NHS funding shoulkd address the excessive costs they are paying their buraucrats.
Their numbers have gone from original five at inception of nHs to millions with fat undeserved salaries
The relevance is that SIGNICANT costs were saved long term and short term in julien given's paper on all problems encountered in general practice
Julien GIven's paper covered all conditions seen in general practice COPD,Asthma,Hypertension Cardiovascular disease,uro -genital diseases,CNS disease including endocrinological Diabetes included
the cost savings by NHS begs questioning.
They recommend and still doctors use the old Hypoglycaemia inducing Sulphonyulurea in Diabetes now replace by NICE with meal time sulphonyureas repaglinides,which could lower hypos with sulphonylureas in common usage, not prevent metabolic complications MI,CVA,Renal Failures,Blindness,amputations ,which glycosuria inducing ,more expense to purchase Dapagliflozinwe (Forxigo)could.The costs to NHS for diabetes is over two billion pounds p.a. out of which the largest share of costs is in treating secondary complication.The Gliclizides and Glimepirides in use frequently cause hypos which treatment in secondary care according to prof Tony Barnet is hundreds to thousand pounds for each case .
Mr Julien Given of Blue River Consulting Ltd of Newcastle had presented a paper at PriMed Conference I attended and proved from statistics if GPs were allowed slightly more expensive but cost saving in drugs it would save enormous costs to nHs in short and long term
Cost cutting by NHS has gone mad.
For diabetes alone the cost of treatment reaches over two million pounds;the major part of it on treating Diabetic complications -Blindness,MI,CVA,Renal failures,amputations.
Despite evidence presented from Endocrinologists and others like Julien Given of Newcastle Group that if GPs were to prescribe slightly more expensive but cost saving in long and short term drugs the total costs to NHS would be tremendously reduced.Julien Given's paper at PrimEd Conference covered the full spectrum of diseases,Asthma,COPD,Diabetes,Hypertension cardiovascular,Renal and CNS diseases seen in General practice.
The economists and health authorities seem to have got it wrong.
Morbidity,mortality of public and economy would improve if their policies on cutting GPs prescribing budget is reversed with emphasis on cost effective medication
The GPs numbers would not have dwindled if GMC MPTS were given resilience training not take NHS complaints as sacrosanct and investigate them before torturing Gps to distraction and resignation.
Four years ago there were more GPs than could be absorbed.It is mismanagement of bullying of GPs pointed out by prof Brian Jar-man ,David Hands,also cost effective approach to treatments by Tony Barnet that has led to our sad situation.
could Dr Jackie Applebee give the precise address of Unite House were the proposed Conferenced of GPs is to be held
Repaglinide a ultrashort acting sulphonyurea would possibly cause lesshypo then the current ones.
However they would not protect Diabetics from cardiovascular complications which SGPT2 inhibitors would do.Though licensed b y Nice ,i would suggested replacing Repaglinides and all sulphonyureas with these.They will prevent weight increasing morbidity and mortality of Sulphonyureas.
I am sure the GPs and NHS would welcome the cost saving,morbidity saving effects of these SGPLT2 inhibitorslike dapaglizones
Is it too much to ask The Legal and Medical professions should rise above the present penny counting methods that contributed to greed in Dr Harold Shipmans case.
Aristotle in the olden days of lawyers predecessors the Sophists could make an innocent poor man guilty and a rich guilty man free by twisting words in the court of Law .This lead to institution of Aristotelian Logic Training.Our lawyers should rise above penny counting and think of Patient care provision as a whole.
Both legal representatives of doctors and doctors themselves should rise above the present situation. Gps should refuse prescribing Evidence based harmful medication for patients,even at a personal cost to themselves.
A prominent lawyer has told me we cannot expect justice in this world.This requires a revolution in thinking
A Moral revolution is required in The UK.
Throwing money to better patients care will only feed the greedy rich with no help for the patients
There are many changes required to make General Practice attractive to General Practitioners.
The most important one to tackle the cause of depression amongst GPs which led to suicides.
GMC MPTS should scrutinise complaint against GPs before torturing them to distraction or resignation.They should not automatically take complaints before intensely scrutinising them. Summoning GPs from London to Manchester to attended torturing,with GPs often unrepresented by doctors lawyers,as informed by Prof Brian Jarman in his celebrated editorial ' BMJ 2012;245:8239'when Managers rule [patients may suffer and they're the ones who matter has raised issued clearly.
Prof David Michael Hands challenge to investigate bullying in NHS in his letter to Editor should be urgently taken up to save NHS. GPs should be encouraged to whistle blow to bring up our health service standards
GPs mostly take their work as a service for patients which should be rewarded not by torturing hem to resignation.
The Law says Innocent until proved guilty.So the above necessary steps by GMC to prevent suicides and depression recorded amongst GPs.
Resilience training should be forced on GMC MPTS not to take hurting unsubstantiated claims against GPs
Repaglinide may have no sideefects but does not prevent metabolic consequences of diabetes IHD,Amputations ,CVA due to weight increase which Dapaglizone does.Diabetes kills predominantly by silkent MIs CVas Renal failure,Amuations
NICE has stated that Pracetamol is as good as Placebo in musculoskeletal disease .With PPI inhibitors Ibuprofen,now available over the counter has been said by NICE to be more effective.
one should watch for hypersensitivity reactions,gastric sideefects ,avoid in Renal Impairment.BNF mentionsRarely papillary necrosis,or interstional nephrosis associated with NSAIDS may lead to Renal failure.
We can do little else with pains of slipped discs sciatica etc after diclofenac gel application
NHS should stop undue turtures of their employee doctors,They break employment Law in facilities they give to GPs,faulty dangerous error inflicting computers,unqualified staff with big titles;then refer the GPs to GMC for computers faults;When GMC FTPP reinstates them;they still put unnecessary insurmountable hurdles on GPs and doctors.They are putting the last straw on the camels back and destroying this noble health service to patients.
There are easier ways to survive than become a doctor.
John Milton in Lycidas says'What boots it with uncessant care to tend the homy,slighted shepherds trade;And strictly meditate the thankless muse(NHS0;Were it better done ,as others use ,to sport with amrylis in the shade or woth tangles of Naera's hair.He replies'fame is the spur that the noble mind doth crave;That last Infirmity of the noble mind;To scorn delight and live laborious days'
NHS England has dug its grave for health service ,by not following evidence based medicine.They with GMC MPTS are the cause of exit of doctors from Uk
They have in a gross error of cost savings in enforcing cheap to acquire severe hypoglycaremia inducingsulphonyureas as second line treatment in Diaebtes,which according to Diabetogoa Magazine lowers sugar similar to Insulin in first three years.
Yet in further cost saving Blood sugar testing strips are not allowed by NHs to prescribe for patients on Sulphonyureas. which NICE had said we should not prescribe if we fear hypoglycaemia.Endocrinologist have always stated .
GMC MPTS should not be seenas they are seen to do , to accept NHs accusations without scrutiny .GPs will continue fleeing UK after qualifying or resigning causing a very heavy work load on residual GP.
,The cost of treating hypos in secondary care per case i acording to Prof Tont Barnet £100-1000 /casenegating the cost saving.The metabolic and lng term side effects MIs,CVA,Renal failure cost 3100s per case.Now NICe has advised a very short Suphonyurea Repaglinide before meals .Dapaglizone which has been shown to cause weight loss would be a far better for public health
GMC'MPTS which act as unquestioning lawyers for NHS,which despite NHS going against evidence based mecine,pointed out by accused GPs do not consider GPs statement.They dismiss it saying they cannot sue NHS.they persecute the GPs to distraction,force them to resign or leave the country
recruitment poblems amongst General practitioners will remain as long as NHS uses GMC MPTS as its lawyers to bully GPs to accept NHS non evidence based medicine approach.Of late NICE guidelines have stoped allowing sulphonyureas as 2nd line Antidiabetics,replacing them ironically with on demand SUs repaglinide.Dapaglizone an SGLPT2 inhibitirhas been shown to combat metabolic sideffects and its tremendous costs of treatment of weight and hypoglycaemia.
As long as GMC MPTS unquestioningly supports NHS's negative approach to treatment of the public ,the public will suffer the consequences and Recruitment crisis wil not be addressed.
GPs have been trained to put patients first before costs
If the British GPs want to preserve their sanity ,the bond between GMC MPTS and NHS should be completely broken before they contemplate returning.
If the Australia living British Gp want to preserve their sanity until current NHS organised is more doctor and patient friendly they should stay put where they are
NICE should promote weight reducing SPLTP2 inhibitors Dapaglizone which causes weight loss, instead of replaglinide with on demand suphonyurea stimulating Insulin release rapid onset action,short duration of activity but can cause weight gain
Groundless complaints do not only come from patients but from employers as well.
This is poem to describe the dilemma of our NHS:
Yet once more Oh ye Myrtles and Oh ye Ivy Brown,
I come to pluck your berries harsh and crude,
And with forced fonger rude,
Shatter your leaves before the mellowing year.
Before the mellowing year.
Bitter constraint and sad occasion due.
For National Health is dead,
Dead err its prime and National which has no seer.,
Who would not weep for the National Health.
The Heath service in Evidence Based Medicine gross disdain,
They who are supposed to boost ruin the education of their doctors due.
In favour of saving pennies pounds are lost too.
The economy is going down the shute!
The sideeffects of medication cost hospitals thousands,
When the authorities are told they take out their cudgels and the doctors pound.
Doctors and suffering public can only sigh,
fFor they are destined to die!
Now doctors to refuse harm to their patients resign,
The National Health to GMC these doctors malign.
This Noble profession is only due for toture these days to prevent them being Noble