History cannot be re-written . The truth is Mr Massey would not behave like what he is behaving right now , trying to be the ‘good guy’ again ‘bridging’ the differences between the profession and GMC . The problem is one word : Trust .
One cannot sustain on his feet if trust is already lost .(民無信不立） Analects.
Mr Massey , with decency and conscience, should you consider stepping down now ?😑
The ideology of PCN is always at risk of becoming a slippery slope fallacy with the same kind of traditional mentality in NHSE . Two-tier system , biases, one size fits all ; how many times have we been criticising NHSE and its hierarchy on flawed principles. Bottom line is : loss of touch with the frontline and implementation of some politically correct directives in short space of time .
Some people might be allurred and enticed by your charm , Boris . Sorry , we are not ......
I kind of expected this from MojoBojo . He is so predictable and ‘charming’ , isn’t he? In parallel universe , he is actually Winston Churchill 2.0. But this is our reality here instead .
He needs the approvals from as many sectors for leaving with no deal on 31.10.2019 as possible.
Whether this money is new or old , I don’t think his new cabinet cares too much about that , as long as optimism about 31:10.2019 remains .
You see .
Putin appeared to have a ‘point’ when he said western democracy and liberty were dead and outdated . I would say that everything is inevitably undergoing an evolution.
Ultimately, it is not about deserve , it is about what you believe . Had done a lot of soul-searching after witnessing this currently historic , most extraordinary ‘revolution’ in Hong Kong .
Come what may , time will tell and history will judge all of us .
Our own battle goes on .
We never stop fighting battles , don’t we ?
First we have Agent Hunt and Lord Vader , now we have Robocop and his Babylonians.
Game on !
Nine lids to cover ten cups as far as the CCG is concerned .
I am not entirely sure whether Robocop is really that ‘happy’ about carrying on in the same position as health secretary is always the ‘sh***ty job nobody wants ‘ . Robocop certainly has pledged 100% loyalty to MojoBojo . Question is why he didn’t get a more essential role in the cabinet?🤨🤪😂
Finally , alas .
How long have we been moaning about how ‘out of touch’ are these academics, especially NICE , on this platform?
I wonder what has changed as far as internal politics is concerned before these three finally get their heads and acts together 🤨😄?
We want more ‘redemptions’ from NICE , dude (sorry , can’t help it after being ‘inspired’ by MojoBojo😆)
The interesting question is how long do you think the mojo of Bojo will last before it burns out , dude ?😜
1) It is increasingly apparent that this ideology of PCNs has become a slippery slope fallacy . In fact , if I deviously reverted to a populistic conspiracy theory ,this is a ‘trap’ set up to destroy GP partnership ( my previous question of PCN being a Trojan Horse?) once and for all .
(2) While the slogan ‘CCGs are GPs and GPs are CCGs’ is still ringing in our ears , the continuing austerity imposed on CCGs from NHSE and above is never going to be consistent with this new ideology anyway . It is easy to say that CCGs must find the money to ensure the ‘success ‘ of PCNs , but the year and year on financial restrain from NHSE is simply stifling. Worst of all , the end game is CCGs having no choice but drastically reducing spending elsewhere in various services . The consequences of these services being slashed could easily divert pressure back to GPs and increase our workload paradoxically.
(3) The argument ,of forcing the already diminished number of GPs to spend more time in the bureaucracy of PCNs leading to compromised patient care ( hence , continuity of care ), is a valid and realistic one . Continuity of care becomes a price to be sacrificed.
What is the final destination ?
Discard the formula of funding GP practices individually (D)
‘Unite’ GP practices into humongous practice(s) (U)
Digitalise all GP services (including GP consultation in Babylonian style). (D)
End GP partnership model ( E)
Boris , dude , you and your new government has a serious decision to make for the health service!
The ideology should be having better direct physiotherapy access to GPs , NOT to patients.
My mother is really a woman !🤪
(1) My sincere best wishes , David .
(2) I always believe that things always happen in our lives for a ‘reason’ . If we can look at that sensibly enough , we actually become ‘wiser’ as a result .
(3) While in these days , our younger training colleagues are undoubtedly dominated by advancing technology (eventually AI) , the first rule of thumb in medicine is proper and meticulous history taking and then examination . Every situation is a new situation. Yes , there is an argument that continuity of care might create a blind spot because you thought you knew your patient very well. But equally, the awareness of somebody being completely healthy ‘up to now’ from the history simply means we need to be more humbled in exercising our confidence in medicine , facing the probability of ups and downs in life .
Please get well soon , David
(1) Remember whose idea and for what purpose was NHS111 created? Right in the middle of the austerity period .
(2) The medico-legal implications created pressure on NHS 111 that they must refer to some clinicians with indemnity cover , no matter what to cover their own arses .
(3) Too expensive to go to A/E(and the appalling headlines of inundated A/E otherwise), so GP land is the perfect dumping ground .
The injustice created by this monster is simply deplorable, callous and unscrupulous.
'Last year a record 3,473 doctors were recruited into GP training and the new historic five-year contract for general practice will provide greater certainty for GPs to plan ahead and will see funding towards up to 20,000 extra staff working in GP practices – helping free up doctors to spend more time with the patients who need them.'
Ehhh, I presume it was an unintentional mistake of replacing the word ‘uncertainty’ by ‘certainty’ in the original script ?🤨😆🤪
As far as the new ideology of Primary Care Network (PCN) is concerned , I would think this survey marks the ground zero reference point . Any deviation ( better or worse) from this in the coming years will certainly judge whether PCN was a success or failure.
My speculation is if Mr Johnson becomes the next PM which looks more likely up to now , the current health secretary will be rewarded a more promising position in the cabinet ( as nobody really wants to be the health secretary in this country if one has a choice ) for supporting him . This loop hole in the GMS contract allowing GP at Hand to grow will be tightened up .
(1) Agreed that there should be more precise understanding (hence, training ) in the physiological as well as psychosomatic characteristics of pain . Pain is a complex syndrome entity . The treatment approaches( including pharmacological) we have adopted traditionally could have been ‘wrong’ entirely. The ‘’analgesics ladder’’ could be subjected to falsifiability (or even refutability) ? Recent new evidences suggesting our traditional approach of cutting off all saturated fat without looking into the type of food sources in preventing cardiovascular morbidities and more importantly, mortalities , could be a slippery slope . As Sir Karl Popper advocated , we must have the courage to admit that we could be wrong with our present knowledge in science and be ready to prove ourselves wrong everyday .
(2) I prefer more GPs with better communication and decision-sharing skills preserving continuity of care, to pain specialists who ,in all due respect, could have been one of the sources of the problems we are facing right now . The heavy emphasis (arguably , easy access) on seeing specialists in America, for instance, could also be a precipitating factor of an even bigger problem of prescription drug addiction over there . Premature deaths in high-profile , relatively young , celebrities told only part of the story.
(3) Then it leads to one of my recent , favourite subjects ; Internet-smartphone-AI driven private GP services. I would love to see some statements from these providers who had taken on so many relatively younger patients , about how they would like to manage these prescription drug addiction problems. If these providers are to stay in NHS , they clearly have a responsibility of , at least , NOT to pose additional risks to an already precarious and vulnerable situation .
The name of this game is called , ‘Who is the real health secretary?’
One has to realise that we are virtually running without a government. The health secretary is too busy supporting Mr Johnson’s campaign. Robocop fancied a ‘better’ position in the new cabinet if MojoBojo managed to win the leadership contest .