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Gold, incentives and meh

Just Your Average Joe

  • GPs to see 'minimal changes' to their contract from April

    Just Your Average Joe's comment 16 Feb 2018 10:55pm

    GPs to see 'minimal changes' in pay, change can go down as well as up:

    With increased costs, locums rates, staff costs, salaried GPs, multiple job adverts almost no-one replies to as there aren't any more doctors willing to take substantive posts.

    With rising pension contributions, tax on annual and lifetime allowances for those still believing they mat get a pension in 40 years time!

    Rising wages by 1% when expenses up 3%, mortgage rates going north as well - makes you wonder how the DOH thinks they are going to find their 5000 GPs??????

  • Number of GPs continues to decline as 200 leave in three months

    Just Your Average Joe's comment 16 Feb 2018 8:36am

    Need to face facts 1 Full time GP male partner out - needs 2-3 part time/locum, very possibly might consider salaried options, Out of post/maternity/career break/Australia etc, replacements.

    The fantasy of 1 in and 1 out is a shattered piece of DOH fallacy and wishful thinking.

    Reverse all the reasons why older GPs leaving and there might be a hope and it would be that expensive to implement, as the money from it has been only recently grabbed in taxes and redistributions. Others are just free and reverse policies bashing GPs.

    -Start with appraisal and revalidation
    -seniority payments (value experience)
    -Lifetime and annual pension allowances for those who would like to remain in this ponzi scheme
    -Scrap the manslaughter with hunts and change the law so overwhelming negligence only can be a cause of investigation - where, a panel of doctors advises if this level of incompetence and negligence has occurred before a prosecution can proceed in case where it truely needed.
    - GMC and CQC and MDU/MPS fees
    -Scrap CQC
    -Stop the privatisation and APMS agenda to force out GP's

    Actually invest in the most cost effective part of the NHS which allows the rest to work.

  • GMC says it is 'not discriminatory' following Dr Bawa-Garba case

    Just Your Average Joe's comment 13 Feb 2018 6:52pm

    This comment has been removed by the moderator

  • GPs having to deal with angry patients when refusing antibiotics

    Just Your Average Joe's comment 12 Feb 2018 11:00pm

    David Banner - Ditto says it all.

  • GMC says it is 'not discriminatory' following Dr Bawa-Garba case

    Just Your Average Joe's comment 12 Feb 2018 10:56pm

    Point of law anyone - Did Dr BG cause the arrest by personally administering the Enalapril? No it was a family member (?Mum)

    Therefore he arrested and died. Dr BG attended a dead patient and tried to bring them back to life and this was unsuccessful.

    If Jack was dead before she arrived on the scene - how was she responsible for killing a patient who was already dead? This is impossible.

    The causal suggested chain of might have had a n impact on his care/outcome all comes to a halt - where someone else actively administered Enalapril which changed the course of a recovering patient into a hypotensive arrest.

    Even if she called the arrest efforts to halt earlier than hind sight suggests - even though continuing for longer had no guarantee of success.

    You can never manslaughter a dead patient - through a failed arrest effort - as they were dead before you start.

    If any idiot tries to argue otherwise - there would never be another arrest effort - through fear of failure to bring the dead back to life leading to a prison sentence and loss of your medical status - doctor or nurse, or any other scape goat.

    'Dissenter argues the process was not racist - however as Professor Cato's experience of missing sepsis leads to knighthood and president status - Dr BG, not the consultant in charge, not the family member who administered the Enalapril, is the one the CPS decided fit the profile of Scape goat - and the flawed system, with its b81151t bias of withholding key evidence from the jury, which we know from recent collapsed rape trials, is one of the Ace's the CPS uses to falsely persecute (sorry prosecute) defendants in trial cases.

    This travesty of justice, where the judge in the original trial was negligent in allowing anything other than overwhelming negligence to be proven prior to allowing a guilty verdict, which was not even plausible in this case of systemic avalanche of disasters, which provided miles of probable doubt and alternative targets for prosecution.

    Here the overwhelming systemic failure - should allow fingers to be pointed at senior managers, hospital HR, the directors, local NHS England as commissioners allowing such shoddy work conditions and staffing, the DOH and our beloved health secretary, and right up to the PM, for allowing vanity projects like trident and HS2, PFI hospital deals and privatisation to take money from front line NHS care.

    Sadly the law was changed to stop the health secretary being personally responsible for the NHS in the healthcare bill - but he certainly is asleep at the wheel for this one.

    Dr BG is a training doctor who did her best in impossible stacked circumstances - and the powers that be targeted her to be the scape goat - that was followed by the GMC being guilty of the same - when they failed to protect a doctor who was a victim of a miscarriage of justice - and instead they lynched her again -

    All those in the GMC responsible for this should hang their heads in shame and resign - you don't represent me, and not in my name - or the thousands of health professionals who are not institutionally racist.

  • New asthma guidelines – double trouble for GPs?

    Just Your Average Joe's comment 09 Feb 2018 10:13pm

    NICE also reverses the place of leukotriene receptor antagonists (LTRAs) and long-acting beta-2 agonists (LABAs) as add-on therapy to ICS, suggesting an LTRA before LABA. This is because they have examined the evidence from a cost-effectiveness as well as a clinical effectiveness point of view, and recommend trying an LTRA first when stepping up therapy, despite acknowledging that LABA is more clinically effective.

    Ivory tower committee who will not defend you in court when the patient dies as they forgot the pill, and if only they had been given the correct combined inhaler - which was held back to save money.

    Money saved on inhaler 36 pounds - millions paid out when sued, and a career lost and dr in jail.

  • Struck-off junior doctor to appeal High Court decision

    Just Your Average Joe's comment 08 Feb 2018 8:37am

    Has anyone looked a the shambolic quality of her original legal team which defended the manslaughter case.

    A 5yr old who had watched 1 episode of a tv court case should have been able to get her off with all the systemic failures that occurred on that day.

    The prosecution needed to present an overwhelming case of personal negligence and from the discussions on here and details from the case published - there is no way they should have been able to do that.

    Simply the fact that a family member/mother gave enalapril that precipitated the arrest - means she was in no way to blame, as once arrested the patient is already dead.

    Her efforts to resuscitate are irrelevant as you can't kill someone who has no pulse and is not breathing as they are already dead.

    This technicality alone should have been enough to stop her - as otherwise every paramedic and doctor or nurse involved in a resuscitation attempt in the UK over many years is at risk of manslaughter. The end result - no would go near a collapsed patient in fear of this.

    Watch healthcare collapse on itself.

    The only time when a healthcare professional should ever be at risk of prosecution, is if there is any evidence of intent, foul play. If there is an error it should be leant from and prevented from happening again - and retraining as appropriate, for as long as required with supervision if needed.

  • GPs to be funded to order two types of flu vaccines for next winter

    Just Your Average Joe's comment 07 Feb 2018 8:10am

    What happens to pre-orders that many practices have already agreed for next year?

    The companies where orders have been placed aren't likely to let them be released from this commitment.

  • Healthcare bosses pay consultancy firm £6m to make budget cuts

    Just Your Average Joe's comment 06 Feb 2018 8:22am

    The plan is simple - move expensive stuff from hospitals and make GPs do it for free as they have an all you can eat buffet style contract.

    Plus they are too nice to say no.

    Thanks I'll cash that 6 million in now.

    To recoup that loss - fire as many of the managers in the area as needed to break even on that spend - and not see a jot of difference in patient care.

    The STP and transformational plans are more b@11sh17 and require millions in wasted monies that could be spent on patient care - essentially making more cuts to services.

    Just stop all the money haemorrhaging to PFI deals and privatisation and tendering. Its a really good start to saving money.

    Then sack most of the NHS managers - go back to the situation 20yrs ago when hospitals still ran and patients were cared for - and there were less managers than porters.

  • Exit out-of-hours stage left

    Just Your Average Joe's comment 06 Feb 2018 0:24am

    Sadly - even if out of hours paid all indemnity and double the current hourly rate - the risk and stresses involved will not attract many back to the fold of Out of hours care.

    It is so badly staffed, it makes you laugh, and that was when it is fully staffed! The endless procession of 'private' providers who are all looking to make a quick buck from running the service - are simply pulling out cash, and swapping doctors for allied professionals, and now dipping into unqualified staff reading from protocols on computers.

    They are no longer running a OOH service but instead running it into the ground. It is not all their fault, but the DOH has funded the service so poorly in the past, that reinventing the wheel so many times has led to it falling off.

    111 is the straw that may break in hours primary care - as well as OOH, if they keep pushing the stupidity of letting 111 directly book into surgery appointments - as almost nothing they send my way or to A&E is of concern, and the ones they don't occasionally turn out to be potential disasters.

    Not the fault of the poor operators, but google doc/protocols are no replacement for a GP who knows his a75e from his elbow.

  • Thank you, Dr Bawa-Garba, for bringing us to our senses

    Just Your Average Joe's comment 04 Feb 2018 8:38pm

    https://petition.parliament.uk/petitions/211232

    Make GMC a tax-payer funded organisation and not to be funded by doctors.

    Please consider signing and forward to like minded people

    Many thanks

  • Police 'to discuss' calls to prosecute hospital over Bawa-Garba case

    Just Your Average Joe's comment 04 Feb 2018 8:38pm

    https://petition.parliament.uk/petitions/211232

    Make GMC a tax-payer funded organisation and not to be funded by doctors.

    Please consider signing and forward to like minded people

    Many thanks

  • Police 'to discuss' calls to prosecute hospital over Bawa-Garba case

    Just Your Average Joe's comment 03 Feb 2018 12:35pm

    Dear BAPIO

    Thanks for you efforts on behalf of Dr Bawa Garba and the profession as a whole.

    Please also take the CPS/GMC to task for racial discrimination based on this case.

    Dr Bawa Garba deemed to have made mistakes in the care of a child with sepsis who dies and convicted of criminal charges and stripped of licence to practice.

    Professor Sir Graeme Catto - a doctor who has openly admitted failure to spot early sepsis in a patient who died - proceeded to be knighted and made president of the GMC!

    Can anyone see the difference colour, ethnicity, religion, a head scarf and gender may have played?

  • Almost 3,000 GPs retired before the age of 60 over the past five years

    Just Your Average Joe's comment 01 Feb 2018 8:39pm

    3157 trainees in - reckon as an estimate 1600 WTE out on an optimistic day for a snow flake falling in hell.

    With huge numbers not choosing to work at all, part time if your lucky, locum without any commitments - allowing them to take off school holidays, with a few venturing to salaried or partnership.

    With full time GPs retiring - you are not replacing like for like, so prove my estimates to be out, but no chance you will be increasing overall numbers with current strategies and recruitment.

    Need more male GPs to ensure at least 50% entry into medical schools - and GP only medical schools where entrants are only going to exit as GPs.

    Try that and maybe you might get closer to the outcome needed for survival of primary care - but only if you reverse the long list of issues mentioned by:

    '1988 graduate | Locum GP01 Feb 2018 9:43am

    annual allowance tax
    lifetime allowance tax
    appraisals
    revalidation
    cqc
    gmc
    complaint culture
    no win no fee
    risk of manslaughter charge
    indemity costs
    reducing pay '

  • 'Dr Bawa-Garba could have been any one of us'

    Just Your Average Joe's comment 29 Jan 2018 10:54pm

    The GMC has lost its way - It was meant to be self regulation of doctors, and has sacrificed itself at the altar of patient protection, when there was no reason to punish a doctor who was sadly let down by systemic failures hidden from the Jury in the criminal case.

    The high court judgement is therefore flawed in expecting the panel who spared Dr Bawa-Garba erasure from the register, to act in the same way as directed by the jury verdict.

    The panel did not have a legal duty to follow the flawed verdict, as they were aware of the full situation of that sad day, where Dr Bawa-Garba was left to carry the burden of the days events and the sad death, whereas the jury were only given a piecemeal of information that suited the prosecution case.

    Hence the judge in the original case allowed a flawed trial, and failed to allow justice by refusing leave to appeal.

    This is what the GMC should have appealed, the GMC that should be supporting doctors, while protecting patients. Like the thousands of patients who benefited from Dr Bawa-Garba's time and care in the time she was allowed to continue working before she was given her flawed verdict.

    The time she was working and learning her speciality so she could continue to help other children, who will not be protected as there is one less doctor in the NHS which is crying out for more doctors.

    GMC - the management and leadership who were involved in prosecuting Dr Bawa-Garba should all resign in shame, and if they refused be sacked by us, the doctors who pay for our own self regulation, as I hope I speak for many if not most, do not want a regulator who persecutes doctors.

  • Doctors 'face more severe sentences' if convicted of negligent manslaughter

    Just Your Average Joe's comment 29 Jan 2018 10:34pm

    To avoid risk, massive rise in referrals and admissions - JUST IN CASE mentality.

    When Referral management policies refuse these referrals and someone comes to harm - can we be clear those running and commissioning these services will be brought up on manslaughter charges, not the GP who tried to refer but was refused this patient right to a specialist opinion under the NHS Charter.

  • Bawa-Garba: timeline of a case that has rocked medicine

    Just Your Average Joe's comment 27 Jan 2018 1:25pm

    @'Testing | Locum GP26 Jan 2018 10:29pm

    Wonder why she did not appeal the initial verdict.. Did the medical defence organisation use their discretionary powers to refuse support for an appeal ??

    The original decision did not give her the right to appeal.

  • ‘Uber-like’ GP providers seek doctors for national rollout

    Just Your Average Joe's comment 27 Jan 2018 1:17pm

    Costed as a race to the bottom - look at how much emergency plumbers etc cost and think again.

    Value yourself that low and it will result in a failure of applicants as it will be better paid to work in the sweat shops of OOH!

  • Health secretary 'deeply concerned' about implications of GMC court ruling

    Just Your Average Joe's comment 27 Jan 2018 1:10pm

    First time I have ever agreed with JH !

    I am perplexed why the GMC even exists in the format it is in - self regulation by your peers is what was intended, but no longer in place.

    Who unilaterally made the decision to challenge this GMC decision not to erase her in the high court? They should resign immediately for putting the profession into disrepute.

    The Jury made a criminal case decision, based on lawyer presented screened evidence, and they in my opinion made an incorrect decision, as they systemic failures which led to the death were outside the control of the poor doctor involved.

    Its like a car shunting you from behind after an driver had a heart attack driving down and steep hill, and you hit and kill a pedestrian crossing in front of you. To prosecute the driver of the car that actually hit the pedestrian is grossly unfair, as they were only in the position they were put into by circumstances outside their control.

    A panel of the GMC who are informed and aware of the full facts in the case made a sound decision that should have been respected as it was the right and fair decision on the ability for her to work again, just like any person who is released from prison has a right to fresh start once a sentence is served, rather than continue to persecute this doctor by taking away their hard work and training, and the profession they have trained their whole life for - which would help many patients in the future - bringing good to the world.

    If the GMC wishes to be a kangaroo court, stop charging doctors and let the government pay for prosecuting doctors, and stop fleecing us as an extra tax when it is no longer self regulation, but the rules from the GMC lead to potential self incrimination and harm to your careers.

  • Appraisal guidance needs 'immediate update' after Bawa-Garba case

    Just Your Average Joe's comment 27 Jan 2018 12:55pm

    The day the medical profession was open to manslaughter charges when errors were made - despite every effort to act in good faith is the day doctors needed to change practice and become defensive and protect their reputations and careers from outside attempts to tie a noose around their necks when things go wrong, even though they were a small cog in a larger system endemic with failures.

    Why this poor doctor was made the scapegoat, not the hospital management, or the commissioners at NHSE or the home secretary or even PM for allowing failures such as this on their watch?

    The elephant in the room is clear, when you see how reflections for self review and learning can be handed to lawyers, who like sharks use her own doubts to tear her apart, breaching her right not to incriminate herself as those thoughts were not supplied under any warning that they may be used against her in the future.