Thursday, 10 July 2014

More coffee vicar?

What has happened to our fellow journalists ask the GPs we are now forced to report upon at the weekend’s resistance meeting?

The week before Good Morning Britain reported that a massive 1.67% of A&E attendances were due to the fact that people could not, allegedly, get a GP appointment. Mmmn.

We couldn’t link directly to this item but here is a more reasoned account of the story. There are plenty of other (Daily Mail) rants about what they think the research showed.

Does that mean that a massive 98.33% of A&E attendances were due to the fact that A&E patients had another reason for attending other than they could not get a GP appointment?

This simple fact could explain why the great Westminster Hunt said that the A&E problem was purely down to the idle overpaid GPs’ 2004 contract?

A massive 1.67% of A&E attendances due to patients unable to get a GP appointment. As a junior grunt in training one of the doctors at ND Central recalled a patient at a surgery in the morning ask for an appointment to see a GP and when told they could have one that afternoon they said that was not good enough and left.

Later that afternoon the same doctor who was in the local A&E department saw the same lying patient tell the receptionist when challenged about why their life threatening problem was an emergency said they “had tried” to get an appointment but “couldn’t get one” so “had had to come to A&E” because their problem was “an emergency”. (Not).

Now you would expected in what used to be called Gormless Moron TV the usual idle overpaid underworked bastard GPs story to follow. 

But no there was actually a former head of the Royal College of General Practitioners stating that there is apparently a shortfall of 10,000 GPs in the UK which is one of the most under doctored countries in Europe. 

What is wrong with the British media these past 2 weeks?

A couple of weeks ago one of the team had a sortie down South to meet some friends from across the world from grunt school a couple of hours flying time away. During some idle conversation there was a discussion about A&E and why people attended.

Some unpublished research discussed suggested that most people attend A&E not with an “Accident” nor any genuine “Emergency” but the vast majority attend for a non-medical reason. Can you or the Party guess what the this reason for attendance at any Accident or Emergency department is that is not medical? It was an unexpected one.

Wait for the research if it gets published but it was interesting but admittedly not from the hugely affluent agricultural Northernshire where once again all GPs will be drawing lots to see who gets four whole days of golfing leaving this week.

A scene we are sure will be repeated all over the UK as we are after all only short of 10,000 GPs. The UK only trains about 8000 medical graduates a year so that short fall won’t take long to make up will it? Anyone wonder why you might have to wait to see a GP?

Praise be to the Party for ensuring that if you tell a lie often enough the thick will believe it and that is just the great Jeremy the Hunt the GPs’ best friend. More GPs anyone?

Sunday, 29 June 2014

Waking up and smelling the coffee - what has happened to the British media this week?

The last few days the GPs we are now forced to report on under GMC censorship for doctors have noted that 2 news organizations have reported that there might just be a problem with the great non-paying British public getting to see their GPs.

In most countries in the world with far better healthcare than that in the UK there might be a small consideration before demanding an urgent same day appointment for Tarquin’s asymptomatic rash of 3 years’ duration that has caused him no problems until someone suggested it might be meningitis. 

So Good Morning Britain (ITV) has reported thus. (Please be aware there are adverts and you may have to wait to see the full report but this is commercial for profit organization not the NHS). 

The next day the BBC have now put this little item up and later that day this piece. 

So to summarize the past few years of Party and press speak.

GPs are idle overpaid bastards say the press and politicians.

All those idle over paid GPs have been doing nothing other than trouser the dosh and ignore patients when in fact they have done more work (number of appointments up 15.7% since 2008), with less funding (10.7% of the NHS budget in 2005-6 compared with 8.4% of the budget in 20011-12) and a workforce decrease of 3% since 2009. In the commercial world this might be classed as a success.

Idle overpaid bastards say the press and politicians.

This is set to get worse because intelligent medical students paying a fortune for qualifications are going to use the free market to choose their career and repay their student loans and are choosing not to train as GPs. They may also want to do what normal people do with their hard earned dosh and buy houses (not practices), start families and have some time to enjoy them so a 9-5 hospital job with the odd night on call suddenly seems very attractive compared with a minimum Party determined day of 08.00 - 18.30 and threat of having to do the same or more 7 days a week (did we forget the extended Brown shifts on top as well?).

From meetings we know of GP training schemes that are struggling to fill places and which are only c 80% full and the reason a little old lady was removed from a list was because a practice could not replace a GP. If large number of GPs are set to retire and you cannot fill enough vacancies to maintain the status quo can anyone guess what might happen? 

Politicians claim an increase in GP numbers but this is just smoke and mirrors as more and more GPs seek to reduce hours. So let us say that there are 10 GPs working full time and we increase the number of GPs by 100% to 20 GPs but then all 20 GPs choose to work half time then the 100% increase in numbers is in fact a 0% increase in GP availability. This is what has happened at ND Central and in many local practices as GPs realize the job sucks when it didn’t used to. 

Increase demand, reduce resources and something has to give.

Anyone still want to be a GP? Anyone in the TriPartite health alliance smelt the coffee yet? The media only just have but after many years of reporting that everything is rosey.

Praise be to the Party for once again blaming those who are not the problem for the problem and in doing so ignoring the problem. It takes 10-11 years to take a first year medical student and train them to be a GP and the number of GPs retiring is set to increase year on year until 2022 while GP training schemes cannot be filled just to maintain the status quo.

You have been warned comrades things can only get worse while the politicians continue to fiddle and ignore the fire. 



Tuesday, 15 April 2014

Extended hours.

So the BBC have broadcast that the pilots for extended hours have been announced even though earlier the health secretary announced their results. The BBC also proclaims that these will ease the pressure on A&E. 

Well you do not have to be a rocket scientist to realize that these will make not a tad of a difference to A&E attendances in the same way that a former Scottish prime minister thought that extending the standard 10.5 hour GP working day would allow all those busy commuting pensioners and toddlers to be seen when they were not busy at nursery or the Darby and Joan club. That worked so well now children didn’t it?

A few observations from the doctors at ND Central are being reported on here. From experience when you have a lot of doctors available surgeries do not always get full and there are sometimes free spaces especially if that coincides with periods of low demand like work shut down periods (when the former PCT was on holiday).

Under such (rare) circumstances someone ringing up with an urgent emergency, all general practice consults are for precisely this, for example an itchy scrot of 6 months duration, then receptionists are able to say: NHS free at the point of need and abuse sir/madam? That will do nicely I can fit you in straight away.

Now the converse also applies for example during school holidays when doctors who do not see much of their families during the politically determined minimum 10.5 hour day plus extended hours might want to spend some time with their children and so there is a shortage of surgery slots.

As a result there are rarely gaps in surgeries and so when the above emergency, extremely urgent MUST be seen NOW that day case rings up and is told we have no spare slots today we can fit you in tomorrow, next week or you can play Blair appointment roulette and see if you get a lucky on the day appointment what does the punter do?

They use NHS Choice and after a torrent of abuse to the receptionist (abuse is always free at the point of care on the NHS) and how they pay their taxes they march off to A&E comfortable in the knowledge that there is no come back for abuse or wasting an Accident and Emergency department’s time for something that is rarely if ever an accident and even less so an emergency. Increasing A&E is a general practice service with x-ray for those who cannot get what they want, when they want it and it is always NOW – regardless of true (medical) need.

Now using the above experience at a surgery level can anyone see a possible way of improving things? Will a few extra appointments for a few extra hours in a few locations with no extra doctors make any difference?

The issue here is the number of doctors that are available and the politicians are ignoring the elephant in the room and the fact that this elephant is getting bigger year on year. However, they conveniently ignore this and try to stretch a very thin film of puncture repair material over an increasingly large puncture hole they have created at the same time that they are increasing the pressure of demand in the tyre they are trying to fix.

Anyone who has been a cyclist will know what will happen under these circumstances. Do any of the politicians who cycle know this or can work out what is wrong?

Praise be to the Party who whenever they do not provide enough always blame the workforce for not working hard enough. There are 2 one day bank holidays in May this year can you guess how many days the politicians won’t be working in May? No wonder you can never see a politician when you are ill.