There was an old doc from Esquirement,
Who found himself surplus to requirement,
For the CQC
Shut his surgery,
So instead he took early retirement.
The depressed are going to A&E, not GP????
Could’ve fooled me.
A robust policy would avoid your understandable slippery slope concerns.
- ONLY those patients with full capacity, with a proven terminal illness, and with less than 6 months to live according to the opinion of 2 doctors, would be allowed to make this choice.
- no doctor would ever be pushed into signing a form if they morally object
- simply being old, depressed or demented would not be justification enough.
- The Netherlands have operated this compassionate policy for decades.
- terminal patients are already voting with their feet, dragging their exhausted bones to Zurich, paying thousands and risking prosecution of caring relatives just for some final control and dignity.
I sincerely hope that this option is available by the time I become terminally ill. I still find it astonishing that we (rightly) allow the right of termination at the start of life , yet still block it at the end, condemning poor patients with zero hope of improvement to a dragged out, painful , undignified end that we would never force on our beloved pets. We at least deserve the same rights as our cats and dogs.
A long long time ago GPs provided drop in surgeries with no appointments.
Then HMG decided to dump more and more tasks upon us, forcing GPs to introduce appointment systems across the board to manage the deluge of patients, the majority of whom were well, not ill.
So what about the acutely unwell?
Well, they started rocking up at A&E.
No worries, NHS111, extended hours, walk in centres.....these will mop them up.
And yet the hordes are still invading A&E.
Transforming GPs from care givers for the ill to administrators for the well was a catastrophic error which continues to reverberate throughout a broken NHS.
Cheadle?? Tory/Lib Dem marginal seat. Labour were 14,000 votes behind Conservatives, and 10,000 behind the Lib Dems.
Not a prayer, I’m afraid.
So we knew there was a nasty Aussie Flu coming down the pipe.
Then we had huge delays in vaccine supplies arriving (yet again), meaning large numbers of cancelled clinics in October, and disgruntled patients deciding not to bother again.
And A&E already overrun in Summer. IN SUMMER!!
Antivirals are useless, a near placebo fig leaf, involve a huge amount of GP time (coming from where, precisely??), and are thrown at uninfected individuals who may then be diagnosed far too late as they have already been “treated”.
TOTLights is right, this really could be the breaking point. I believe Australia is nice this time of year?
Naturally it will be APMS, staffed with ruinously expensive locums, then close down in 2 years time as unprofitable.
One day someone at the top will realise that GMS wasn’t so bad after all. Too late now, though, nobody with half a brain would touch a partnership with a barge pole.
When “rights” clash it never ends well, especially when both sides are determined not to compromise.
Hence religious groups picketing schools educating pupils about same sex relationships.
Or radical feminists who see their identity being erased by the rise of the transgender lobby.
Yet when the Abortion Act passed doctors were allowed to exclude themselves depending on their personal beliefs.
But such a sensible compromise seems impossible in these polarised times.
There are already storms brewing over GPs being strong armed into prescribing puberty blockers to trans children (is it more abusive to prescribe or not to prescribe?).
But reasonable debate is suppressed over fears of being labelled phobic.
(However, we should refer to any patient by whatever name or pronoun they like, it’s simple decent courtesy)
“20 Embassy, tenner of diesel, giant Mars Bar, can of coke and me statins please mate”
I’d stay away from the petroleum jelly if I were you though.
No political party will back this. It’s a vote loser. This is a Pyrrhic victory. In fact, it puts home visits back in the minds of patients who may have thought that ruthless triaging had effectively banished them in all but name. Many GPs only visit when they deem it necessary (mainly palliative) and stiffly reject/divert/admit/ bring to surgery the rest. If we all did this the problem would rapidly recede, without all the negative publicity we will receive if this is enacted.
Grow a spine, filter out 80% of requests, regain control, after a while patients stop asking. Only visit if you want/need to at a time that suits yourself. Can’t wait? Then go to A&E, we’re not an emergency service. Study the 2004 contract, we have control if we choose to enforce it.
My understanding from hospital colleagues is that there will be no “paying the bill”, but that the AA charge will be “scheme pays”. Then on retirement the AA amount will be knocked off. Of course, this means the Treasury claws some money back in increased Lifetime Allowance, but might attract doctors back to work this Winter without shelling out millions settling their tax bills.
Quite clever, really, but scrapping the taper and increasing AA to former levels would be far more effective.
I’m all in favour of a bit of optimism in these dark times, but focusing on “medical feminism” or “inclusivity and kindness” does seem to be missing the point.
As us old, knackered full time (mainly) male partners are worked into extinction, the young, spirited part time(mainly) female salaried doctors are (quite rightly) not willing to bear the yoke of 8am - 6.30pm 5 days a week with bottomless workload that we are/were subjected to.
Which begs the simple question. How will Primary Care survive?
The sexist point is well made but is rapidly becoming historical. Kicking the pale male stale corpse may give some satisfaction, but it’s already dead.
And being kind and inclusive is difficult when chained to your desk for 10 hours or more.
We need radical new ideas, not just empty Woke sloganeering.
“What a beautiful building! May I see a doctor please?”
“Sure. Here’s a map to show you the way to A&E”
“Oooh! It’s laminated too! Wonderful!”
Just a small piece of the chronic pain polypharmacy Pharmageddon jigsaw. These patients are hooked on the strongest opiates, return in more pain, then demand the next cab off the rank....duloxetine, pregabalin, NSAIDs and eventually tricyclics. It’s frightening how many of these patients take the lot, often backed by a Pain Clinic (discharge) letter. I suspect these stories will become more common, and GPs will take the blame as usual. Time to start rowing back on these drugs.
Excellent article. Agree with all of it, but probably political suicide to put it in a manifesto if comments like BonesFromStarTrek are anything to go by (“I’m a doctor, Jim, not a damned nanny!”).
If we’re serious about zero tolerance concerning racism then the guilty patients should be either removed from the list, or given a final written warning that any repeat behaviour will result in their immediate removal (and possible prosecution). If everything is properly documented then I don’t see PALS or any other patient rights groups being prepared to defend racists.
GPs have to be prepared to follow through with action, rather than letting this odious behaviour continue. Receptionists must record and report every “I only want to see the British doctor” incident for further action. Zero Tolerance is an empty slogan if we don’t.
Whoaml 12.22 - quite right!!
GP IS exciting! It’s a white knuckle ride every day....will your partner stay or leave? Will CQC treat you kindly? Will there be enough money in the account to pay the staff this month? Will Capita get their sums right just once? Will the extortionately expensive locum do any admin today? Who will you be lumbered with in the Home Visit lottery? Will you have a lunch break? Will you make it home before the kids are in bed? tick, tick, tick, tick......BOOM!!
Every day is like Mission Impossible. Step aside, Tom Cruise, the GP partner is in the front seat.......GO!!! WOO-HOO!!!!!
Health Minister - “Hmmmm, GPs want to give up home visits. How much does this currently cost us?”
Lackey- “nothing, Minister”
HM - “And how much would it cost to provide a visiting service?”
Lackey - “Many many millions, Minister”
HM - “Right, issue the the usual BS about how we “really value GPs”, reheat the 5000 more GPs promise.....no, make that 6000, it doesn’t really matter, there’s none any way....., and butter them up with all that “jewel in the NHS crown” crap, that usually fobs the moaners of for a year or so. Oh, and don’t forget the “out for consultation” tripe too”
Lackey- “Yes Minister”
Laugh or cry?
Which one did you do after reading this garbage?
I laughed, then felt miserable all morning. Didn’t cry, though. They’ve broken me already,