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William Murray

  • 'Struggling' NHS 111 puts pressure on GP out-of-hours services as calls soar

    William Murray's comment 05 Jan 2018 12:19pm

    Please can we have some objectivity on this re.”flu epidemic”.Is there one currently?Figures suggest normal Winter season variation in respiratory and “flu-like” illness.Over the last 10 yrs or so this has been a great”smoking mirrors”strategy by Government spokespeople to deflect the Real A/E problem which is lack of hospital beds due to constant bed closures/numbers as part of NHS policy.If you combine this with their other convenient scapegoat-too many old people “blocking “the ever diminishing bed availability no amount of extra financial and staff resources in A/E will make the slightest difference.

  • Record number of GP practices hand back contracts

    William Murray's comment 26 Sep 2017 5:49pm

    23% of the Scottish NHS budget going to primary care??? ---- surely this MSP is deluded! He presumably means Health And Social Care and that also sounds unbelievable.The actual GP service gets a fraction of this and it has been reduced over the last 10 yrs or so.He presumably believes the consistent current government sound bites of "we keep pumping money into the NHS in Scotland and there are more doctors and more nurses than ever and everything in the garden is coming up roses,so don't believe any of the current statements coming from doctors and nurses that we are currently slowly sinking."The MSP in question should go see for himself and ask some people that are actually in the firing line to see what is actually happening and why patients are having difficulties being seen----- anywhere in the NHS not just General Practice.

  • New BMA GP committee chair named most powerful GP in UK

    William Murray's comment 01 Sep 2017 12:24pm

    I have recently cancelled my direct debits for BMA and RCGP. In retrospect I should have done it 15 yrs ago.They stopped representing me around this time and I have watched general practice slowly but surely go down the tubes ever since.I have seen nothing but capitulation and cooperation with various governments and various examples of gp rhetoric and good practice advice have rendered me speechless..I could not justify funding them any longer in spite of the "tax deductible" benefits??? Of the membership fees.I expect the craziness to continue but without my financial support.

  • GPs to be asked to 'peer review' all referrals

    William Murray's comment 29 Aug 2017 2:20pm

    As a Scottish gp I look on with increasing incredulity at some of the crackpot ideas emanating from CCG's in England.Every gp with any experience will know that there are very varied and complicated social ,psychological,physical and cultural reasons why a gp makes a decision to refer.Without actually knowing and seeing the patient it is almost impossible to make a decision about the need for the referral especially with financial implications bearing down from accountants.As an aside,who will scrutinise the referrals of nurses,pharmacists,physician assistants and opticians when they take over the bulk of gp work.?? Will this be left to a diminishing group of gp experts(sic) who are prepared to take " the fall" for any medicolegal disasters?.

  • Scottish GPs may not be given a vote on new contract

    William Murray's comment 09 Mar 2017 11:36pm

    When is a contract not a contract ,when it is " imposed" before the contractor i.e. The independent gp contractor has seen it.Am I alone in finding this incredibly arrogant.I can't believe that this has even been considered.There goes 40 yrs of continuous BMA membership.I am finally,officially, on my own!This is absolutely and finally the lady straw!!!

  • Et tu GPC?

    William Murray's comment 24 Sep 2016 11:30am

    Have to be a little bit suspicious about the GMC involvement in the junior docs withdrawal from their intended first week of withdrawal of labour.My own personal opinion is that they have been"got at" by our political masters-again!!! and were parachuted in at the seventh hour to threaten the juniors with GMC attention in the event of any patients suffering extra pain or harm on account of treatment/surgery and outpatient app cancellations.Only the other day it was announced that the 50 percent of health authorities in England who bothered to reply to media queries about cancellations that had nothing whatsoever to do with the junior docs had cancelled 44000 ops n one year due to lack of available beds due to bed cuts and failures to fund their flagship policy of care in the community.No great concern shown for prolongation of pain and suffering in patients there then!!!.As for the BMA/GPC and their motivations re junior docs and the current self evident melt down in general practice,something does not smell right in the state of Denmark.The less said about the efforts of our Royal College the better.!

  • Hospitals banned from requesting re-referrals from GPs

    William Murray's comment 21 Apr 2016 5:44pm

    GP registrar 3.37 pm
    Good point - but why does the hospital/ secondary care management not set up a community service using secondary care venepuncturists Ie at their own expense for this purpose.I assume you have a lot to learn about GP funding.This phenomenon only came about in the last 10 yrs as a consequence of the precipitate-sometimes indecent haste that-"medically fit" patients are chucked back to the tender mercies of the severely under- resourced community teams.of doctors and nurses who have no other work to do!!!!

  • GP out-of-hours services to include more prominent role for nurses

    William Murray's comment 06 Apr 2016 4:48pm

    Obviously juxtaposes with an increasing difficulty in attracting "time served" GPs to do these sessions which are during "unsocial hours" at the "greedy fat cat rates" much discussed in various highly authoritative(politically partisan ergo anti-doctor) newspapers.I don't have any objection to advanced nurse practitioners trying to do this work although it would help if I knew what training in examination/diagnosis and management they have had,what scrutiny this has been subjected to and what ongoing appraisal ensures their standards.I personally would not be happy to supervise someone in this situation.I know a lot of nurses who feel very confident about doing this but confidence does not equate to competence.Are these nurses going to be given medical training and who is going to provide this.Handing them stacks of protocols and algorithms and throwing in some Crown Immunity may prove very costly to the British tax payers in the short,medium and long term.

  • GPs to be trained in 'leadership' and redesigning services

    William Murray's comment 23 Feb 2016 0:22am

    The excitement is getting the better of me."Focusing on complex care,whole system quality improvement,and undifferentiated presentations".Apart from the fact that I deal with 40 undifferentiated presentations daily,sweat buckets over dealing with complex care and with any spare time that is left(precious little) I attempt whole system guality improvement,I still look forward to getting time away to be instructed in these fine arts.However I have no idea where the time will come from to deal with the mountain of paperwork generated every day
    All of this ,designed of course,to take pressures off hospital based services in spite of a 3 percent or so reduction in primary care services and a burgeoning post discharge workload coming from primary care.
    Sorry but the figures don,t add up to me.Unless this whole concept is appropriately funded it will fall flat very quickly and HSCPs will be a miserable failure
    Unfortunately if things keep deteriorating in general practice,ANPs will be required to do bog standard GP work any there will be precious few if any GPs to help the Government to keep "bed blockers" out of hospital as they have been pejoratively called with increasing vociferousness in the last few years.

  • 'Striking is just something doctors should not do'

    William Murray's comment 17 Jan 2016 4:28pm

    Of course Dr Summerton is entitled to his opinion but so are all the junior docs who felt strong enough to take strike action when confronted by an intransigent government with an alternative agenda.I remember thinking while toiling away as a resident that if the taxpayers had to pay me an hourly rate for each hour I worked rather than a fraction then collectively the junior docs alone could have caused a major financial crisis in the country.Then came the EWTD and the gradual and total emasculation(and I don't mean this in the gender sense) together with the de-professionalisation of medical practitioners especially within the secondary care setting, combined with the supermarket type managerial hierarchies installed to make hospitals competitive and "more productive" that anyone who could think for themselves should have been able to see that the "perfect storm" had been created.This is clearly a recipe that was all about turning junior docs,in combination with the current revolving door policy of getting patients out of hospital as soon as possible to complement the continual shrinkage of bed numbers,into controllable automatons.Unfortunately it is still costing too much money and junior doctors are easy target when combined with weak leadership from the BMA RCGP and increasing hostility from the GMC.So I say as one old doctor to a lot of young doctors-"more power to your elbow".Unless your senior colleagues decide to man the barricades you are the only thing left between the continuance and the end of the Health Service as we know it.

  • The risks of noctors, phoctors & mocktors

    William Murray's comment 25 Oct 2015 5:49pm

    I don't think I can take my argument/ discussion any further forward.I think we have to beg to differ on who takes ultimate responsibility, in the law courts,in the event of an adverse reaction for whatever reason to a prescribed drug..GP partner 25th of October 2015 10.08 am says in a couple of sentences what I have been saying over the last week.I think if you ask some of your GP colleagues what they really think of this problem and assuming that they are being honest,you may be surprised at their response

  • The risks of noctors, phoctors & mocktors

    William Murray's comment 25 Oct 2015 5:49pm

    I don't think I can take my argument/ discussion any further forward.I think we have to beg to differ on who takes ultimate responsibility, in the law courts,in the event of an adverse reaction for whatever reason to a prescribed drug..GP partner 25th of October 2015 10.08 am says in a couple of sentences what I have been saying over the last week.I think if you ask some of your GP colleagues what they really think of this problem and assuming that they are being honest,you may be surprised at their response

  • The risks of noctors, phoctors & mocktors

    William Murray's comment 23 Oct 2015 9:32pm

    Re anonymous nurse 22 Oct 2015 10.52pm

    I apologise if you feel I am making a personal attack on you and what you do as this is not the sentiment I am trying to get across.My aim is to set up a discussion about who takes responsibility for what as originally posed by Shaba Nabi.I thought her article was a very reasonable attempt at initiating a sensible discussion about a new trend that is occurring in secondary care.This phenomenon has evolved without any meaningful consultation with Primary Care in spite of the fact that there are,potentially, very serious medico-legal connotations for GPs if things go wrong.As already stated I could not get any meaningful or reassuring advice from my Defence Organization which did not help."My gp and consultant colleagues are following this thread , with a mixture of despair and amusement".---I suggest that it may be more fruitful and constructive if they take the bull by the horns and wade into the discussion and explain why they feel the way they do hopefully with some identification,then everyone can feel the mixture of despair and amusement.
    I have not called anyone a noctor and I certainly did not call you darling and it is not my aim to disrespect anyone.Some of the comments I have seen in the 60 odd posts so far have been completely uncalled but not surprising considering the amount of negative spin in the press and tv media of late about doctors in general.At the end of the day all practitioners who see ,assess ,examine ,investigate ,diagnose and treat patients should take full responsibility for their own actions and this will silence me instantly-hopefully the Law Courts will treat is in the same even handed way.

  • The risks of noctors, phoctors & mocktors

    William Murray's comment 23 Oct 2015 9:32pm

    Re anonymous nurse 22 Oct 2015 10.52pm

    I apologise if you feel I am making a personal attack on you and what you do as this is not the sentiment I am trying to get across.My aim is to set up a discussion about who takes responsibility for what as originally posed by Shaba Nabi.I thought her article was a very reasonable attempt at initiating a sensible discussion about a new trend that is occurring in secondary care.This phenomenon has evolved without any meaningful consultation with Primary Care in spite of the fact that there are,potentially, very serious medico-legal connotations for GPs if things go wrong.As already stated I could not get any meaningful or reassuring advice from my Defence Organization which did not help."My gp and consultant colleagues are following this thread , with a mixture of despair and amusement".---I suggest that it may be more fruitful and constructive if they take the bull by the horns and wade into the discussion and explain why they feel the way they do hopefully with some identification,then everyone can feel the mixture of despair and amusement.
    I have not called anyone a noctor and I certainly did not call you darling and it is not my aim to disrespect anyone.Some of the comments I have seen in the 60 odd posts so far have been completely uncalled but not surprising considering the amount of negative spin in the press and tv media of late about doctors in general.At the end of the day all practitioners who see ,assess ,examine ,investigate ,diagnose and treat patients should take full responsibility for their own actions and this will silence me instantly-hopefully the Law Courts will treat is in the same even handed way.

  • The risks of noctors, phoctors & mocktors

    William Murray's comment 22 Oct 2015 8:52pm

    Re anonymous nurse 22 Oct 2015 0.41am
    Thank you for the invitation but my original comments were about responsibility for prescribing not about whether or not you have an encyclopaedic knowledge of epilepsy..I have no reason to doubt that you have acquired a lot of knowledge of this and it would appear that you run your own autonomous clinic open to referrals from "all airts and pairts "but as a GP I still have a problem convincing my Defence Organization that they should give me the same cover as I get when a hospital doctor asks me to prescribe something without the usual "smoking mirror" legal jargonese that effectively covers their backs.You are not under any obligation to prove anything to me about your knowledge or skill set and hopefully your pay grade reflects this.
    This blog has certainly set off a complete bun fight and as my colleague Shabi Nabi has said the main thrust of her article was about who takes responsibility for whose actions.I have no problem with anyone who feels confident to deal with medical or psychiatric problems after making an assessment to go ahead and do so but only if they stand alone and accept responsibility for their actions.A pharmacy colleague commented that GPS will have to learn to rely on other practitioners such as ANPS and pharmacists to make diagnoses and initiate treatments if the health service is to survive.The only thing I disagree with regarding this comment is that it is patients and not doctors who have to rely on these practitioners.
    I have to say that it seems that "doctors" are not held in very high esteem by their pharmacy colleagues.I think this is regrettable.
    Lastly it appears to me in the blogs appearing in pulse that the metamorphosis in the NHS in the last 10 -15 yrs particularly in secondary care has caused a huge amount of inter - professional rivalry and judging from the amount of vim and vitriol emanating from these dark rivalries it is difficult to see much future for " our Jewel in the crown"

    PS I have posted under my own name as there cannot be much respect for colleagues who post anonymously

  • The risks of noctors, phoctors & mocktors

    William Murray's comment 21 Oct 2015 10:07pm

    Re Anonymous nurse. 21st October 0.22am.
    I have to say your further comments about professional responsibility for prescription advice does not reassure me in any way.Also in many ways it worries me that your consultant colleagues have no apparent input into your actions when dealing with patients that they must also be involved with and that they would not feel in any way responsible in any way for the choices that you make.I note that you worked as a generalist in general practice but I do not really know what this means.
    I was told by my defence union that they had no objection to gps acting on advice from nurses as they felt that the nurses were known to their medical colleagues who must be happy with their prescribing choices???.This seems to be at odds with what you say.They also reminded me that I was responsible for any prescriptions that I write regardless of who gave the recommendation.Therefore I felt their advice was useless!!!.However if a consultant physician or even a medically qualified junior asked me to prescribe a medication and there were catastrophic consequences for the patient I would be more confident of defending myself in court.Sorry to sat that but this is self preserving fact of life.I feel a lot of water has to go under the bridge before I take a leap of faith in this respect. I don't know how my colleagues feel about this but I would be very interested to hear.

    ,

  • Pharmacies ‘discouraging’ patients from GP flu jabs

    William Murray's comment 17 Oct 2015 2:03pm

    Watching this bun fight progress and gradually deteriorate between gps and pharmacists has been in parts interesting,enlightening but also worrying.Two groups of professionals both having a go at each other without having any useful or insightful knowledge of each other's working practices and work related pressures. Most of the comments and arguments on both sides are based on false premise.Only people getting satisfaction from these interactions are our political masters who must currently be w allowing in their own smugness.

  • Pedaloing into an evidence-free future

    William Murray's comment 14 Sep 2015 6:13pm

    I love it when Copperfield points out the banana skin slipping u- turns taken by our high and mighty clinical superiors at the RCGP and their soulmates on the EBM Committees that are NICE and SIGN.There is always a bit of room in General Practice for a little bit of witch-doctoring or it's latter day equivalent-Personal Health Budgets.The big fly in the ointment(presumably a Nice/Sign approved ointment)is that standard GP witch doctoring perhaps better known as holistically sympathetic treatment strategies,are much cheaper to the tax payers.Keep up the good work Copperfield your critical blogs are worth a barrow load of Personal Health Budgets to my physical psychological and social well being and they cost the DH nothing!!!

  • GP witch-hunt could boost morale

    William Murray's comment 02 Aug 2014 3:45pm

    If we had better representation from a group of people (the bma) who at their very best can only shout quietly and a group of people (royal college of gps-spelling without capitals a deliberate mistake) who frankly seem so short sighted they cannot see the wood for the trees and who seem-with the occasional exception-to lose control of their senses, the British public may realise they have"to give a sh*t".So far they are being bombarded by much cleverer and more eloquent newspaper columnists.On the run up to election 2015 our spokespersons have to really go on the offensive otherwise the battle will be lost.

  • NHS Health Checks no more effective than usual practice, study finds

    William Murray's comment 02 Aug 2014 3:25pm

    Acquiescing to easy income streams over the last 10yrs have become a characteristic of gp independent contractors.It mostly flies in the face of their sense of integrity which has been lost because of a political masterstroke ie tying it in with the maintainence of income-not an increase.As a result objectivity has disappeared out of the widow on many occasions.This has given even more heavy calibre ammunition to the uneven handed and politically motivated newspapers Little wonder gp morale is now lower than a limbo stick.The news that a small number of "leading gps" have spoken out in favour of privatization is another own goal.I see no evidence of our royal college,the BMA, or LMCS.taking a strong stance on any of this--who do they represent-not me!!!!.It sure is lonely out here!!!