All for one ?
Unscepted is so right . Trust patients receive 25% more for admin alone. I think the extra funding provided would have sustained all GP practices that were taken over. But the NHS has always been thus. Some GP surgeries get 200 , others 120/ patient. Of course, there are likely to be some variation as say London vs Fermanagh, but profit per patient year can vary from 120 to 40 pounds. Trusts are all better paid per patient and perhaps while we may lose independence on the swings, we may gain workload controls, safety and stability on the hobby horses.
Jaimie, we GPs do not define safe workloads. It is pointless to keep saying 'excessive' without any definition of ' normal' is.
We accept a Patient number based contract with no definition of appointments/ consultations per patient. So, if consultation per patient goes up threefold in 20 years and continues to rise year on year, but we continue to stick to the same patient number mantra rather than define workloads by appointment number, which we can quantify as safe then we can only blame ourselves.
BMA ARMs through the years have decided against appointment based Contracts or even defining safe consultation/ day/week.
I remember Clare Gerada [ I think ] saying she would not like to the GP's 50th patient that day, but did not stay to define what number she would like to be.
I did maths once and it is still my hobby. I believe the Universe is mathematical. How many GPs we need [ eg 6000] has to be based on some mathematical concept of appointment numbers/ WTE GPs/ workload capacity to define a few parameters.
The ball is not with the Govt. It lies with us.
I love the practice of medicine, it has become a cherished hobby and checkpoint inhibitors and MABs for malignant melanomas and blockers that affect b3 receptors and all this wonderful, magical profession we belong to; but I cannot stand the unfettered demands anymore and I and leaving with a heavy heart. When will the BMA, our Union, realise that unless you look after doctors by defining safety in workloads and conditions, then there will be fewer of them left?
At Cross roads
So sorry to hear of your troubles. Retirement age of NI women GPs is 41, I believe.
But in some ways, we GPs have ourselves to blame for this.
We accept an unlimited patient number based Contract, instead of a limited appointment based Contract. W cannot accept something legally and then complain of workloads, when we do not define safe workloads.
I have tried, times without number, in BMA , ARMs, LMC meetings to define workload safety and/or appointment based Contracts.
The meeting have voted against these defined workloads every single time. I have given up. I may be wrong anyway in worrying about the health of GPs, burnout, litigation, Gross negligence manslaughter all due to workload issues [ as in Dr BG ], because the numbers of GP trainees is increasing.
It is bizarre to so tarnish an entire profession and then say you need 5000 more of these lazy, fraudulent, overpaid GPs who spend most of their time playing golf !!!
More than 80% of the total world antibiotic use is by 2 countries in farming.These reactivate genes for antibiotic resistance that are millions of years old [ found in bacteria buried deep in permafrost long before antibiotic use by mankind], washed down through rivers into oceans and ship's ballasts and multiple ways of spreading. Our use of antibiotics is probably about 0.01 % of world usage.But we still need to be careful, even though we do not make any difference to global AMR genes.
Dr BG was found guilty for ' ignoring obvious deterioration' as stated by the expert. But, in actual fact, Jack improved under her care and was transferred to a general ward where he got an ACEI. He was unresponsive on admission and very ill around 10 am. Yet at 7 pm, he was well enough to be transferred to a general ward by ANOTHER clinician [ not BG].
YET, DR BG was convicted for the following, according ti Sir Thomas QC prosecuting [ under expert witness advice] :
' Due to their neglect [ Amaro and BG], Jack Adcock's condition declined to a point of no return before transfer to a general ward.'
I find this absurd as a prosecution statement, because Jack was unresponsive on admission and if he declined he would be moribund and could not be transferred to a general ward.
The whole case is actually absurd and the expert witness is squarely to blame for that, for stating decline, when Jack actually got better.
It is not the GMC is at fault, it is the expert witness who stated that a diagnosis of gastroenteritis in Jack who had vomiting and diarrhoea as negligent.
I despair that no gastroenterologist has written to GMC or law society defending Dr BG's diagnosis and the expert witness has gone unchecked by the defence team.
I even heard a professor in Hobart, Tasmania, state that had Jack remained under DR BG's care, he would not have got the ACEI, as she had rightly thought it contraindicated in V+D, and he would have gone home.!!
A case could easily be made that it was because Jack was transferred from DR BG's care that he died!
Perhaps this is a blessing in disguise and we should all work less and more sensibly any way.
Truth finder.Jack had been unresponsive on admission and had improved so much he was discharged to a general ward because he was so well by another clinician.
Ye Bawa Garba is convicted for 'neglecting decline to a point of no return', according to the expert; which is completely the opposite of clinical reality. How did this ever happen and what can we do about this? Where was the defence team?
No wonder no one wants to work as a doctor here in the UK. No one should in these GNM conditions.
Truth finder is right. These ghostly figures are all fraudulent, they are just spooks from a quantum unreality.
Yet the BMA ARM voted overwhelmingly for the new 5 year Contract with PCNs.
Sadly, Dr BG did work so hard covering so many doctors. This was used against her as she did not see the XR earlier because she was attending to other children with meningitis and sepsis, children that should have been dealt with by absent doctors.
You don't get thank yous here in the UK, you get GNM instead.
Why would any doctor wish to work in this insane country? Look at pensions. If you earn 1 pound more you pay 2 pounds back.
The UK is becoming insane.
NHSPS and Capita are examples of this madness.
Also needs to be sued for fraudulent billing.
I remember when Conference voted to ballot to resign. But GPC decided not to, so ultimately the GPC does not care.
As Jonathan points out the tax charges are ridiculous and against all natural justice. You earn less money and less pension if you work harder. The UK is sadly becoming a country of ridiculous laws. Take Dr Bawa Garba's case her treatment of poor Jack is taken in isolation ie she did not see the XR till 3pm. The fact that she was attending to another child with meningitis and another with sepsis does not count. She is treated in court as if she was sitting watching TV and drinking tea. This is the UK.
The much vaunted Francis report is another of these mindless aberrations.
Mid- Staffs was a 3 star top rated hospital in the 90s. To save money [ 2 million], management cut nursing staff. Christine Hancock warned them that patients would suffer and die if staff were removed.
So, when they cut staff and patients suffered as a result, what did they do ? Not replace the staff, that would be too simple. Instead, we have a legal chair report costing 13 million with 500 recommendations !!!.
They saved 2 million on cutting staff and spent 13 million on a Francis report for a predicated [Hancock] outcome.
They then spent another 40 million on compensation and shutting the hospital, which has become a by word for poor care.
But hang on, this was a super hospital once.
Pensions are on a par with this kind of madness.
You earn less if you work harder!!
So BMA, perhaps there is a moral to this story. Perhaps we doctors should look better at a work life balance and don't do that extra clinic or management because we will actually earn less.
The BMA should indicate an ideal earning per year. Go above it at your peril.
Not Kohli, then??
Add complaints, GNM, litigation, pensions and CQC to this mix and there should be no GPs at all. But we guys are so foolish and silly for clinging on, hoping. What dopes !!
I find it utterly insulting that GPs are thought of as fraudulent over such a minor issue. I have ghost patients, but I do not have a foggy who they are. They belong in an unattainable dimension like Rumsfeld's unknown unknowns 'we don't know we don't know.'
This is in the same category as those lazy GPs playing golf earning millions and Mr Hunt's penance.
Should we really remain in such a system that is so utterly stupid and malicious ? I, for one, will be glad to see the end of GP land as it stands. If there are IQs out there who cannot tell the difference between fraud and happenstance than we should not be here.
A blessing in disguise. Leave now and no worries about CQC, Appraisal, GNM, Pensions, Complaints, GMC etc.
There is no pleasure as relief from pain.
I am not even sure how this can be done. Perhaps I am naive. Anyway, I have a few ghost patients unbeknownst to me. That is not fraud. It is the language of managers that is intensely annoying,
to me, it is a resignation issue. If they say nasty things about us GPs knowing it to be untrue, then we should resign from GP land or get paid per consultation,