sorry, I meant I agree with @Undercover
(brain fog -wonder why..)
I agree with @Copernicus about the final nail.
I won't be happy until I can metamorphose to a general medical and and community consultant.
As The Proclaimers could hvae sung: 'GP No More'!
love the picture of the poor badgers!
This thread continues because the latest Pulse article on 'workload' is dull..
I agree with comments above that 'society has deemed a GP worth less than an orthopod' etc. But what to do? Many GPs just find add-on roles so that they can see far fewer patients (or none) (list is endless)But this is not an answer that helps newly qualified doctors looking at their future career.
GPs need to be given the option to convert their self-employed independent contractor status to an employed consultant in general and community medicine. Lack of private work cf orthopods will be an issue but I think we can find solutions to that -but it will depend on the 'BUPA'-type closed shop being broken up. The NHS will provide less so more will have to be done in a private, partly insurance-based,system.
agree with Peter Holden (and Allingham hinted). We are getting emails from mangers which aren't work reading because they are basically just trying to justify their existence.
Re premises this too is scary. The irony is that our PFI-type lease is a reason GPs don't want to be be partners and yet I can't see the Gov taking over our lease UNLESS we become salaried
Prashant Patel: why? seriously?
This could be the best thing to happen to the NHS for years; patients can adapt to less of a 'I want whatever and I'm not prepared to take responsibility for my own health'.
Go to the USA if you don't like the NHS
Windscale became Sellafield.
We can be re-badged.
GPs should have option to become, after appropriate exam, salaried community consultants in general medicine.
The 'traditional GP' role can't be resurrected
GPs should not have to provide premises to work in.
There is a parallel here with teaching; the govt no longer sees teaching as a life-long career but something you do while young and energetic and then move on when burnt out. Same for primary care -but not for consultants!
@Nick Mann: managed healthcare; the USA model that is the long-term trajectory of NHSE etc.PCNs only make ANY sense as a preliminary mechanism for further imposed changes in that direction. (especially with 11pm tonight in mind)
agree it is awful -but I asked BMA Pensions (Pamela Moreland) to act on my behalf and made some progress through the 'complaints' procedure.
Unfortunately there is some truth in both above views. What I provide for my patients (NHS general practice) is less than what I would like for various reasons mainly because what can (not necessarily should) be done for patients has no obvious upper limit.
But what we must stand firm for in the NHS system is that there is little or no financial gain for me in recommending one treatment compared to another, or no treatment at all.
You simply can't say that for private practice.
my AW8 has been accepted :)
there is how I think our French friends would respond to eg 'fourtnightly care home visits'; "bien sur, demain peut-etre" with a Gallic shrug.
The latest missive from Nigel Watson (Wessex LMC) says 'The LMC is very supportive of PCNs...' and 'all GPs would support the 5 service specifications' but 'In their current format we do not think that these are supportive of General Practice'.
PCNs are for trying to help secondary care by keeping patients out of hospital. Thats the easiest way in which their 'success' can be measured. From the government's point of view, in the great NHS scheme of things, General Practice is expendable.
Was recently off for a week with food poisoning and last winter with flu or something. Patients with appointments get contacted to let them know their appointment has had to be cancelled.
Curious thing is they never seem to mind much. It's the getting the appointment in the first place that they rate so highly!!
time to start a serious conversation about how general practice can be replaced. If Pulse want to make me an offer to write an article...
too late to go back to the halcyon days of personal lists of around 1800. The future is to get rid of the primary/secondary care divide and for all newly qualified doctores to work for at least 5 years as generalists and then all to specialise in 2 areas -current GPs like myself are essentially geriatricians and psychiatrists. Higher trained practice nurses will be the fist point of call, the new GPs.
we can't turn back the clock and be 'proper GPs' because the system won't pay enough of us an appropriate hourly rate to do things properly.
General Practice wasn't designed to work with. mostly patients with multiple complex problems and hardly anywhere to refer to.
So the whole system needs redesigning without GPs.
PCN = P retty C rap N ews
Eleanor, can you re-write this article so it is clear?