So easy because all the problems of the NHS are due to an Evil Tory Plot.Would that we could raise the intellectual level of debate on health services above the level of the Infants School Playground.
Nothing will improve until politicians have the courage to tell the public the NHS is for their needs and not their wants.Unfortunately "evil Tory plot" gets in the way of any attempts at reform.Why can we not have a cross-party consensus that acknowledges the current construct is broken, and that we should regard the NHS as a means to and end (a defined provision of healthcare)and not an end in itself? Sacred cows should be slaughtered!
When I was a GP CCG Exec under the past regime of the Blessed St Tony, we were given "World Class Commissioning".The apparatchiks always looked hurt when I suggested that I presumed that the relevant "World" was the Third one.
Plus ca change etc.....
Any new T2DM with a BMI of 30 should be told to go away and lose 3 stones. We simply cannot afford Nanny state measures any more.The public has to accept the consequences of its lifestyle choices.Why on Earth should the taxpayer fund expensive and possibly risky surgery for patients who refuse to acknowledge the folly of their dietary excess?
"successive governments have disinvested"??Fake news methinks.They have actually poured more and more into an ever demanding system.Having been involved (as David Wrigley can vouch!)in NHS finance at CCG level, I can assure you that the NHS is appalling wasteful in funding management.Throwing money at a problem is a fatuous proposal for a genuine crisis.There are many ways in which we can run things better,for the same budget. A paper in 2013 showed that if all hospital Trusts were as efficient as the top 20%, we could save £20 billion.
"Accountability" is meaningless.These organisations need to have the power to overcome bleating and shroud waving from Trust CEOs, and shift responsibilities (AND resources) into Primary Care, where it was in the 1980s when I started in GP. STPs should be the nemesis of DGHs that see themselves as an end rather than a means to an end.What was good in 1949 may not be good in 2017.
Having gained weight slowly,most patients are unaware of the load this actually creates.I used to have an antique cast iron 14lb weight that I told them to hold whilst I discussed their obesity.I also suggested the visit the supermarket and load up their trolley with 5lb bags of spuds (3 bags+approx 1 stone).Most were at least 3 stone overweight viz 9 bags of spuds, which probably fills the trolley.
NHS Budget 2015-16: £116.4 billion, so that would be a gold-plated shoestring then.....
Primum non nocere. The beardy old Greek was right(albeit immortalised in Latin).
Oh dear.The little people have dared to have an opinion that the Lear jet liberals disagree with.Such was the arrogance that did for Cameron and Clinton.You may, like me, disagree with opinions expressed by Trump or Farage,but if you fail to comprehend the context for why the millions voted as they did,you will deserve to suffer the consequences.
If I had a pound for every GANFYD demanded by nurseries I would be able to afford that gold-plated Trumpton laptop I promised myself.
Happy Tots Nursery Business Plan:any problems,dump them on the GP.
Health watch is incorrect.There is nothing in the legislation giving people the right to be idle at the taxpayers expense and the more we collude with their delusion the greater will be the demand. Many believe themselves to be incapable of work,but it is patronising to state they are unemployable.
..so you still feel you can have a therapeutic relationship with someone who blackmails you into fraudulently signing a certificate that is effectively a cheque to defraud the taxpayer? The GMC might wish to take a view on this.
There is ample evidence that being in work has strong health benefits and that the corollary is true.
We are not being asked to be Occupational Physicians, but simply to take a common sense view of a person's functional capabilities. Anyone feeling that this is too much of an intellectual challenge is probably in the wrong job.
The "at scale" comments are irrelevant.A larger group of Practices in an area to which it is difficult to recruit will fail regardless of its size nor whether it is run by a private company or a GP confederation.
Management at scale has the potential to stabilise situations but is neither a cure all, nor a cause of failure.
We can land probes on Mars, sometimes even in one piece, but we cannot remove a surfeit of cerumen. Me, I blame it all on Brexit.Someone should be told !
Primum non nocere (for you Millenials that is: First do no harm).We have spent the last 50 years medicalising Life, and giving the public utterly unrealistic expectations of what we can do (treating unhappiness with anti depressants being a case in point).
It will take a concerted effort by the Government to reconfigure the NHS to meet patients' needs not their wants, but the Royal Colleges have made a good start.Agree we need top cover from MDU/MPS.
For most of my 34 years as a GP I was fortunate to deal with a Coroner who was a wise and much respected colleague, available (or with his Deputy)24 hours a day.His pragmatic and common sense decisions saved many families distress.
Essex now seems to be offering instead a "customer service department".Yet another example of how we have lost the ethos of a National Health Service in which we were once proud to serve.
Jo, I am sure "working for a pharmaceutical company " gives you a clear insight into General Practice but I can assure you in my neck of the woods if you suggested to the GPs here that they are going through the hard labour of merging and federation just for "ideological " reasons,they would probably ask you to "step outside " for a short "UKIP"-style "discussion".
They are doing it firstly out of a sheer instinct for survival from a model that is clearly not sustainable, principally in recruiting terms,and secondly because they believe collaborative working will benefit patients.
Neither you nor I will know whether they are right for several years but in the meantime let us salute their carpe diem courage.
What we all acknowledge is that General Practice in its current model is not sustainable, nor is that of Secondary Care.
We need to redefine the clinical paradigm so that we can have the resources(human,technical,financial etc)to enable us to deliver this.
Infantile whining about "evil Tory plot" gets us nowhere. Our patients deserve better.
Lets endorse positive changes for the future and liberate ourselves from the Dr Finlay "cottage industry"mindset.
@5.55pm, you equally sound like an unreconstructed bigot. Diversity is just that. By definition a diverse community has to embrace a diversity of views. I do not agree with this patient's views but neither did I agree with the views of female staff from a strict Muslim school who registered with us but who refused to see a male GP under any circumstances.
I suspect you would find yourself on very difficult ground trying to conflate the advice of the GMC with the attitude of someone who may not be very bright.