Thursday, 1 October 2015

Junior doctors less for more or more for less?

One of the team at ND Central was informed by their batman, all Ferrari driving GPs who inhabit baronial mansions in the UK have batmen to attend to their personal needs, that the damned supermarkets had increased the costs of their products. Now this is not just any supermarket it is many and this has been done by stealth.

Supermarkets operate in the free market so beloved of politicians so when ones batman tells you as they serve one ones evening meal that a tin of something contains 25% less than it did a week ago, or that a packet of something has decreased in weight by 25% or that another product has decreased the volume by 15% but increased in price by 15% then by jingo one just has to slap ones thigh with a riding crop and say thank goodness for the increase in value for money for busy working people that the free market represents.

And then write a stiff letter to the Times and sign it with one’s former military rank of Brigadeer General (Miss).

As our illustration to this post we include the classic demand and supply curve which suggests without going too deep into economic theory that if a commodity is in short supply then its price should rise. However, none of the commodities refered to above are in short supply.

So in the NHS if demand rises and supply decreases what should socialized medicine’s internal market do?

1) Increase costs to the non paying customer? No Comrades NHS healthcare is free at the point of abuse.

2) Restrict supply? Of course Comrades for using the above free market examples should a GP surgery of 24 patients be reduced by 25% to 18 for the same cost true free market economics and value for money for the non paying consumer?

Of course not comrades what one does is promise an increase in supply of healthcare across the board of 40% (7 day working) and assume that demand and cost stays the same. In that way economic theory would suggest that costs fall, we think, due to economic efficiencies as supply theoretically increases.

This we are sure is the level of retardatation that your average Secretary of Health with a degree in PPE from the University of Oxford would apply. There is Economics and there is PPE and then there are Secretaries of Health.

And then there is real world healthcare.

Supermarkets and their suppliers are trying to keep profits the same or increase them by reducing supply and hoping that demand says the same and that no one will notice these small changes. Some interesting figures seen by accident by one of the team at a small local supermarket showed that the day before there were around 3000 customers who on average spent c. £ 25+ a basket. They even gave the percentage increase in spend over the previous week, day and sickness figures.

These figures showed that patients are happy to spend more on food than they do on healthcare for the numbers involved at the supermarket are many times more than those attending ND Central on a single day who pay nothing for a basket (consultation) which averages out at £ 22.67 a consultation.

Curious how when it comes to food there is no problem for patients paying more for less and there are clear efficiency gains here (for the food industry) as what are known in medicine affectionally as fat bastards are just getting fatter and this is by getting less but paying more for the privilege.

So the free market meets demand by restricting supply and generates profit while the NHS market creates demand which it cannot supply and expects all involved in doing so to suffer a loss.

Which is where the junior doctors come in. All parties in the Tripartite health alliance regard junior doctors as nothing more than cheap labour as the recent letter to the Prime Minister shows. And yet they are the people that if you go into hospital you are likely to see amongst the first and are to be the first to treat you.

The Party using supermarket economics is using the less for more argument with junior doctors whereby they are seeking to reduce the costs for them working out of hours in the same way that Joe the plumber if asked to work outside of normal hours will always say that will cost you guv’ double time before 20.00 triple time after that and at weekends plus a call out fee. Yet you can see from this link to a more detailed account of how the Party plans to reward junior doctors’ time and what they feel their basic working week should be.

Jeremy clearly understands Oxford PPE economics for if something is in short supply, namely junior doctors wanting to train as GPs what better way of making general practice more attractive than decreasing GP registrars’ salaries by 31%? And being a true equalitarian he will do the same to other junior doctors as well.

Praise be to the Party for failing to even grasp basic ecomonics and promising a New Deal to all doctors. Work harder and longer for less for the NHS you know it makes sense? No wonder they are a tad angry.

Sunday, 13 September 2015


The more the doctors at ND Central work the more examples of the free at the point abuse National Health Service(?) they see and comment on at increasingly fewer Resistence meetings at the infamous Café Michelle.

Still those that in between patient commitents, Scottish retard politically imposed extra work for no extra pay and more recently the drive towards 7 seven day working for all bar politicians and busy working people supported by science like this it is amazing that idle non working GPs do anything useful at all given the constant political interference and media bad press. There is another take here on the same aspect. 

Still idle GPs will take comfort from the fact that Jeremy is now back in the play pen after his busy summer break and only has to work just a few more weeks until he is off again. 

So as more and more patients use the NHS as a want and go service to paraphrase an advert from the 1980s for a hair shampoo that you had to pay for in contrast to the NHS patients want more and more for nothing.

And like Violet Elizabeth if they do not get what they want they will scream and scream until they are sick in the hope that anyone now trained by the RCGP will consider their demands and be NICE to them after considering their ICE(s) and give in.

Appeasement has rarely worked in the face of an increasingly hostile threat and often what has happened is that a patient thinks they have something but the patient’s theory of disease has been rejected on more than one occasion. So more often than not after a trip to the local hostellery or if the 56kbs dial up is slow during peak porn download times they start googling for specialists.

Eventually they discover an expert in London who they think will, not can, help them. They then DEMAND a referral there for a 57th opinion to reinforce the 56 other ones that all state they haven’t got what they think they have.

The referral letter usually goes along the lines of please see farmer Scroggins who is convinced after reading an article on New Guniea brain disease and touching a holiday brochure about New Guinea that he has acquired such a brain disease to explain his congenital complete absence of higher cerebral function which might help him with his benefit claim.

Scroggo, as he is affectionaly known to our staff as he is a frequent flyer but rarely if ever consults a vet, has seen numerous consultants over the years copies of their corresponance are enclosed all 4 realms of A4 of them which are but a mere summary of Scroggo’s many volumes of notes. I wonder if you could or could confirm if this or is not the case?

Later farmer Scroggins gets their appointment and then works out how long it would take him to drive to London in his tractor at 20 leagues to the day. “I can’t afford to be away from the pub for that long I demand an ambulance.”

“But farmer Scroggins you regularly take part in sheep dog trials across the land, take part in grouse shoots and take the train to horse races all over the country I can’t justify an ambulance for that.”

“It’s my right.”

“But you don’t qualify. You are foot mobile and can drive.”

Prior to the NHS 90% of ambulance service work was for emergencies but within 2 years that figure had dropped to 10%. While patients can be transported by family members to baptisms, barmitzas, marriages, funerals, hairdressors, vets and all of the above when it comes to travel to a hospital appointment this instantaneously becomes the responsibility of the NHS.

It will cost me 2 sheep to get there if I go by train/bus or tractor I can’t afford to get down there in my Range Rover Sport I need an ambulance.”

And how much will it cost by ambulance for what would be a 24+ hour round trip and overnight stay given the appointment times and distances involved for a driver and their tachograph?

£ 1000 + and an ambulance out of service for that time for one self centred patient.

“Well that’s alright then I pay my taxes. I am 75 can I have my sick note while I am here and my Viagra too as I am off to a cattle fair in Texas next week and am hoping to get some Texas prime while I am there (nudge, nudge wink, wink know what I mean doc?). I still need that ambulance as I am too sick to travel for that appointment . . .”

“You want an ambulance you can have it if you are prepared to pay for it?”

“Can’t afford to doc.”

“On your bike.”

“Perhaps Mr Scroggins while you are on the plane to Texas you could (just) ask the pilot to divert to Heathrow and drop you off for your appointment before flying you on to Texas afterwards? I’m sure they wouldn’t mind waiting after all you have paid for the flight . . .”

Praise be to the Party for ensuring that all those born in the UK know how to abuse their rights so freely and when it comes to healthcare have forgotten the concept of a self preservation society but when it comes to their own convienence other peoples’ money is no object.