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".
Christopher Ho | GP Partner/Principal26 Jun 2019 5:31pm
Hi - I just realised who you are (a conservative troll, I believe).
I mixed you up with Vinci Ho! Ha Ha Ha. (Apologies to Vinci!)
I won't be pursuing this thread, as I don't believe you are amenable to reasoned argument.
Once again - "Have a nice day" and "Power to the People!"
Christopher Ho | GP Partner/Principal26 Jun 2019 11:06am
I wondered whether it was worth replying, as this is not truly apposite to the topic of the article; however, I normally enjoy reading very much your contributions, so here's a response:
Firstly, I don't think quoting Churchill, a right wing racist whose actions have purportedly contributed to millions of deaths around the world, helps your arguments, although I think you have actually missed my point.
Secondly, your youtube videos reference the views of Jordan Peterson, a controversial figure who aligns himself with the views of white supremacists and alt-right fascism.
Again, not persuasive.
My point is not to advocate swapping the few capitalists at the top of organisations with equivalent state "stooges" who act in an identical way (as in Soviet Russia for example).
However, having the workforce being involved in deciding how company profits are used (for example having workers be represented on the Board of Directors, an idea which which was once mooted by this Tory government, then quietly shelved)
would inevitably eventually reduce pay disparity between the top and bottom, and would reduce the closure of businesses solely to re-locate abroad, to take but 2 examples.
These are both worthy aims (reduce inequality and reduce redundancies from relocations).
I know that this is only indirectly pertinent to NHS GPs, as we have to deal with the fallout of society's ills; but the principle is sound, and, I feel, is something worth exploring - and pragmatically, most likely done by the Labour Party (under Corbyn) as it stands at the moment.
There must be checks and balances, but, as I have said, in my opinion, the principle is sound.
Finally -- Have a nice day! as they say in the States (and we ARE following in their footsteps), and Power to the People!
By they way, Prof Richard Wolff, at the end of the 2nd video (the Google Talks one) refers, by way of illustration, to Jeremy Corbyn in UK's Labour (as well as a highly profitable firm, a Co-operative, in Spain) as someone who is trying to "democratise" the workplace and re-dress capitalism's inherent inequities to society.
to Dane | Hospital Doctor26 Jun 2019 9:34am
Joe Public has been misinformed about Labour for years; Capitalism is broken and has always been so; it inevitably leads to 4-7 yearly cycles of boom and bust and increases inequality. Marxian economics has been ignored for decades and has been omitted from Economics courses deliberately.
We need an economic model that re-dresses the obscene levels of inequality, and, believe it or not, Labour is our best (only) hope of turning around this nightmare.
Please keep an open mind!
I recommend you watch these two video clips by Prof Richard Wolff (he has done numerous presentations; plenty to choose from)
this is a 14 minute video of "what is not taught on economics courses".
this is a 1 hour presentation at Google Talks about "Democracy at Work: A Cure for Capitalism".
Time well spent watching, in my opinion, as you won't get this information from the propaganda system we know as "main stream media".
The ideas presented are anathema to the "establishment" because they threaten the "gravy train" the elite are running, but from which we are all suffering.
All part of the "Establishment" plan to further the demoralisation of staff and to continue to run down the NHS in preparation for its transfer to private sector!
This app has nothing to do with "free(ing) up ‘thousands’ of GP practices in England" and everything to do with directing dispensing business to the Co-Op; also controlling, or interfering with, the patients interaction with their GP practice - "Patients can’t order more than they need, can’t edit things".
There is no direct relationship between the number of GP appointments for consultations and profitability or economic viability of a practice; rather, appointment demand needs to be managed in a way to best provide safe GP practice.
An "App" is likely to skew the status quo towards an increase in demand for appointments (not good for the practice) or interfere in the dialogue between patient and practice (not good for patient or practice).
This "solution" doesn't answer any of the real problems we face in GP and has the potential for increasing micro-management and producing their own version of "Crapita" chaos.
Christopher Ho | GP Partner/Principal30 Jan 2019 10:17am
You say "it is in societies with MOST socialist policies, that we see people dying of starvation/malnutrition/lack of healthcare."
I say look at the scandinavian countries, all of whom have a socialist bias in their policies. They're doing a helluva lot better than we are (healthcare wise, certainly).
to: Christopher Ho | GP Partner/Principal29 Jan 2019 5:39pm
A shining example of the best of the NHS values is that of equitable access to health care, prioritised on health care needs, not ability to pay; the traditional role of General Practice (as a gatekeeper to secondary care) was a key factor in keeping the costs and health care wastes down; of course governments have eroded that gatekeeper role and abused and taken advantage of our good will; that doesn't change the principle.
Many health services around the world are copying that model for their own health care services.
Even the USA has made attempts to move in that direction.
Suggest you watch "Sicko" - old film now, by Michael Moore about different health services around the world (incl our NHS) designed to show what the USA may "steal" from other countries. I especially recommend his interview with Tony Benn.
Subsequent films by Michael Moore don't feature the UK so much. Why? Because we have moved so far towards the USA system, we have nothing good left to steal!
You say "And lack of awareness of our true market value globally." - I say that mindset is the problem; the NHS does not operate well as a "market", as has been consistently shown since Maggie Thatcher introduced more management in the 1980's.
Regarding Venezuala - which is off topic, by the way - I suggest you stop swallowing all the Main Stream Media and BBC (Tory party propaganda service) propaganda, and research the issues; Venezuala has one of the largest oil reserves in the world and the USA has been trying to interfere in their politics for over 20 years now; there are problems, of course, but the current socialist government has supported welfare for the poor, and not toadied to the USA so much. The UN rapporteur who visited Venezuala recently accused the USA of "economic warfare" against Venezuala, hurting their economy and killing people; he reported that the US sanctions were illegal and could amount to "crimes against humanity" under international law.