Dr Stephen Fowler, GP Partner
The list of tasks they can perform seems very similiar to the list of things I learn't to do at medical school.
A newly qualified house officer also gets paid considerably less than a new PA, but of course also has to do unpleasant things like overnight/OOH wrok too.
Why don;t they just train more doctors?
Given that there is absolutely no evidence at all of benefit to either patients or doctors the whole appraisal and revalidation system should be scrapped.
We are the most over regulated doctors in Europe (if not the world) and we also have one of the lowest GP:patient ratios - maybe the two are linked...
Teaching granny to suck eggs come to mind....
There may well be some positives in here, but at the end of the day it does nothing to address one of the main factors behind GP recrutiment - SALARY - I realise no-one likes to talk about this but it's the elephant in the room - a 20% pay cut over the ;ast 10yrs must have an effect. Coupled with that this new contract will do nothing to address our workload, although it might help with some of the year on year increase.
No reduction in day to day workload, no pay rise - is it any surprise that GPs are leaving early and new recruits don't want to join in?
And this is news why? I seemed to remember something called the 'inverse care law' which has existed for decades and which succesive governments have done nothing to address - in fact Mr Hancock's obsession with digital media and apps will only make it worse.
Is this what Public Health and the government are supposed to do?
What is needed is a coherent, evidence based strategy on diet from PHE and the government. There is plenty of evidence now that T2DM can be completely reversed with the correct dietary advice (and that isn't low fat). This would save many, many millions of pounds on prescribing (and bariatric surgery), but would of course invole the government taking a much firmer stance with the food industry.
T2DM/metabolic syndrome is a lifestyle problem and should be treated with lifestyle measures. However we cannot really blmae the patients when they have been given the wrong dietary advice for over 30yrs now and in lots of cases continue to be advised incorrectly, despite evidence to the contrary.
And PHE and the government have a responsibility to make sure the right dietary advice is given to the population eg. fogert the fear of fat, which has no evidence whatsoever to back it up and start [romiting much lower CHO diets, which do.
I suggest you revist some basic medical science - insulin drives obesity, not fat (and there is plenty of evdience for this).
Carbs (be they starchy or refined) drive insulin production.
I only hope that PHE starts to take notice of the mounting evidence prsented by 'the low carbers' and actually does something positive to halt the obesity epidemic
Or NHSE could pull their fingers out and sort out the supply problem - surely if pharmacies can source the correct vaccine then why can't primary care?
We certainly do need to look at the bigger picture - mainly the incorrect cietary advice that's been dished out by government (and us) for over 30 yrs now. Dietary fat is not the issue, there's absolutely no evidence to support low fat,calorie restricted diets. The problem is INSULIN and the carbohydrate (refined or otherwise) that drives its secretion.
There is also no evidence that exercise (aka moving more) leads to weight loss. Exercise is good for all sorts of reasons, but unfortunately losing weight isn't one of them.
A low carb, ketogenic diet is the correct advice to give and in my view government and PHE need to get on board with the mouinting levels of evidence which support this approach.
Presumably they are sending letters to every vet and farmer in the land too....
Tony - do you have any objection to me quoting your article to the GMC, as I very prepared to raise a formal complaint to them - fight fire with fire
Carbohydrates are the problem, because they all break down into simple sugars, allbeit at slight differing rates.Insulin resistance is the cause of the obesity epidemic, not fat.
It would be really interesting to take a closer look at the 10% of Practices deemed to need improvement and see whether they were already on someone's radar anyway - in other words the whole CQC was a massive waste of time and resource. Struggling Practices are already known about for all sorts of other reasons and we don't need the CQC to tell us as well, in just the same way that we don't need revalidation to tell us about struggling doctors.
Yest again a sledgehammer to crack a nut.
Before hospitals start refusing paper referrals they need to make sure their end of the system works perfectly all of the time.
I assume these also means they'll be sending all clinic letters back electronically as well.....
Adopting the 'Low Carbohydrate High Fat' diet would be far more effective and no cost to the health service. It is evidence based, but of course big pharma would much prefer people to consume ever larger quantities of the latest 'gliptin'
It's not the record that needs to change - it's the entirely unrealistic expectations of patients, fueled largely by our political masters, who seem to live in a different world.
Start charging for GP appointments and see how quickly the workload drops
What would a dentist do, or be advised to do, if a patient consulted them with chest pain?
Would they be expected to carry out an 'adequate assessment' or would they simply refer on?
Preumably the ambulance service are giving part of their budget to General Practice as well..........