writes 'Things have gotten worse since with all the third parties meddling in (and making great salaries from) doctors’ professional lives. Doctors acquire learned helplessness from their colleagues and the dominion medical culture. Medicine is an apprenticeship profession. If all your colleagues are being abused and bullied and are fearful of losing their professional standing if they don’t support the status quo, then young physicians line right up behind them and we all fall off the cliff together. The system persecutes the bullied victims because those in charge are making a great living from enslaved doctors. Did the slavemasters really want to release their slaves in the South US? I think not. The plantations and cotton fields were dependent on the enslaved. We change the system when the bullied and abused doctors (and nurses) have had enough and they stand up for themselves. Doctors can not be healers and victims at the same time.'

    Since we have no leverage, ie our trade union is not Unite or Unison and refuses to ballot its GP members on any form of industrial action (save the last one on their pensions), GPs are taking silent action, taking voluntary early retirement, handing back GP partnerships, emigrating, changing careers, trying their hand in private practice, resigning on the eve of their impending revalidation date, etc.

    Both the US and UK have huge national public govt deficits which may explain the abuse of NHS GPs and US family physicians who accept state govt funded Medicare pts as doctors try to collect their reimbursements for consultations from their respective governments but must submit to a zillion electronic box ticks, paperwork hurdles and unannounced practice inspections in order to do so.

  • Revealed: Sixty GP practices across the country facing imminent closure

    Una Coales's comment 06 Jul 2014 9:58am

    @9:33 I am sorry you did not help your IMG GP trainees even when you 'knew' they would fail. I did help IMG GP trainees by teaching them how to control unconscious bias when forced to sit an exam behind closed doors with only one examiner and not 2 to reduce observer bias, an exam with no CCTV recording to challenge at appeal, an exam which fails 4x more British BMEs than white UK grads.

    I have had the pleasure of seeing IMGs achieve a resit CSA score of 95 and 101 after a one day CSA course. This score is even higher than some UK grad scores. I have seen an IMG go from 55 to a score of 85 after one day of learning how to control unconscious bias against IMGs, a belief that IMGs or foreign training is substandard.

    I see IMGs as geniuses and boost their self confidence which has been damaged by beliefs from colleagues that they are substandard. I am an IMG and proud to be one. I am also a British born BME and proud to be one.

    I have fought for exam fairness for IMGs because I know that before the CSA changed its format in Sept 2010, more IMGs passed and fewer white UK grads passed. I know that CSA can be improved once the RCGP acknowledges unconscious bias, tests for it and applies controls as is done in America since 2007.

    The past president of the BMA is an IMG Indian. The past chair of the RCGP Mayur Lakhani is an IMG. IMGs are NOT substandard because they are forced to sit an exam behind closed doors with just one examiner per station. Make the exam fairer and you will ensure the public that you have not passed substandard white UK doctors who passed due to positive unconscious bias or strong unconscious racial preference for whites or failed bright IMGs due to strong unconscious racial preference against foreigners.

  • Revealed: Sixty GP practices across the country facing imminent closure

    Una Coales's comment 06 Jul 2014 9:27am

    http://youtu.be/3v4Sq7oDCgo all NHS GP partners facing bankruptcy should watch this clip of a singlehanded GP in North Carolina who underwent similar nightmare tick box bureaucracy, CMS inspection (like CQC and NHS Eng) and finally had to close her practice in rural NC due to stress and bankruptcy. Government overregulation is to blame!

    Allow semiprivate practitioners autonomy to treat patients in peace. Alas in countries with a huge national deficit, govt public funding is tightly ringfenced and that includes any public state funded healthcare like NHS or medicare/medicaid. To work in such a public funded system in the context of a national govt deficit will always be stressful.