Any chance of a patient shortage?
Always worth googling the 'other voices' who 'chip in' when the minister speaks.
Have a look at Duncan Selbie's Wikipedia entry (Public Health England chief executive).
He 'joined the NHS as a teenager'. According to Wikipedia he claims no special public health knowledge. He earns just south of £190K each year.
The key skills required for this post?
Just guessing - the 100 page close typed complainer - suffers from CFS / ME?
An excellent article.
A rather depressing reminder of the mind-numbing complexity surrounding just one single type of incidental investigation finding.
The policy of trying to persistently bamboozle everyone who comes into contact with ESA is not accidental.
Excellent article- perhaps the most interesting primary care clinical piece that I have read this year.
I suspect that there is far more mileage in evidence based data mining of our existing records than in trying to replace GPs with an AI driven interface.
Good luck old son.
Excellent article - the whole point of General Practice is building long term relationships with patients and their families. It is just utterly meaningless otherwise. One might as well work in a call centre.
The process that this unfortunate young doctor has been subjected to is beyond the wildest imaginings of Franz Kafka.
I read the article with increasing horror. What the F is happening to the world.
I hope that - as a minimum - she will receive a personal apology from Capita and some financial recognition of her considerable inconvenience.
One can only wish Dr Bawa-Garba good fortune and offer one's admiration for the way she has conducted herself.
I'm a man and I'm with Motdoc above. It's very simple - the average female GP (in my view) is more technically and socially competent than the average male GP.
Amongst 'poor performers' - female GPs are far more likely to have some insight into their limitations and will often retire or restrict their practice.
Both the main 'ill health' benefits - ESA and PIP - are payed on a "points mean prizes" basis. Other benefits - DLA for kids and carer's allowance are indirectly linked to judgements about health issues.
A minority of applicants for these benefits feel that the "more doctors they have seen and the more diagnostic labels and tests they have had the more points they should get".
This phenomenon is only going to get worse if the GP record moves 'centre stage' in the assessment process.
I read this article twice and I was still left confused.
Exactly which activities in a normal GP's day will not be covered by the NHS scheme (and indeed looking at the statements made by the defence orgs - what is not covered by their membership now)?
I wonder if pulse would consider commissioning an 'experts view' article about the limits of indemnity schemes?
Agree with everything other commentators have said. Constant rejigging of appraisal has worn everybody down. It is too frequent and too complex. Many docs - including me - time their retirement to avoid 'another cycle'
My anxiety about replacing it is:
a. No one that I know, has ever met anyone who 'failed' re-validation. Joe public / the Daily Wail have not noticed this!
b. The obvious alternative to re-validation by appraisal is an exam (as I think some licencing boards require in the US.) I suspect this would be considerable more stressful and would definitely produce 'failures'. There would be inevitable pressure to make scores available to patients.
Just as well that the average doc has so much free time available to plonk around with all this.
Does anyone actually understand this?
The (presumed) trade off between this very small increase in global sum and the 'gain' from not having to pay so much in indemnity subs is totally unclear to me.
The underlying problem here is that optimal use (or non-use!) of opiates (for chronic non-fatal pathologies) involves the doc making a subjective judgement about a patient's pain and personality. These decisions can rarely be completely right or completely wrong.
This balancing process is made more difficult by a "points mean prizes" benefits system that is seen as the only viable income option by some patients.
Many GPs have been surprised over the years by the decisions made by many pain clinic consultants.
I agree with most of the other commentators here. There are two main points being made:
1) Starting a patient on potent opiates - or gabapentinoids - is infinitely easier than stopping them. (A point repeatedly denied by some proponents of some pain management strategies.)
2) It seems rather unfair for one group of docs to undertaking the easy bit (starting!) and for another group of docs to have to cope with the task of trying to stop the stuff.
Like the above two commentators I'm rather surprised that this (eminently sensible) sentence has been passed. "Surely it was somehow the doctor's fault".
In all fairness to the National Committee their actual recommendations are pretty clear on most matters (a firm thumbs down to the majority of suggested national programs for adults)
Their recent and historic recommendations are available at:
I agree with Tony that we just don't hear enough about the Committee's opinions. Again as Tony implies this is probably because their views are "evidence based" rather than "read it in the Mail" based.
Late in the day - in every sense - just before the Christmas break and in the middle of the Brexit silly season.
I hear the sound of earth clods falling heavily as dangerous news is buried.