Excellent article, emotive and passionate.
Unfortunately, as already discussed - no easy answers.
The world knew of the dangers of a new pandemic infection - this was looked at late last year (about Oct 2019) with dire outcomes concluded; the report was broadly ignored in the west (not compatible with neo-liberal, private better than public, ideology).
Some countries prepared, and have coped better - China, Taiwan, South Korea, Singapore.
Germany's health service had capacity before the pandemic, and they have responded better - more testing etc.
Noam Chomsky notes that, despite the horrendous death rates, the world and its population will eventually overcome Covid-19. However, the bigger dangers for mankind survival which need action now, is Climate Change & Global Warming (with likely loss of habitat, food shortages etc) and the increasing risk of Nuclear War (esp with the current buffoon leading the USA, denying climate change and aggravating international relations). There is a risk that more authoritarian regimes spring up, threatening democracy.
On a personal note, I have a family member who looks to be becoming Manic (new presentation); the Crisis Team now seem to assess only by telephone with no F2F assessment, so not seeing the chaotic change in her living conditions; she has been passed to the Access Team, who apparently also only do telephone consultations. I feel like I'm just waiting for circumstances to change until Police need to use a section 136.
This Coronavirus pandemic, as already discussed, is creating a lot of collateral damage!
Curious | Locum GP13 Mar 2020 2:10pm
As a locum are you covered under death in service?????
I suspect NHS Pensions will not consider you covered under death in service unless you were working, employed, on the date of your death.
There was some discussion about this last year I think.
Tis article underscores my comments on testing etc.
A scary but likely true analysis of the spread of Covid-19.
This is a really interesting (and frightening) assessment of how Covid-19 is spreading.
GPs routine work involves seeing those who are ill or who believe themselves to be ill. Covid-19 can present as mild viral rest tract infection or flu like symptoms (myalgia, malaise). There is no way to discriminate between Covid-19 and non Covid-19 without testing.
I suggest GPs be able NOT to see any viral URTI or flulike illness, as now all these patients need testing - PHE needs to immediately put in place a massive rollout of testing for all URTI and flu like illness, irrespective of cost. This has been done in South Korea.
Only then will we get a true picture of the problem.
At the other end of the scale, the ITU bottleneck will be apparent very soon.
If we are not there already, medics will soon be deciding who gets treated and who dies.
Last Man Standing | GP Partner/Principal03 Mar 2020 12:54pm
If they were serious, a complete ban on the need for ALL sicknotes (no "discretion" needed), starting immediately, for a period of, let's say, the next 3months, would be easily understood by everyone, and no requirement to "identify" Coronavirus.
It couldn't happen to a more incompetent government!
This government, and preceeding governments, certainly since the 1990 GP contract in my living memory, are determined to turn the NHS from providing a health service into being a cash cow for the very wealthy, corporations and the like.
GPs, and all other NHS staff, are just not valued, and are viewed just as an expense, which must be squeezed as much as possible (by management, NHSE etc).
It is socialism for the elite oligarchs (with bank bailouts, etc) and austerity capitalism for the rest.
I'm afraid this won't change until we move from capitalism to social democracy.
This is just an excuse for rationing.
Just look at the risks and outcomes; do obese smokers with shot knees benefit from knee surgery (in which case it shouldn't necessarily be withheld) and what are the risks (which involves patient counselling and appropriate informed consent).
Let the patient decide, unless CLINICALLY contra-indicated.
Sorry - GP recruitment!
Having said that, I agree this statement from Ashworth is facile and pretty much pie in the sky, as regards HP recruitment.
More important are conditions of work, reducing micro-management in all its forms, renewing the principles of working as a professional with more degree of autonomy and work-life balance.
For this audience, a meaningless article.
Whystayagp? | GP Partner/Principal14 Nov 2019 1:44pm
"Labour will have such a high tax rate the pensions problems will be dwarfed out of significance because it will not pay any GP to work more than a couple of days a week anyway".
Sorry, this is wrong. Our pensions, and what we pay in Superannuation contributions, are based on our total superannual income, whereas any tax increase would only be on taxable income (not profits, or gross income, or net income - but taxable) amounts over £80,000. This is a huge difference, and SPN payments reduce your taxable income.
"Even if they do, they will not want to as they will no longer be able to pass what they earn to their children because of Labours proposed maximum £125000 limit to inheritance".
Assuming this, is actually jumping the gun. There was a report (Land for the many) which was produced to look at the problems of land and home ownership (owning multiple homes, some left empty; buy to rent; new buyers being priced out of the market; banks loaning monies on mortgages [sub prime scandal]; raw deal for renters; problems of homelessness; etc) and one paragraph (I think) considered a deduction in the cap on inheritance values.
This is all very long term, is still up for discussion, and, in terms of this article, has nothing to do with being a GP, a consultant or whatever.
copernicus | GP Partner/Principal13 Nov 2019 7:47pm
No, not a "stooge".
FYI, Everyone gets a "Personal Allowance" - that's the initial first part of your gross income which is not taxed - £12.500, last time I looked.
The Superannuation shenanigans are completely different, and I agree that's needs to be sorted separately. My point was that monies paid into Superannuation comes off your highest rate of taxed taxable income, saving tax on those monies if you had otherwise kept them.
Premises are again a separate thing, except that monies paid for premises service charges (heating, cleaning, etc) are again tax deductible from your highest rate of tax. If you own your premises, you are likely to gain a profit when you sell - this would be Capital Gains, taxed differently to Income Tax, with a different set of tax allowances.
My point is that a small amount of extra tax on taxable income of £80,000 per annum, for GPs who probably don't earn masses more than that, is reasonable, I think. The "fat cats" earning £150,000 or more need to pay their fair share.
Did you pay for your own medical education or did you benefit from the state paying your educational costs?
If you went to private schools, did your school benefit from charitable status, courtesy of the state?
Did you know that the funding for Grammar schools was greater per student than Secondary Modern Schools? Did you benefit from that? I know I did.
Our society's biggest problem (next to climate change etc) is growing inequity, and our tax rates (at the very top) are historically very low. Money needs to be found to re-balance society, to all our benefit.
My point is, we are only talking about a very small change - not taking us back to the very high rates in the 1960's.
to wickerman | GP Partner/Principal13 Nov 2019 9:32am
The Labour party offer to increase tax slightly on those earning more than £80,000 TAXABLE INCOME p.a.
After expenses, Superannuation payments, and £12,500 personal allowance, how much does an average GP have as taxable income nowadays?
When I retired 5yrs ago, I was being taxed on less than £80,000 taxable income per annum anyway, at that time.
I thought, with Locums taking a big chunk these days, that maybe GP pay hadn't gone up that much.
With £100,000 pa taxable income, a 5-10% increase in tax is only £1000-£2000 pa -- and nothing at my previous rate of pay.
Overall, given the promise of substantial monies to go into the NHS, I think, worth it.
Not sure if everyone's aware, but the DAUK (Doctors' Association UK) have already given their "manifesto" with key priorities to the government.
Seems sensible to me. Not sure whether will have tangible results but worth trying.
NB - I am not a member of DAUK, nor a member of BMA, or RCGP.
This is all part of the establishment plan unfortunately - defund and demoralise a public service until the public finally accept "privatisation" as a remedy; and the establishment fat cats make a killing.
Mass resignation would certainly bring things to a head quickly, and government is weak at the moment; however, the profession would need a list accepted by the profession, of firm and united ideas on what it wants in order to subvert a mass resignation demand.
The government has always used divide and conquer tactics very successfully.
Are we sufficiently united and determined? I don't think so; I think still too many are tied into punitive mortgage and leased premises and are scared in losing their "job security" regards the future.
However, they say that drastic times call for drastic measures.
Nick Mann | Salaried GP10 Oct 2019 5:03pm
I 100% agree
I'm sure this is happening all over the country where any mergers are contemplated - where Primary Care and GP practices in some areas have received historically more money per patient than others in neighbouring areas; the relatively affluent (if we could call it that) areas will never voluntarily merge finances with less "affluent" areas.
The system is inequitable and this kind of tinkering helps no-one.
Bottom line = More money is needed.
Cassandra | GP Partner/Principal18 Jul 2019 5:47pm
Agree 100%. Private firms should lose the NHS logo!
It's all part of the "game plan" to privatise the NHS, and turn it from a "health care provider" to a "source of profit" for the rich "elite".