Clinical directors resigning! Things must be really bad. The Government has used those willing GPs fist through clinical commissioning groups and moving work from secondary care to primary care. Then used willing GPs in these networks. I take it that it’s finally dawned on them that it isn’t going to be less bad with them “helping” the government destroy primary care. The profession reaps what it sows. It’s unwillingness to be more militant and it’s pathological desire to be liked by the public has led it to this point. Soon ye shall all be more akin to salaried nurse practitioners following a protocol driven existence. The profession doesn’t have the guts or the will to demand the block contract goes and it is paid per item of service. Being paid for what you do. I’m sure that is a simple enough concept to sell to the public. But the government won’t want to pay what each service is worth. So you have to set rates. What is our time worth? We have to value ourselves. If we don’t appropriately value ourselves we can’t expect others to do so. If the government doesn’t want to pay the full rate then there needs to be a co-payment system. Throw out the current contract and start again. Worry more about what GPs won’t like rather than worrying so much about what patients won’t like. GPs are retiring early, reducing hours, emigrating and even suciding. The perspective needs to change. The current system is killing doctors it needs to change. These network proposals will kill more doctors with additional stress. Our language needs to change.
It’s good to hear that patients are still receiving world class care from the NHS.
If she is happy to fly to Brisbane I can squeeze her in into my appointments schedule this Friday morning. Australia has reciprocal healthcare arrangements with the UK. She just needs to pop into the Medicare office for a visitors Medicare card when she arrives. For a GP colleague I always bulk bill. So just the cost of the fares then.
BAME doctors born and trained in the UK are more likely to have complaints against and more likely to have a visit to the GMC than their white colleagues. You know, the ones that don’t even sound foreign. Rates are higher in those doctors that do retain an accent and aren’t white. I’ve had patients removed from the practice list for overt racism. The casual racism traditionally has been allowed to slide. We wouldn’t want our white colleagues labelling us as snowflakes now would we. Great article but I shalln’t be holding my breath on any significant changes. A grass roots uprising is unlikely to succeed without help from the top.
Appropriate complaints against doctors I have no problem with. Vexatious complaints don’t have appropriate penalties. Especially those where race is a primary factor. Not only is the existing culture within the wider NHS inexcusable in this regard but there are systemic organisational and systems issues. Politicians & leaders in peak bodies are mostly white. This is a problem for them for them to help address. You know that thing called leadership.
Whom at the BMA would like Copperfield to do their appraisals for them?
Sadly they will remain in their insular world and do each other’s appraisals. They were all great and anyone with a different view to them is dismissed as a complete moron and not worth listening to. This matter was completely unforeseen and unpredictable so no one is to blame and anyway they have a no blame, no responsibility culture. No one is responsible or accountable so we know where we can stick our blame.
I must not tell lies.
Hospitals aren’t on the whole funded by a global sum anymore. GP’s are. So unsurprisingly there has been a shift of work from secondary care to primary care of the less profitable work. Fewer follow ups. If patients need to be seen again they will need a new referral and that comes with a bigger fee for the hospitals. The Commissioners haven’t felt the need to pay the GPs any more. It doesn’t seem that the LMC wants GPs to be paid for increased intensity of work, the increased contacts. More work that was done historically by secondary care is happening in primary care and the population is getting older and has more health needs. GPs need to be paid for the actual work they do it seems rather than counting the living and the dead on their registers. Having fee for service like the Australian system would threaten the profitability of many practices. If there is no list then people can go wherever and see whomever they choose. New players can enter the market if you don’t need an nhs contract. You just need a provider number and be registered as a practitioner and you can set up shop wherever you want like in Australia. Whether it would work all comes down to the items of service that the government would pay for and that the reimbursement values of those services. Could be as hard as brexit.