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Gold, incentives and meh

Vinci Ho

  • GP petition threatens RCGP resignation due to 'controversial' conference speaker

    Vinci Ho's comment 18 May 2019 7:08pm

    Mmmm
    It appears to be an issue of freedom of speech in here but perhaps not quite .
    The conference is like a private party you throw in your own house , just like this platform where Jaimie and Pulse is the host .
    The interesting question here is , ‘ Who is the host in this private party of annual RCGP conference?’ The College is formed and funded by its members. Should it respect the feelings of the members ,who incidentally are the ones coming to this party ?

  • Prime Minister hopes to recruit 5,000 extra GPs 'as soon as possible'

    Vinci Ho's comment 16 May 2019 10:06pm

    Sigh !
    Guys , where is your empathy towards our poor , ‘dying’ prime minister ?Auntie has less than a month before her ‘Endgame ballot ‘ ( fourth of the kind ) . Her fate is sealed .
    What she said about getting 5000 GPs ASAP is out of an ‘innocent’ wishful thinking , please embrace with your good heart .😁
    ‘ When a bird is about to die , its tweet is particularly poignant. When a person comes to the end of life , his/her last words are naturally out of kind nature .’ Analects.
    (鳥之將死 ,其鳴也哀。人之將死 ,其言也善。)😑

  • Shadow health secretary raises Pulse findings in Commons public health debate

    Vinci Ho's comment 16 May 2019 3:11pm

    Jaimie , you should be honoured. If there was no PULSE , these politicians would have nothing to talk about .As I always suspect, they have specially designated staff monitoring this platform every single day . Of course , some even tried to ‘infiltrate’ . Remember Madangate?😄

  • NHS workforce implementation plan delayed again

    Vinci Ho's comment 02 May 2019 6:00pm

    Well , the intention of this Robocop is never more apparent: Why does he need to lose sleep about the legacy of Agent Hunt’s wonderful achievement ? Reaching the target of 5000, 6000 or 7000 more GPs , who cares now ?
    His nerdy obsession in technology, GP at Hand , smartphone apps and ultimately, AI to replace GPs , is the driving force to shift the narrative ,sooner or later , that GPs are perhaps , not so important as we think traditionally . They are indeed too expensive and let’s move on with 21st technology . Of course , he has some wonderful private companies under his umbrella ready for this ‘groundbreaking’ digital revolution in first general practice, then secondary care in NHS .
    Allowing GP at Hand to develop its own GP network is the first step of Robocop’s own grand plan .
    If this is not war , I don’t know what else is ?

  • GP at Hand set to apply to be single network in 'destabilising' move

    Vinci Ho's comment 02 May 2019 3:26pm

    Interestingly , there is an interesting , analytical article on Sky News today about the digital/technology mentality of our honourable incumbent Health Secretary :

    https://news.sky.com/story/sky-views-porn-block-highlights-concerns-about-proud-nerd-matt-hancock-11709054

  • The global sum smoke and mirrors

    Vinci Ho's comment 01 May 2019 3:04pm

    Is GP networking a Trojan Horse ?

    Desperate times need desperate measures.
    On the land of politics in our country, nothing is currently more controversial than the cross-party discussion of the direction Brexit will take place between Labour and Conservative parties .
    For our beloved GP land , the formation of GP networks is the main theme of this new five-year GP contract . The price tags have been allocated but we are yet to see the actual money as far as the bookkeepers of the networks are concerned.
    Finally , in the fantasy world of Westeros( Game of Thrones) , we saw the incest-bound union(more appropriately mating )between Daenerys Targaryen and Jon Snow , the relationship of whom we know now as aunt and nephew.
    All parties of interest in these three worlds have one thing in common : their fundamental relationship is potentially competitive and antagonistic with the risk of serving as anathema to each other .

    xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

    Like every new ideology appearing on the horizon, we should lay aside our prejudice for a minute and welcome it with open arms. But that , certainly, does not mean questions are not to be asked . My LMC Secretary once taught me, ‘ Do not ask the question in politics unless you knew the answers.’ So there are some questions worth considering for this notion of GP networking:
    (1) Can member practices in a network live happy ever after ?
    As I wrote before , it is difficult for five GP partners in a practice to agree unanimously on certain issues , how hard is it to be in a network covering 30-50,000 patients. Always remember the trilemma principle:- amongst sovereignty, integration and democracy, one can only have two out of the three but never all of them.
    (2) How can the new resources injected into GP networks from the governments be evenly and fairly distributed? For example, for pharmacists , physician assistants , physiotherapists , how much time should they spend in each member practice every week? And when it comes to the new money and how to spend it; well , the caveat is in fact , a potential civil war within a network?
    (3) Perhaps , that is why ‘super-practices’ come into the equation . They provide the governance to save your headaches and settle disputes with your fellow network members . Actually, this is an extraordinary phenomenon simply because the government refuses to equate super-practices with GP networks. Bottom line is , it wants to move away from investing in GP practices individually . Will this create another complex behemoth of bureaucracy stifling flexibility and hence , efficiency? What is the natural history of these big monsters eventually?
    (4) We need the new money to address this current crisis of shortage in resources. We have been starved of tools to provide the current services . The objectives of this new contract , however , appear to be , by GP networking , widening the ‘dumping ground ‘ for more work to be thrown at us from all directions. Yes , you are giving us some new tools but these are easily outweighed by the number of new tasks waiting on the line . Where is the STOP button ?
    5) Hence , last but not the least , GP workload . I am yet to be convinced that the government actually understood how heavy our daily workload was before it sat down to negotiate this new contract with our representatives. Because not too long ago , its propaganda media( you know who!) was still bashing and condemning us as lazy , ignorant and irresponsible ( the tone might have been changed after the Big Boss stepped down ) . If it was not for some strident figures showing a dramatic drop in the number of full-time equivalent GPs in the country ( all four nations) last few years , do you think we would have had this conversation today ? Crisis , what crisis? Remember that ?
    Having said that , I understand from listening to our BMA colleague during a recent roadshow that the new contract is subjected to some path-finding and self-correction as we move down the road . But this can only be credible if the government is receptive and shows some humility.
    Hence , I am looking forward to see Jaimie’s new born baby called GP workload survey report .
    xxxxxxxxxxxxxxx
    Step by step
    Heart to heart
    Left, right, left
    We all fall down
    Like toy soldiers
    Bit by bit torn apart
    We never win
    But the battle wages on
    For toy soldiers

    Too many of our colleagues have been burnt out and fallen down . Is it my fantasy that all toy soldiers can , one day , unite together as a true army to resist our enemy who is always trying to divide and conquer us ?

  • Only 9p per patient of global sum uplift is new funding

    Vinci Ho's comment 01 May 2019 2:44pm

    My biggest concern remains in this funding mechanism through GP networks and practically representing an end to funding practices individually . As I wrote in my recent long comment ( Is GP networking a Trojan Horse?) , I cannot see members of networks could happily agree how to divide these new funding and resources ( pharmacist, physiotherapist , paramedic etc in the coming years) fairly without dispute and potential in-fighting . Yes , the option of merging into a super-practice remains and of course , in the expense of continuity of care .

  • Automation could free up 31% of GP time, says Hancock report

    Vinci Ho's comment 01 May 2019 1:44pm

    (1) Obviously , Robocop is trying to change the narrative of how future health services should be conducted and he wanted to start from general practice as we are in a crisis anyway . Just like the movie(1987 one , not the bloody remake) , the crime-beleaguered Detroit in a dystopian future needed a new way to fight crime and it was about giving a contract to private company to develop pure technology-driven Robocop (The mayor signed a deal with the mega-corporation Omni Consumer Products (OCP), giving it complete control of the underfunded Detroit Police Department. ) . Remember that ?
    (2) Then ,obviously you need egghead researchers to publish articles to support the claim . How many times have we seen this ? Credit to Imperial College and Azeem to be the child laughing at the Emperor’s new clothes .
    (3) Absolutely no doubt we need a faster and more efficient broadband system to deliver what we are doing everyday . But this is because we owe our patients even better continuity of care which is constantly being eroded by this bunch of politicians and policy-pen pushing -makers .
    (4) I do not know whether AI can deliver exactly what we are doing now , one day in the future with its alternate ‘human touch’. But right now , we can do with less ostentatious ideologies siphoning away the vital resources we need every day to look after our patients .
    (5) The truth is always the truth and cannot be condemned to be a lie . A lie is a lie and cannot be wrapped up and packaged to become the truth 😑

  • Death by a thousand workload dumps

    Vinci Ho's comment 25 Apr 2019 1:30pm

    Yes , I am the stupid bas**** who keeps writing everyday , free of charge , even when I am sitting on the toilet ! Ha ha ha 🤪

  • Death by a thousand workload dumps

    Vinci Ho's comment 24 Apr 2019 2:58pm

    Correction
    ......paperless-NHS...

  • Death by a thousand workload dumps

    Vinci Ho's comment 24 Apr 2019 2:57pm

    The blind faith on technology and absolute paperless-NHD(manifested by universal e-referral with zero letter referral) has killed off any flexibility. Apart from 2 week rule referrals , nothing called ‘urgent’ referral is taken seriously by secondary care any more . GPs cannot fax or send an urgent letter to a consultant. Many serious non- cancerous conditions are being pushed to the back of the queue in all specialties .
    After all , the referral to treatment time(RTT) continues to go beyond the target of 62 days , despite the fact that most resources in secondary care are diverted to cancer care . The arithmetic just does not add up .
    Dumping workload to GPs is a natural consequence of stifling growth in resources per year in the last 10 years . Another new GP contract is merely trying to over-compensate while a serious ,honest debate of how to raise resources (various different ways to consider) for a totally protected health care budget , is now inevitable.

  • 'We must tackle the epidemic of stupid tweets'

    Vinci Ho's comment 21 Apr 2019 9:18am

    (i) Sheer egoism. Desire to seem clever, to be talked about, to be remembered after death, to get your own back on the grown-ups who snubbed you in childhood, etc., etc. It is humbug to pretend this is not a motive, and a strong one. Writers share this characteristic with scientists, artists, politicians, lawyers, soldiers, successful businessmen — in short, with the whole top crust of humanity. The great mass of human beings are not acutely selfish. After the age of about thirty they almost abandon the sense of being individuals at all — and live chiefly for others, or are simply smothered under drudgery. But there is also the minority of gifted, willful people who are determined to live their own lives to the end, and writers belong in this class. Serious writers, I should say, are on the whole more vain and self-centered than journalists, though less interested in money.
    (ii) Aesthetic enthusiasm. Perception of beauty in the external world, or, on the other hand, in words and their right arrangement. Pleasure in the impact of one sound on another, in the firmness of good prose or the rhythm of a good story. Desire to share an experience which one feels is valuable and ought not to be missed. The aesthetic motive is very feeble in a lot of writers, but even a pamphleteer or writer of textbooks will have pet words and phrases which appeal to him for non-utilitarian reasons; or he may feel strongly about typography, width of margins, etc. Above the level of a railway guide, no book is quite free from aesthetic considerations.
    (iii) Historical impulse. Desire to see things as they are, to find out true facts and store them up for the use of posterity.
    (iv) Political purpose. — Using the word ‘political’ in the widest possible sense. Desire to push the world in a certain direction, to alter other peoples’ idea of the kind of society that they should strive after. Once again, no book is genuinely free from political bias. The opinion that art should have nothing to do with politics is itself a political attitude.

  • 'We must tackle the epidemic of stupid tweets'

    Vinci Ho's comment 21 Apr 2019 9:18am

    Such a strong temptation to pick up your smartphone and write something on your most favourite social media everyday , why?
    I would like to recall George Orwell’s four insightful explanations in his prose ‘Why I write?’ in 1946:-

  • 'We must tackle the epidemic of stupid tweets'

    Vinci Ho's comment 21 Apr 2019 9:01am

    Thanks to 21st century technology with smartphone and social media , we have a modernised definition of 'ignorance' , one of the Five Giant Evils named by William Beverige in 1942.
    While illiteracy was perhaps really 'evil' and many people were unable to express their opinions with little knowledge, we have now millions of 'Key Opnion Leaders' (KOLs) making this world 'better' everyday. Wonderful !😂

  • First-contact physio 'can deal with 99% of MSK patients'

    Vinci Ho's comment 16 Apr 2019 8:10am

    Told you so .
    My mother is a woman!
    So why do we still have to wait a year or two to have community physiotherapists attached to GP networks??

  • Half of patients on statins have ‘sub-optimal’ response to treatment

    Vinci Ho's comment 16 Apr 2019 7:52am

    ‘’When figures were adjusted for age, sub-optimal responders were 22% more likely to experience a CVD-related event, such as coronary artery disease, stroke or TIA, or peripheral vascular disease than optimal responders.
    Sub-optimal responders were also 25% more likely to die of CVD-related causes.’’

    So these are , in fact, figures of comparison . But I suppose the question is , ‘Is suboptimal response still better and more beneficial than not taking statin , to what extent ?’

  • Superpractices looking to take leadership roles on GP networks across England

    Vinci Ho's comment 15 Apr 2019 3:28pm

    Is GP networking a Trojan Horse ?

    Desperate times need desperate measures.
    On the land of politics in our country, nothing is currently more controversial than the cross-party discussion of the direction Brexit will take place between Labour and Conservative parties .
    For our beloved GP land , the formation of GP networks is the main theme of this new five-year GP contract . The price tags have been allocated but we are yet to see the actual money as far as the bookkeepers of the networks are concerned.
    Finally , in the fantasy world of Westeros( Game of Thrones) , we saw the incest-bound union(more appropriately mating )between Daenerys Targaryen and Jon Snow , the relationship of whom we know now as aunt and nephew.
    All parties of interest in these three worlds have one thing in common : their fundamental relationship is potentially competitive and antagonistic with the risk of serving as anathema to each other .

    xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

    Like every new ideology appearing on the horizon, we should lay aside our prejudice for a minute and welcome it with open arms. But that , certainly, does not mean questions are not to be asked . My LMC Secretary once taught me, ‘ Do not ask the question in politics unless you knew the answers.’ So there are some questions worth considering for this notion of GP networking:
    (1) Can member practices in a network live happy ever after ?
    As I wrote before , it is difficult for five GP partners in a practice to agree unanimously on certain issues , how hard is it to be in a network covering 30-50,000 patients. Always remember the trilemma principle:- amongst sovereignty, integration and democracy, one can only have two out of the three but never all of them.
    (2) How can the new resources injected into GP networks from the governments be evenly and fairly distributed? For example, for pharmacists , physician assistants , physiotherapists , how much time should they spend in each member practice every week? And when it comes to the new money and how to spend it; well , the caveat is in fact , a potential civil war within a network?
    (3) Perhaps , that is why ‘super-practices’ come into the equation . They provide the governance to save your headaches and settle disputes with your fellow network members . Actually, this is an extraordinary phenomenon simply because the government refuses to equate super-practices with GP networks. Bottom line is , it wants to move away from investing in GP practices individually . Will this create another complex behemoth of bureaucracy stifling flexibility and hence , efficiency? What is the natural history of these big monsters eventually?
    (4) We need the new money to address this current crisis of shortage in resources. We have been starved of tools to provide the current services . The objectives of this new contract , however , appear to be , by GP networking , widening the ‘dumping ground ‘ for more work to be thrown at us from all directions. Yes , you are giving us some new tools but these are easily outweighed by the number of new tasks waiting on the line . Where is the STOP button ?
    5) Hence , last but not the least , GP workload . I am yet to be convinced that the government actually understood how heavy our daily workload was before it sat down to negotiate this new contract with our representatives. Because not too long ago , its propaganda media( you know who!) was still bashing and condemning us as lazy , ignorant and irresponsible ( the tone might have been changed after the Big Boss stepped down ) . If it was not for some strident figures showing a dramatic drop in the number of full-time equivalent GPs in the country ( all four nations) last few years , do you think we would have had this conversation today ? Crisis , what crisis? Remember that ?
    Having said that , I understand from listening to our BMA colleague during a recent roadshow that the new contract is subjected to some path-finding and self-correction as we move down the road . But this can only be credible if the government is receptive and shows some humility.
    Hence , I am looking forward to see Jaimie’s new born baby called GP workload survey report .
    xxxxxxxxxxxxxxx
    Step by step
    Heart to heart
    Left, right, left
    We all fall down
    Like toy soldiers
    Bit by bit torn apart
    We never win
    But the battle wages on
    For toy soldiers

    Too many of our colleagues have been burnt out and fallen down . Is it my fantasy that all toy soldiers can , one day , unite together as a true army to resist our enemy who is always trying to divide and conquer us ?

  • GP workload is a matter of life and death

    Vinci Ho's comment 14 Apr 2019 9:52pm

    Is GP networking a Trojan Horse ?

    Desperate times need desperate measures.
    On the land of politics in our country, nothing is currently more controversial than the cross-party discussion of the direction Brexit will take place between Labour and Conservative parties .
    For our beloved GP land , the formation of GP networks is the main theme of this new five-year GP contract . The price tags have been allocated but we are yet to see the actual money as far as the bookkeepers of the networks are concerned.
    Finally , in the fantasy world of Westeros( Game of Thrones) , we saw the incest-bound union(more appropriately mating )between Daenerys Targaryen and Jon Snow , the relationship of whom we know now as aunt and nephew.
    All parties of interest in these three worlds have one thing in common : their fundamental relationship is potentially competitive and antagonistic with the risk of serving as anathema to each other .

    xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

    Like every new ideology appearing on the horizon, we should lay aside our prejudice for a minute and welcome it with open arms. But that , certainly, does not mean questions are not to be asked . My LMC Secretary once taught me, ‘ Do not ask the question in politics unless you knew the answers.’ So there are some questions worth considering for this notion of GP networking:
    (1) Can member practices in a network live happy ever after ?
    As I wrote before , it is difficult for five GP partners in a practice to agree unanimously on certain issues , how hard is it to be in a network covering 30-50,000 patients. Always remember the trilemma principle:- amongst sovereignty, integration and democracy, one can only have two out of the three but never all of them.
    (2) How can the new resources injected into GP networks from the governments be evenly and fairly distributed? For example, for pharmacists , physician assistants , physiotherapists , how much time should they spend in each member practice every week? And when it comes to the new money and how to spend it; well , the caveat is in fact , a potential civil war within a network?
    (3) Perhaps , that is why ‘super-practices’ come into the equation . They provide the governance to save your headaches and settle disputes with your fellow network members . Actually, this is an extraordinary phenomenon simply because the government refuses to equate super-practices with GP networks. Bottom line is , it wants to move away from investing in GP practices individually . Will this create another complex behemoth of bureaucracy stifling flexibility and hence , efficiency? What is the natural history of these big monsters eventually?
    (4) We need the new money to address this current crisis of shortage in resources. We have been starved of tools to provide the current services . The objectives of this new contract , however , appear to be , by GP networking , widening the ‘dumping ground ‘ for more work to be thrown at us from all directions. Yes , you are giving us some new tools but these are easily outweighed by the number of new tasks waiting on the line . Where is the STOP button ?
    5) Hence , last but not the least , GP workload . I am yet to be convinced that the government actually understood how heavy our daily workload was before it sat down to negotiate this new contract with our representatives. Because not too long ago , its propaganda media( you know who!) was still bashing and condemning us as lazy , ignorant and irresponsible ( the tone might have been changed after the Big Boss stepped down ) . If it was not for some strident figures showing a dramatic drop in the number of full-time equivalent GPs in the country ( all four nations) last few years , do you think we would have had this conversation today ? Crisis , what crisis? Remember that ?
    Having said that , I understand from listening to our BMA colleague during a recent roadshow that the new contract is subjected to some path-finding and self-correction as we move down the road . But this can only be credible if the government is receptive and shows some humility.
    Hence , I am looking forward to see Jaimie’s new born baby called GP workload survey report .
    xxxxxxxxxxxxxxx
    Step by step
    Heart to heart
    Left, right, left
    We all fall down
    Like toy soldiers
    Bit by bit torn apart
    We never win
    But the battle wages on
    For toy soldiers

    Too many of our colleagues have been burnt out and fallen down . Is it my fantasy that all toy soldiers can , one day , unite together as a true army to resist our enemy who is always trying to divide and conquer us ?

  • I'm glad the College has acted on my petition

    Vinci Ho's comment 12 Apr 2019 2:16pm

    Well done , young lady .
    Remember the truth-telling child in the The Emperor’s new clothes ?
    When you are well assimilated in an establishment , you become afraid of telling the truth because of baggages .....

  • Dr Bawa-Garba allowed to return to practice from July 2019

    Vinci Ho's comment 10 Apr 2019 6:02am

    And more importantly, if you read the latest BBC new Health on the case of Ian Paterson , it clearly demonstrates (a) the importance of a balanced approach in a regulatory system (b) the difference between a ‘crime’ with intent and no intent (c) the contrast between NHS and private sector):
    ‘’Private hospitals must do more to keep patients safe and prevent rogue surgeons like Ian Paterson from harming anyone again, the Royal College of Surgeons says.........’’
    https://www.bbc.co.uk/news/health-47867281