How does this sort of thing accidentally happen? Clearly it was deliberate. Someone has seen the problem and had some new stickers made up and applied. They should have had some new boxes made up and repackaged the out of date masks. Counterfeiters at the local market do a better job. This just goes to show the utter contempt they have for doctors that they didn’t try harder with the concealment.
So what is the projection on how many GPs are going to be killed by this?
What are immunocompromised colleagues, pregnant colleagues, those who have had a baby within the last 12 months, those on ACEI, ARBs, smokers and generally anyone at increased risk above the mean supposed to do? We are not all 30 years old and fit & well with no co-morbidities. Don’t we have a union that is supposed to stand up for our interests and advise us about such matters? Have they issued any advice?
A flat rate of tax of 33% would stimulate productivity. The more you earn the more you pay because that’s how percentages work. The nonsense of an effective tax rate of 60% between £100k and 125k. With National insurance tax on top of that which all goes into the general taxation pot. What the hell? Similar issues with taxing the hell out of people’s pensions. The UK is one of the most overtaxed states. Despite that health inequality and income inequality are getting worse. Get out whilst you still can.
Letters for the insurance companies aren’t covered by GMS contract or similar. Being a bit anxious about travelling when that that is a reasonable response to the situation is not a medical condition but rather it is a normal response. I trust everyone is charging Private fees for private work that suitably renumerates you for your time. If not you only have yourselves to blame yet again.
Positive people who see the world through a different prism. We need more of them. Even with all the problems and the highly probable outcome that PCNs will fail acknowledged by the article it is still very positive. There is no point being depressed by something in your life that you don’t have the will to change.
It would make more sense to pay GPs to stay past retirement age for a few years for a bonus of 20k per year tax free lump sum. 5000 extra doctors- election promise delivered by the time of the next election. Much quicker than having to train new ones.
Or if one is feeling radical and not in the mood to pay for it. There is a national crisis extreme measures are required. Stop GPs retiring early by not allowing them to collect any part of their pension until age 68yrs. I’m really surprised they haven’t brought that in.
Agreeableness is a personality trait that is more typically feminine. General practice has become more feminine over the years, Changes to the training program have helped bring that about. We have seen and are seeing demographic changes with an increasing proportion of GPs being those who identify as female taking their place amongst the profession also.
Women on average earn less than men across many industries. So who is actually surprised that now General Practice is increasingly feminised that GP income has fallen. This was completely foreseeable for those of us with eyes.
I hear some colleagues still say they didn’t get into medicine for money. If they wanted to earn big bucks they would have gone into the City. Surprisingly none of them are working as missionaries or working for free in some other way. I suspect most of them wouldn’t actually survive in the world of high finance. It is however rather prophetic that incomes are dropping. I suppose this is of no concern to many of us as we didn’t go into medicine for the money. Those locum doctor types on the other hand must be cut from another piece of cloth, their incomes and their workloads are very different to the rest of us. Still mostly men in that cohort.
Why are we laying the blame on the surgeons? They are only passing on the message from their employers who in turn are passing on the rules laid down by the commissioners. Rather bad form to be criticising our hospital colleagues when they don’t deserve it.
BMI 30 isn’t that fat- or possibly isn’t fat at all if you happen to be a stocky rugby player type or a gym junkie.
Smokers are a possible health and safety issue for the poor anaesthetists breathing out Contaminated air from their lungs. Well anything is possible and if you need a justification to discriminate against these social pariahs it seems a reasonable enough excuse.
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.