Loaded with a good supply of Orlistat, sticking a nicotine patch and a good selection of Vapor Cigas and Vape Pens in the pocket, they start their daily round with a Big Mac, moving on to Starbucks for a Venti signature hot chocolate with whipped cream + whole milk and a carrot cake. Time for luncheon at the Bull and Mouth washed down with a couple a pints.
3.20pm, time for their health check at the GP surgery and their miraculous anti-cholesterol jab to cover them until time comes for bariatric surgery. Long Live the NHS, that meets the needs of everyone, FREE at the point of delivery.
Here it is for those not that long in the tooth:
* Dramatic drop of standards, thanks to brain drain and a RCGP that has forgotten Education and deals chiefly with Politics.
* Referrals and drug budgets zoom
* Desperate situations need desperate measure - NICE is born
* "Treat patients as individuals" is out and "One size fits all" is in - GUIDELINES are born
* Guidelines replace medical schools and they are here to stay, unless the process is reversed, but we are not holding our breath.
As for the noble idea of replacing Guidelines with Information, the question is: Who provides the information? Pulse and its medical adviser?
As clear as mud.
But let's accept that there has been a decrease in the number of FTE GPs. Could NHS Digital please help us to track down our missing colleagues, starting with:
How many are sitting comfortably at CCG governing body tables?
How many "represent" us at LMCs?
How many have become medical directors for Health Education England?
How many have joined DH & NHSE and their "agencies"?
How many choose to give pointless advice to patients (if you eat less) from Public Health England and H&W Boards platforms?
For more on "missing GPs' read the Peverley classic:
I see. It's the BMA's fault and nothing to do with the LMCs.
In which case why are GP FORCED BY LAW to maintain them?
Take London for example. They deduct at source £0.5384 per patient. For a Greater London population of 8,539,000 that gives them an annual income of £4,597,397. For this, London LMCs are telling practices that "they would secure the future of general practice in London through our work with all partners in the health and social care sector and beyond"
At least with the BMA, GPs can decide whether they wish to subscribe or not. With the LMCs, GPs have no choice.
Isn't it time PULSE contacts a survey among London GPs to see if they feel that they are getting value for money? Especially as they now propose to increase the levy to £0.5778 per patient, increasing their income to just under £5,000,000 per annum.
Maybe my figures are wrong, in which case, I would welcome a correction from London LMCs and happy to apologise.
Once upon a time RCGP was purely an educational establishment, ensuring quality standards in general practice. It then became heavily politicised, trying to fill the gap left by the consultant-led BMA, but also promote its own interests and its directors'.
The rest is history (this is a rather flat entry as my legal adviser has sat on it - braver colleagues may wish to enrich it).
Any figures on Phil Peverley's 5,000 extra GPs GOVERNING the rest of us? http://www.pulsetoday.co.uk/views/blogs/peverley
They are not 5,400 now? Or, are they?!
Dear Anonymous Doc 10.37am,
May I add some additional beneficiaries to your absolutely correct comment.
1. Top medical defence salaries rise by up to 45% as fees spiral
2. Legions of lawyers working FOR defence unions. It suits them to see more and more "no win-no fee" colleagues feeding them with more and more claims and litigation.
So, everybody is a winner, defence bosses, lawyers for the plaintiffs and lawyers for the defence.
What about the doctors? Ah well, no problem there, we also pay RCGP, BMA and LMCs to look after us and they are doping a smashing job.
Is this tax free? Or, is it lumped into practice income so that the Treasury can claw back 40%? 45%
"history rewrites itself" Vinci Ho is right, but I'm afraid for the wrong reason.
Those of us a bit long in the tooth, have learnt the basic principles of the NHS:
* 90% of the NHS top brass are of hospital background (please look up NHS board)
* they treat hospitals as the aristocracy and GPs as plebs
* they siphon money from general practice to the hospitals (STP is their latest plot)
* they install their placewomen/men at regional and local level (PCT CCG or whatever next) to neutralise any resistance from GPs
* the governing body GPs rubberstamp the local commissars' decisions dictated to them by their bosses
* LMCs, often staffed by CCG governing body GPs, countersign.
But what about our trade union? Our college? That's another story.
It was the most biased survey I have ever seen, packed with questions leading you to admit that "Brexit is awful" and "since Brexit my patients hate me".
Even the Guardian wouldn't have drafted such a loaded survey. But even if it is true, let's have another survey to find out how many doctors from the Commonwealth will be coming to Britain after Brexit.
@04 Feb 2017 12:16pm
Following a spinal injury 12 years, I have found that Diclofenac is the only medication that relieves my intermittent back pain. Hundreds of patients also say the same.
Why the big headlines then?
The answer is in the authors' conclusion: "There is an urgent need to develop new analgesics for spinal pain."
Don't be surprised folk if this magic pill is around the corner, for 10 times the price of Ibuprofen and 20 times the price of Aspirin.
I've lost count how many times I've seen this scenario.
It is an enigma to me that although we all acknowledge BMA's complacency, we are prepared to resign from the NHS but not from the BMA.
Our union barons will carry on paying lip service and looking forward to their next gong for as long as we are prepared to foot the bill for their salaries, pensions and their Tavistock palatial offices.
In Godfather Episode II, the following immortal words were uttered to an unco-operative producer: "What is going to be on the dotted line, your signature or your brains?" We can slightly paraphrase that to "Either you save general practice or we stop paying you."
Interesting to see what will happen after those doctors join the GP pool.
Will they stay with the practice, or will they join one of the myriad LOCUM agencies to make more money?
In September 2016, there were the equivalent of about 9,000 more doctors working full-time for NHS England than in September 2010 (DH falsely claimed 11,500) and yet general practice has not seen the benefits from the new recruits. My guess is that the majority have become locums, or joined some cushy number as administrators, medical directors, governing bodies members and a few other non-clinical posts with handsome remuneration.
Of course, when we are all locums run by GP aristocrats or agencies, these short-termist doctors will see their income halved and their workload doubles.
You have been warned!
There is plenty more of the same to come from No 10 as Mrs May's new health adviser is Dr James Kent, a former junior doctor who left medicine to become management consultant. He has expressed his views on the NHS in several articles, easily accessible on the net.
Perhaps, PULSE might consider seeking an interview with Dr Kent.
For credibility, it would be better to have comments from BMA and LMC please.
"The unusually late conclusion of the annual GP contract negotiations is due to the UK’s vote to leave the EU, the GPC has told Pulse."
Really? I thought it was Trump winning the election. Or, perhaps, Climate Change. No, no, it's demographic changes and the ageing population.
For God's sake, are we actually contributing towards those people's pensions?
From a long experience:
1. A large proprtion will go to administration and CCG salaries
2. A bigger chunk will go towards signing blank chequers to bankrupt local hospitals for artificial activity.
3. What's left would be "offered" to practices AFTER setting impossible targets on referrals and prescribing.
The great enigma to me has been why investigative journalists have never looked into where the money goes, starting from the individual salaries of CCG governing body members, varying from £80 k to £260+. All in the public domain under CCG Annual Accounts.
I did respond to the aforementioned survey and my comment was:
A stream of leading questions herding the sheep (sorry, GPs) to give the answer the BMA barons want to hear. Survey null and void due to blatantly obvious bias.
Hi Nigel, I didn't think there was much wrong with the old format, but I suppose one has to go with the majority.
Nevertheless, I will miss some very wise and constructive comments from pharmacists. Our practice is currently working closely with pharmacists in two pilot schemes and we have found their contribution "indispensable" (intended!). After all, general practice and pharmacy (with dentistry and eye care) are the hard core of Primary Care.
Any chance that you might reconsider?
@Paul Bunting 11.01
That was pointed out on 28 10 2014 (http://www.pulsetoday.co.uk/clinical/prescribing/gp-antibiotic-prescribing-under-the-microscope/20008316.article?MsgId=37701#MsgId_37701) but no one was prepared to address this huge problem. I hope you are more successful, but I doubt it as we are up against huge vested interests.