Observation as an 'outsider' since I am not a trainer(ever):
(1) At least , he was honest about 'no guarantees' and the real picture of losing more than what you are giving birth everyday , hence the issue of retention.
(2) Reduced funding only for 'back office' : have you ever played this game called Jenga? Every block you remove from the tower increases the risk of a total collapse for your opponent(hence, beaten in the game) if you just 'survive' this round.
(3) Capita claimed they could deliver a 25% cheaper back office support for all GPs . So history is repeating almost instantaneously.
(4) Still in the subject of education: look at what state schools now have to do to raise funds for survival and the morale amongst teachers . But I suppose the government does not really care much other than preparing for article 50......... and opposition(s) are pathetic..........
This is what Laura Kuenssberg(BBC political editor)said about the £350 millions in a NewStatesman podcast (The Deep Dive podcast):
''The difficulty with the 350 – well, there’s two things - the difficulty with the 350 is that there’s a grain of truth in it. [...] Technically, that was how much cash was allocated to be spent by the European Union. Now, yes, loads of it came back. Yes, it was technically never ‘sent’ to Brussels, like we don’t put a cheque in an envelope and off it goes, but technically and absolutely as a figure it was there. So it was there taken out of context but it wasn’t made up. The problem also then, for the Remain campaign, was they walked completely into the trap. They walked totally into the trap. So every time they complained about the figure, every time they bashed off a letter to the statistics authority or whatever, it worked for Leave - because what Leave wanted was people to be talking about the fact that loads of money goes to the European Union.”
(1) As a preacher of the 'bible'( which in this case , is called GPFV) , he had said what was expected from him. We have seen subordinates of NHSE coming and going . Minimal expectation , minimal disappointment , folks .
(2)Like to read the lessons NHSE had learnt from these mistakes. Give you the credit when you show them to us.
(3) E-mailing NHSE , is there really different from asking people to simply write to their MPs of the constituency for things they are not happy about?
Defend the indefensible is hard .
Defend the ambiguious is even harder.
Hope you have not sacrificed meaning in exchange of power......
I suppose these buses with this £350 millions per week slogan , were the same ones used in last general election? Poor Tories got fined a record £70,000 .......
'The Government has called on NHS England to ensure GPs start providing same-day appointments to patients aged over 75, under a new Government mandate aimed at delivering on a pre-election manifesto commitment.'
Correct me if I am wrong : Auntie May called on NHSE to do so , the mandate is her executive order .
The Chancellor , far more laid back than his predecessor, almost broke his party pre-election manifesto by raising Class 4 NI . The PM cannot allow any impression of deviating from their 'principles' to slip through the net. In fact , I think she is conscious everyday that she is an unelected PM(reminded by the Scottish first minister)and people keep comparing her with Margie all the time.
Earning recognition from her party and the public is her priority under such extraordinary and unique historical circumstances. We became one of her 'useful tools' (so is education) as soon as she labelled GP's access as the cause of A/E crisis . Of course , she would not apologise(pretty sure Sally Wollaston knew this would never happen anyway). We are always the bad guys and she is the heroine with the embellished armour. Read her latest interview in Vogue:
More interested in what would happen to these European colleagues' passport status and how long Home Office will allow them to stay after 29/3/2017.......
The hardest word to find is called 'optimal' , hence , getting the balance right . Easy said than done under the atmosphere created by the government.
The same argument can apply to hospital admissions: early/premature admission or so called 'inappropriate' admission VERSUS delayed admission.
Find this article on NewStatesman inspiring:
'Today's GPs are being shamed into keeping patients out of hospital ' by Phil Whitaker
Remember what Simon said recently?
' I would regard myself as probably the most pro-primary care/GP national NHS figure there has been, possibly ever.’ Extraordinarily it sounds , he is acting as the real McCoy health secretary(Nobody believes anything Agent Hunt says anymore).
As I said ,he shares a similar fate with Mark Carney in Bank of England ; he had to swallow his pride once again recently when his fully entrusted deputy governor was forced to resign as she failed to declare the fact her brother worked for Barclays. At least, he already has a plan to pack his bag for early exit.
You wonder how these have reflected on the credibility and reputation of this government: the prime minister had to be reminded by the Scottish first minister the importance of being chosen and elected in a general election ; the Chancellor first found out he had broken the promises laid down in his party's election manifesto from Laura Kuebssberg from BBC. Not to mention about the record £70,000 fine on Tory Party by Electoral Commission for breaching the rules on election expenses(both Labour and Lib Dem were guilty to lesser degree in the past). You wonder if we are to have a new social norm for any election in this country from now on.
And of course , the Exiting European Union secretary was very honest to say in public that he had no clue what would happen if no deal was agreed with EU for Brexit.
Under normal circumstances, this ruling party should be well slaughtered politically by its opposition parties but we are not living in normal time indeed .The PM certainly 'enjoys' the 20 points lead in most media polls as the opposition(s) is so tame and pathetic.
Oh , the first question is for you , Helen.
Same question to you from me again:
Have you written to Sarah Wollaston? And by the way, Sarah , where are you?
'We are also seeing increased life expectancy from the disease which could be due to earlier diagnosis of the condition as well as drugs such as blood pressure tablets and statins for blood cholesterol.'
Come on , that has not answered the question of more bariatic surgeries are not done to improve the overall morbidities and requirement of various medications.
' This is expected to include funding decreasing if they fail to reduce hospital admissions.'
This will be the details in the devil: you will have to get even bigger until hospital admission is reduced , otherwise less funding . The figure of 15,00 is not going to be far away then!
History seems to have 'soft' spot for a Tory Chancellor and keeps rewriting for him. It is not exactly Groundhog Day but three times in a row he had to U-turn in about a week. Last time , if you remember, it was bloody and brutal when Ozzy was stabbed right on his back by IDS. This time , it was more about breaking promises made in the election manifesto . Yes , it is good news to us ,as GP partners are self employed but SSP certainly couldn't care less about how we feel but had to avoid the embarrassment of the budget not being passed through the parliament otherwise. And according to Yuval Noah Harari in his latest(2016) book Homo-Deus: a brief history of tomorrow:the best reason to study history is not to repeat history so as to predict the future, but to liberate from history, free yourself from the past and imagine alternative destinies , though we are still shaped by the past .SSP certainly had far few alternatives and had to follow the principles of his party and behave like a Tory.
The interesting question remains ,'what will happen to the money going into social care?' and what about all the other domestic issues like NHS, education , public services etc. Perhaps the key is the £60 billions(newly borrowed money according to last Autumn budget)to be locked away for the potential consequences of Brexit. Once again , Brexit is the distraction of everything and it is an understatement to say the government is far from prepared for it. The uncertainty strikes the same tone of the forthcoming Games of Throne season seven (Sorry, my guilty pleasure)
There are many reasons why fans love Games of Throne(TV and novels) so much . George R.R. Martin admitted in an interview the story was indeed inspired by the Wars of the Roses; Tyrion Lannister , for instance, was a character inspired by Richard III.
If Game of Thrones was inspired by our history , it has now inspired our political reality. End of last season(6), we saw Cersei Lannister crowned as the new queen on the Iron Throne under rather unprecedented circumstances, although she played a part in the final conspiracy. It is unfair to compare Cersei with our beloved auntie as the former is a fictional , belligerent and vengeful character but Auntie did create the label 'nasty party' after all.
Up north in Meereen, the dragon girl had now enough firepower with her three dragons marching towards Kings Landing to reclaim her sovereignty. I suppose our famous Scottish lady , like Daenarys Targaryen, wants to set free her own dragon called IR2.0.
In fact , when Auntie May thought she had just shrugged off the bother of the House of Lords' frail attempts to amend the Brexit Bill , her well charged confidence met a sting of the tail attack by our dragon girl who planned to pass IR2.0 in Holyrood next week. So much I believe nationalism and patriotism are often overrated , Auntie risks further surge of this ideology if Westminster says No to IR2.0. The media polls currently suggested the appetite is not quite there yet for independence but who knows ? The real battle will only take place after Article 50 is invoked in two weeks time. And it will be even more interesting if EU commission would use Scotland as a card to blackmail our beloved auntie on the negotiating table.Yes, no deal is better than a bad deal but even Mr Davis just admitted that the government had no assessment of the impact of a no deal situation(hence , go back to WTO by default) but I suppose he would like to say ,'Trust me , I am David.'
Finally , nobody seems to be entirely clear about the intentions of the White Walkers(and its king) in last two seasons(5&6) , but one can perhaps imagine the picture of a Trump-Le Pen-Wilders-Erdogon-Putin world to fill up the blanks .
Nigel, have you found Valyrian Steel?
And Lord Vader , where are you hiding these days?
Couldn't change the ending even after watching La La Land four times up to now as well as carrying the ringtone in my phone . But if my beloved Ed Sheehan has 16 songs in UK Top 20 , I remain hopeful about the future .........
The other issue is PHE being embroiled in substantial budget cut by the government. Expenses involved in these top to bottom directives , of course, are passed onto GPs.
Time certainly flies.
When I look back , this has been an unresolved issue since 2014 . PULSE had a nice summary of Cockrane' studies:
Cochrane Review of Neurominidase Inhibitors - Summary
What did the study look at?
Randomised, placebo-controlled trials on adults and children with confirmed or suspected exposure to naturally occurring influenza
Covered 107 clinical study reports from the European Medicines Agency, GlaxoSmithKline and Roche, plus comments by US Food and Drug Administration and Japanese drugs regulator.
Total of 20 trials of oseltamivir (9,623 participants) and 26 trials of zanamivir (14,628 participants) included in formal analysis after initial judgement of design of the studies.
What were the main findings?
Duration of symptoms and hospitalisations/complications
Oseltamivir reduced the time to first alleviation of symptoms from 7.0 to 6.8 days in adults, and by 29 hours in healthy children, but had no effect in children with asthma.
Zanamivir reduced the time to first alleviation of symptoms from 6.6 to 6.0 days in adults, but had no effect in children.
Oseltamivir had no significant effect on hospitalisations compared with placebo, with a risk difference of 0.15%. There were no zanamivir hospitalisation data.
Neither drug had any impact on serious complications of influenza leading to study withdrawal, where tested.
Oseltamivir cut self-reported, investigator-mediated, unverified pneumonia by 1.0% but had no effect in five trials that used a more detailed diagnostic form of pneumonia, while zanamivir had no effect on either self-reported or radiologically confirmed pneumonia.
Zanamivir reduced bronchitis risk by 1.80% in adults, but oseltamivir had no effect on this. Neither drug reduced the risk of otitis media or sinusitis in children or adults.
Oseltamivir increased nausea (by 3.7%; number needed to harm [NNTH] of 28) and vomiting (4.7%; NNTH of 22) in adults and vomiting (5.3%; NNTH of 19) in children, but cut risk of diarrhoea (2.3%) and cardiac events (0.68%) in adults.
Oseltamivir also had dose-response effect on psychiatric events in two ‘pivotal’ trials.
The risk of developing symptomatic influenza was reduced by 3% by oseltamivir (number needed to benefit [NNTB] of 33) and 2% by zanamivir (NNTB of 51) in individuals but there was no reduction in asymptomatic influenza with either drug.
Oseltamivir increased psychiatric events (1.1%, NNTH of 94), headaches (3.2%, NNTH of 32), renal events (0.7%, NNTH of 150) and nausea (4.2%, NNTH of 25).
The Cochrane Collaboration 2014; available online 10 April
One reason why Mao was so 'successful' in 1968 cultural revolution was he managed to 'mobolise' people under his rule to point fingers against each other ,even son prosecuting his own father etc.
Ultimately , any voice of opposition is wiped out.......
Teach me like I am a ten years old(and I am not good enough to be a GP trainer anyway):
You are going to give extra funding to medical schools encouraging students' exposure to general practice but you actually cut HEE's budget on GP training. Seriously?
(1) Choice of word , Helen . You were not 'frustrated' ; you should be 'pi**ed off'
(2) The level of hypocrisy about recruiting and training GPs is from top to bottom considering Auntie May would never apologise to us about what she said in public. Our common enemy has not disappeared but only changed its outlook.
(3) Presumably you have written to Sarah Wollaston and Health Select Committe. Political question needs a political answer . This is one mission for her if she wants to prove to us what she stands for .
Every practice has its own circumstances and I can see people have very different views about our future. In fact , if you look at the predicament created by Brexit with the 'ball' being thrown between the two houses in Parliament(and of course , the looming Scottish referendum 2.0),the country is divisive enough .
To me , I still believe this flag of general practice cannot just fall down without a fight (yes , I know what some of you would say).
Best of luck of what you are doing , Michelle....