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Independents' Day


  • NICE pushes through guidance limiting GP prescribing options for low back pain

    Innominate's comment 30 Nov 2016 1:11am

    Actually, this is mostly in line with the policy and practice of the pain clinic I work in. Nothing more important than early mobilisation, a daily walk, paced activity and a good physiotherapist. There isn't a medication for every situation. Sorry.

  • LMCs draw up explosive 'plan B' to take GP practices outside the NHS

    Innominate's comment 30 Oct 2016 3:54pm

    I remember as a child well before I went to medical school or even contemplated medicine as a career when the prescription charge of 6d (decimal 2.5p) was introduced in I believe in 1966 (I maybe wrong as I was very young at the time) and I recall experts saying people wouldn't be able to afford scripts and the outrage at having to pay for medicines by some of the population.
    In fact the number of prescriptions filled went up I believe by 10% as they now had value.
    I work in Oz and have done so for decades. It seems to me, if the National religion of America is the right to bear arms then the right to free health care is the National religion of Great Britain.
    I charge a fee for most patients and the government issues a rebate that is paid back into their account usually that day or the next day. The internet is quite effective these days.
    I can choose to accept the governments very low rebate should I so choose to make the consult free. It is up to me to assess the patient's ability to pay and by and large the profession gets it right. Waiting times are non existent and specialist referrals I can mostly get seen within weeks if I twist my mates' arms.
    I understand that there are many patients who say they cannot pay in Britain. My reply is why do you drag the whole population down to the lowest common denominator and by the way how does that result in quality care.
    Last time I was in the UK I ran out of Pregabalin and was told by a GP it was"Black banned".I then asked for a private script and paid for it and sent the bill to my health fund to be rebated. No worries.
    My friends and colleagues,there are many examples of how to fund health care in the world. America is one extreme example as is the NHS. Both appall me. There are many other middle road examples and as is often the case with many problems the middle road is often the best course. The Republic of Ireland is another example with non free health care and better morbidity and mortality statistics. Look at the longevity statistics of Australia versus those of the UK.

    Is"free health care" killing your patients?

    I suspect GPs might have to charge some patients in the UK. Now I have committed sacrilege. Sorry.

  • Orthopaedic clinic - complex regional pain syndrome

    Innominate's comment 15 Aug 2016 3:48pm

    CRPS otherwise called central sensitisation phenomenon and other names is complex and fascinating, It is a significant per centage of our work at our pain clinic. an treatments are varied and multi-modal.
    But for time poor GPs try using 5% lignocaine patches over the most painful part. Sometimes the results are amazing. You will know if it works in a couple of days. So if you can get samples and hand out a couple of sheets giive it a go.

  • Junior doctors risk losing public support

    Innominate's comment 05 Apr 2016 4:23pm

    Like you I am an outside observer though still working as a GP most of the time. I am more concerned that the "Public risk losing Junior Doctors' support". JDs are brilliant highly educated and capable of tremendous things, but that might not include dedication to a monopoly abusive employer such as the NHS.

  • Practices to pay almost £2,000 more in CQC fees from April

    Innominate's comment 03 Apr 2016 4:25pm

    I tell my students there is a very important word that they need to learn. More important than any of the thousands of words they learn in Medical School. It begins with"N" and ends in "O" and has two letters in it. Learn the word.

  • Implement junior doctor contract or lose funding, hospital bosses warned

    Innominate's comment 20 Feb 2016 0:13am

    @robin jackson
    Thanks for your comments. Tri-lingual 2 undergraduate degrees a diploma and two fellowships. I'd take my chances in the private sector.

  • Migrants concerned only with saving their lives, will destroy the NHS

    Innominate's comment 17 Feb 2016 4:08pm

    So succinct. So funny

  • #GPnews: Hunt says parents could check children's rashes online

    Innominate's comment 01 Feb 2016 3:36pm

    Sarah my dear. I respect your point of view . Do you respect that I acted in anticipation of this attitude and have been in OZ for years. Is that ok with you?

  • I still think that doctors should not strike, despite the abuse I've received

    Innominate's comment 24 Jan 2016 6:49pm

    Dear Colleagues, Nick Summerton and Ivan Bennett,
    I would like to briefly reply to you assertions that Doctors should not strike which you ascribe to a loss of professionalism. You describe no evidence of this.

    I qualified in 1983 and passed my MRCGP in 1989. I am of your vintage.
    I remember 1:2s and abusive consultants very well. Far too well.

    Neither of your posts would have any credence (Cochrane Collaboration) and so are not part of evidence based medicine.
    Your junior colleagues are at least as intelligent and as well educated as you are and have been trained by your good selves as well as your colleagues (including the ones that Dr NS has informally consulted with). I suspect they are actually brighter and better educated than I, but that is beside the point, and I wouldn't want to be abusive.

    Firstly, wittering on about discharge summaries is a system failure in the 2016 computer age not a failure of junior doctors or their attitude. Don't be such a Luddite.This is not personal abuse. It is an acknolodgement of a systems failure. Fix the system. Don't shot the messenger.

    Secondly 99.4% of the junior doctors that you have helped train voted for some form of Industrial action (only 222 out of 37,000 did not)and 98% voted for a strike. I feel I have to repeat it 98%!

    98% of an intelligent well educated highly trained caring group of individuals say enough is enough.
    Up till now my comments have not been abusive. I have tried to be factual and unemotional. The NHS still cares for my elderly father even if I no longer work with in the system.
    When this many of your junior colleagues supported by your GP colleagues, and your Consultant colleagues, and the General public, and for that matter your future colleagues in the form of medical students. When all these people a sizable proportion of the population of the UK all disagree with you, can I ask you a question? In a non abusive way?

    Are you wrong?

  • 'Striking is just something doctors should not do'

    Innominate's comment 12 Jan 2016 2:11pm

    The Junior doctors have decided and what they have decided is that they are professionals and patient focused but that the NHS is not professional and not patient focused. They will not work for a non-professional organisation under conditions that are unsafe and unfair and that will decimate the professionalism of their chosen profession in the future. Please don't infantilise your junior colleagues who are probably brighter than and at least as well trained as you. After all who trained them? Back when you and I qualified it was awful being a junior doctor. But being abused by a system should not be passed down the generations as we would not condone the dreadful way that child abuse seems to pass down the generations.
    The juniors are saying it stops now. Enough is enough.
    A seven day service with no extra money and no more doctors won't reduce the death rate at weekends. It will increase the death rates during the week to those of the weekend.
    I suspect that we will look back on this as a moment to radically reform the NHS into an organisation that adapts to future needs with apps remote monitoring, telehealth and technologies that you and I will never understand. Old fogies such as myself and yourself will stand back in amazement as the current junior now senior doctors use technology to help patients and themselves achieve a work life balance.
    Striking is not deprofessionalisation but a recognition of what the future holds. Disruption is an apt choice of words. for disruption of health industry is what is going to happen, but that will happen with or without a strike. Why should Health be the only industry that is not disrupted?