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Janette Lockhart

  • What should Pulse do about anonymous comments?

    Janette Lockhart's comment 22 Jun 2016 5:33pm

    I used to always post in my real name but had a bad experience which made me wary. Since then I have more often than not posted anonymously as it feels safer - though doesn't stop the trolls. So many anonymous posters make personal attacks rather than discussing the issue.

    Here's my suggestions:

    Ban anonymous posts.

    Introduce a registered username system.

    Make it difficult if not impossible for one person to have more than one username - I have seen elsewhere how this can facilitate those determined to subvert discussion.

    Restrict it to those who are part of the GP and community medical services. This is not a forum for patients.

    Please let retired GPs contribute. Now I'm retired I actually have the time to read Pulse regularly and to comment!

  • GP numbers drop by 2% in blow to Government's recruitment pledge

    Janette Lockhart's comment 27 Apr 2016 7:03pm

    It was always going to be pie in the sky. For the record, at the last election the Labour party promised an additional 8,000 GPs and a similar increase in GP funds - £2.5 billion if I remember correctly.

    Promises, promises.

  • Shadow health secretary signals support for routine Saturday GP opening

    Janette Lockhart's comment 17 Feb 2016 11:54pm

    If I remember correctly, when GPs used to regularly work Saturday morning surgeries and visits it was because we were still doing our own out of hours. The surgery was for emergencies only, not routine appointments, as were the visits. This service is now very well covered by the OOH services, with walk in and book on the day appointments and visits as necessary.

    What is now proposed is that GPs work routine surgeries at weekends. In the Manchester pilot, as I understand it, patients can get routine appointments at weekends, but will probably not see their own GP. They are, instead, seen by doctors specially employed to do the weekend surgeries.

    I fail to see the point, really. Most GP routine appointments are for those with chronic and multiple problems, best served by continuity of care with their own GP. The routine sharing of patient records online is fundamental to this system. Along with many people, I've opted out of the CARE record sharing thing, so how does that work?


    I don't know if the same model has been used elsewhere in the pilots, but if so, I suspect this is one reason why the routine appointments offered at weekends are not all that popular.

    PS If we are serious about saving the NHS, lets stop suggesting we make patients pay extra at the point of service. That would not be the NHS any more.

  • 'Striking is just something doctors should not do'

    Janette Lockhart's comment 15 Jan 2016 12:08pm

    @|Anonymous | Sessional/Locum GP|15 Jan 2016 11:47am

    Are you suggesting that only people who agree with the majority should be allowed to express an opinion? I doubt most of those posting on this thread have any special qualification to speak, but in a free society, and in the pursuit of proper debate, they have the right to do so.

    Pulse, quite rightly, often publishes articles by GPs with no special position, but who have an interesting viewpoint. That's what makes it such a valid and appropriate publication.

    And before anyone else starts accusing me - no-one has paid me (or encouraged me)to say this either.

  • 'Striking is just something doctors should not do'

    Janette Lockhart's comment 13 Jan 2016 5:47pm

    @|Anonymous | Sessional/Locum GP|13 Jan 2016 12:40pm

    No-one pays me to say anything. I have my own views.

    I do not think people who disagree with me are stupid, they just see things differently. I find reading others' views interesting and sometimes informative, though not always.

    I don't understand why you consider my posting as 'emotional blackmail'- it certainly wasn't intended that way.

  • 'Striking is just something doctors should not do'

    Janette Lockhart's comment 13 Jan 2016 12:30pm

    I find it quite upsetting to read some of the overtly derogatory personal comment made here about Dr Summerton. Everyone is entitled to an opinion and if you disagree attack the argument, not the author.

    My own view is that the profession has to fight for the best work conditions for their own sake and for that of the patients. However, I am concerned that the BMA has become wrapped in political dogma. There has been exaggeration of the issues in dispute from both sides.

    The NHS is a political football and always will be, but my experience is that it has faced episodes of dreadful mismanagement fairly equally from both ends of the political spectrum. However the NHS being a political issue has one benefit: that it will never be dismantled (as many are claiming) - that would be utter political suicide and one thing politicians always want to do is to cling to power.

    Striking is a double edged sword. It will only take one potentially avoidable death or injury for the media to grab hold of and blame the strikers, and the profession loses public sympathy in a stroke. The risk of this happening will be huge if the 3rd 'all-out' strike goes ahead. If public sympathy is lost, then the politicians will obviously be more likely to prevail and may get away with even more.

    Be careful what you wish for.

  • Hunt promises junior doctors 11% pay rise

    Janette Lockhart's comment 04 Nov 2015 6:46pm

    I can't recall any issue more badly handled by both sides of a dispute. I think there has been much misinformation and deliberate misleading by both the government and the BMA. There is no cogent argument against the need for better cover at weekends by medical staff, diagnostics, physios etc. I've experienced the problems caused by the current system from both sides. So things have to change and it is long overdue. I believe the government proposals are sensible - not the best, but the best in the circumstances. I hope the BMA and junior doctors will examine the detail and give a more measured response. I must say I think the BMA have let the profession down here and, quite frankly, made the profession look a bit stupid.

  • Pulse speaks with Prime Minister David Cameron

    Janette Lockhart's comment 30 Apr 2015 12:52pm

    I'm afraid that the same questions asked of any politician right now would yield similar generic responses. Having read both main party manifestos in full, I am more alarmed by the Labour proposals. Both parties promise things they cannot possibly achieve, but Labour are planning another top-down complete reorganisation of the NHS - something which can only result in even more chaos and wasted money and risks sweeping away the good stuff that's happening as well as the bad (like they did in 1997). Labour also promises re-runs of stuff very similar to what they tried last time, particularly around appointment systems, and which didn't work then and won't work again. They also promise some things which are already up and running or in the pipeline - as if they don't actually know what's going on already.

    For me, the major problem with both parties and the NHS is that they are both completely focussed on their own political dogmas regardless of appropriateness and practicalities, and introduce change, often untested, with too much haste. I guess that will never change.

  • Our rapid mental health service saves lives

    Janette Lockhart's comment 27 Apr 2015 3:23pm

    My old practice had a similar set up in the early 1990s when fundholding was in full swing. We had in-house sessions with a consultant psychiatrist, a clinical psychologist, a CPN and a counsellor. It worked brilliantly, but ...er.... what happened then? A general election, change in government and all that good work was rapidly swept away.... Be warned!

  • NICE expensive drug approvals ‘doing more harm than good’

    Janette Lockhart's comment 20 Feb 2015 2:01pm

    From the study abstract:
    "the limitation of currently available data means that there is substantial uncertainty associated with the estimate of the overall threshold (for each QALY gained)."

    My humble thoughts are that this study is very tentative and makes some (at least partially) unfounded assumptions. The researchers seem to describe it as a first go at estimating a benchmark but admit there are significant limitations. In that case I do not think it deserves the publicity it has received and health policy should not be influenced by such insubstantial research. But there is a General Election looming and all sorts of dubious claims are being touted as fact.

  • Health minister in eight-week Men’s Health challenge to prove busy people have time for exercise

    Janette Lockhart's comment 18 Feb 2015 11:24pm

    re: Anonymous/Sessional/Locum/18Feb 3:19pm

    Please note it was my local MP - not Dan Poulter who supported my campaign. I was making a general comment about MPs. We complain about being portrayed as not working hard enough, which we know is untrue. Earlier posts seemed to assume the same of MPs - and I feel that is also untrue, generally speaking.
    BTW, like many others, I did work regular 100 hour weeks as a junior doctor. I worked 140 hours in one week. But that was the bad old days (qualified in 1974).

  • Health minister in eight-week Men’s Health challenge to prove busy people have time for exercise

    Janette Lockhart's comment 18 Feb 2015 12:26pm

    Having worked fairly closely with my local MP on several occasions over a year or two, including visits to the Commons and DCMS, I can honestly say that MPs work very hard, despite the popular myths expressed in other posts. He helped support a campaign I was involved with - and he wasn't even of my usual political persuasion. He never even asked - it was enough that I was one of his constituents. Sorry that the facts are rather less amusing than the myths, but the truth matters.

  • Quick guide: Labour's 10-year NHS plan

    Janette Lockhart's comment 28 Jan 2015 6:27pm

    A curate's egg of a list. Some ideas are essentially already on the coalition's wish list, and some are similar to those promised by the Tories. Some are stupid repeats of previously failed Labour initiatives (are they incapable of learning?) and some are veering towards the far left wing policies of previous labour governments,prioritising political dogma above practical reality and common sense. Some are loony and possibly dangerous, many are downright unachievable and some are already in place (but maybe under a different name). Can't say I'm particularly impressed.

  • GPs 'bullied' into bulk prescribing flu medicine to whole care homes without necessary testing

    Janette Lockhart's comment 09 Jan 2015 3:53pm

    I am genuinely shocked that any GP would comply with such a request. If you sign the scrip then you are entirely responsible for the consequences, so should never do so unless you are sure it is the right medication for each individual patient. It wasn't even a request from another clinician directly involved in the patient's care - as is the case when a consultant advises on a scrip for a patient they've seen. It seems to me that everything thing was wrong with the requests to start with - clinically, morally and practically. No GP should give in to such bullying - put the patients first, not NHS administrators!

  • GPs 'bullied' into bulk prescribing flu medicine to whole care homes without necessary testing

    Janette Lockhart's comment 09 Jan 2015 3:53pm

    I am genuinely shocked that any GP would comply with such a request. If you sign the scrip then you are entirely responsible for the consequences, so should never do so unless you are sure it is the right medication for each individual patient. It wasn't even a request from another clinician directly involved in the patient's care - as is the case when a consultant advises on a scrip for a patient they've seen. It seems to me that everything thing was wrong with the requests to start with - clinically, morally and practically. No GP should give in to such bullying - put the patients first, not NHS administrators!

  • RCGP chair: Labour's reforms could 'destroy general practice'

    Janette Lockhart's comment 25 Sep 2014 12:38pm

    I believe that what we already have as independent contractors is a system which encourages commitment to do the job right in all its aspects: caring, management, and business . If we don't, we personally lose - and so do our patients. The fundamental element of ownership with a splash of competition works to keep us focussed, whatever the political environment. Its not at all perfect, but it works surprisingly well.
    Moving to a totally salaried system with a single local employer removes all these incentives to commitment. We will no longer bear any real responsibility for the service and will lose all control over every aspect of our working lives. Some may consider that a good thing for them personally, but I suspect most GPs have a bit more spirit - we're not generally the kind who like being told what to do. I have no doubt that such a system will fatally weaken continuity of care in GP (it has never really existed in hospital). Moreover, the loss of the 'rub' between GP and hospital care - which creates a point of critical mutual examination and thus opportunities for improvement - may result in a uniformly mediocre service.

  • GPs' independent status may change under Labour, says Burnham

    Janette Lockhart's comment 05 Jun 2014 4:43pm

    The thought of becoming a salaried profession may sound attractive, given all the hassle of being independent contractors, however be careful what you wish for! The terms would most definitely not be as attractive as some have suggested. Flexibility for hours worked and division of labour (and subsequent adjustment of remuneration share) within the practice is one of the big advantages of independent contractor status - essential when partners want to adjust hours according to home/family circumstances. We would also face a permanent cap on income, unable to increase pay by voluntarily taking on extra stuff, though still liable to face an increasing, imposed work load.

  • Dr Terry McCormack: 'This will extend statin treatment to younger patients'

    Janette Lockhart's comment 12 Feb 2014 12:34pm

    @Anonymous 12Feb. The same argument (that giving people more protection encourages them to take more risk) has been used to warn against many safety advances through the ages - compulsion to wear seatbelts and motor bike helmets, the use of cycle helmets, boat buoyancy etc. This may be the case in a very, very few extreme risk takers, but is certainly not something which affects the general population. On the contrary, it could be argued that recognition by the 'authorities' that a risk exists raises awareness and encourages more risk aversion. As Dr McCormack says in his article - this move by NICE will help GPs access more people to give lifestyle advice and opportunistic BP checks as well as assessing the need for medication. Either we believe prevention is better (and cheaper) than cure, or we don't.

  • Landmark contract deal cuts QOF by 40% and boosts global sum - but will force GPs to publish their pay

    Janette Lockhart's comment 15 Nov 2013 11:10am

    Boomers rob generation X? I am a 'boomer' and marvel at these comments. Being female and having the temerity to have a family (when the profession was still male dominated) early on I spent several years in low paid (but long hours) salaried partnership which had a hugely detrimental effect on my eventual pension, which was reduced even further by me retiring a couple of years early. For some 20 or so years my pension contributions did not provide 'widower's' benefits even though I paid exactly the same as my male colleagues. A challenge to Europe made the change but it was not backdated so my other half will only get a small proportion of what I paid for if I go first. But that said, I still get a comfortable sum - GP pensions are generally excellent so there is a lot of wriggle room.

    There was no working time directive for my hospital years and the vast majority of my GP working life involved 24 hour responsibility for patients - including being contacted by other ooh providers for information even when I wasn't on duty. It wasn't a big deal, it was just what we did.

    The new contract sounds good in part, especially reduction in QOF - I hope that eventually disappears completely as, for me, that was the thing which had the most detrimental effect on enjoyment of the job .

    Big shame about seniority pay but, dare I say it, more money need not be the only thing worth hanging on for - GP offers a great range of opportunities to enhance work satisfaction once you've got to the point when the core work fails to challenge as much... and you may even get extra pay for some of it. I thoroughly enjoyed the extra (unpaid) stuff I did in the latter years and it was only when I was unable to keep that going that I decided to retire.

    A curate's egg indeed. Headline in the Telegraph (dreadful rag - I only look online to see the Matt cartoon) reads ' New GP contract heralds return of 'proper doctors' ' Were we ever anything else?

  • Primary prevention with statin in middle-aged men 'results in cost savings for NHS'

    Janette Lockhart's comment 12 Jul 2013 11:37am

    I don't think there is any social engineering going on. The subjects were 6000 middle aged men with hypercholesterlaemia - known to be a significant health risk. Giving them statins (if they want them) to help prevent a life threatening disease, which they may or may not get, is similar to immunising healthy individuals against polio etc - other life threatening diseases which they may or may not get.