Friday, 29 May 2015

How to increase GP recruitment for political dummies.

Dear Dave and Jeremy,

In the run up to a general election and post election all of the TriPartite health alliance in the Unted Kingdom were promising between 5,000 to 8,000 GPs in the next 5 years. After a busy night at the Café Michelle here are some thoughts from the team to help the Party create the 5,000 new GPs in five years you have promised with absolute certainity.

To avoid any disinformation the number of GPs on the GMC’s register was 64, 972 as opposed to those with a license 59, 619 as of 8 May 2015.

Remember it takes 3 years to train an F2 doctor to become a GP so you have to take 5000 out of the 8000 medical graduates in the first or 2500 out of the first and second years of this parliament and assume no wastage to guarentee achieving this by 2020. Or import to reduce the deficit.

So here’s some help for your recruitment and training plans:
1) Run a publicity campaign to encourage newly qualified doctors to become GPs. 

Repeatedly tell the populus via the media that all GPs are overpaid and underworked despite the fact that they provide 90+% of healthcare in the UK for a fraction of the NHS budget c.8%  and who despite a decrease in funding have increased appointments by 40 million without any political interference.

This in business would be regarded as a success whereby the customer pays less, gets more and productivity is up yet GPs are seen as second rate doctors by medical schools. 

2) Tell the public that GPs are responsible for the A&E crisis.

We believe that 1.67% of A&E attendances are due to not being able to see a GP this instant but others know better.

This is what is known as a lie but this will clearly be there to increase GP recruitment via a morle producing inaccurate political intervention. 

3) Increase working hours by diktat and keep pay the same. 

Pay cuts are always a winner with the workforce. Thank you Gordon we notice how busy your surgeries are in Kirkcaldy if you even know where this is ditto where the Houses of Parliament are given your attendance rates over the last few years. Your achievements in NHS healthcare are on a par to Mr Blair’s in the Middle East and always positively received by the boots on the ground and much appreciated.

4) Motivate the workforce even more. 

What a brilliant idea to increase GP numbers by telling the public that GPs can no longer have a family life by telling the population that at some point they will be able to see a GP 7 days a week from 08.00-20.00. Back this up with robust pilots and announce the results of these pilots as a success even before they have begun.

Hard scientific evidence will always appeal to those new doctors with a scientific background. As there are now more women than men as GPs that should make general practice a very family friendly profession. Particularly for those who choose to work part time to enjoy some family time.

5) Introduce performance related pay. 

The harder you work the more you earn is always a winner with high achievers. So introduce a performance related pay scheme called QOF and when everyone who was actually doing the day job you thought they were not earns their pay alter the rules to mean more worthless work for even less pay. Have you introduced a QOF into hospital medicine?

So if hospital consultants do extra operating lists at the weekend they get paid loads but if GPs are forced to do extra they get paid the same or less as you reduce the number of QOF points. Another sure fire winner as more work in general practice equals less pay. Medical students are not daft.

6) Cut beauocracy. 

Introduce more and more bureaucracy to ensure that more and more general practice time is spent ticking boxes rather than seeing patients and pretend it is quality rather than what it actually is crap (sorry for the grunt word).

Think QOF, CQC, GMC, appraisal, writing care plans et al. Doctors can usually see the results of these mind numbing exercises take the unplanned admissions and all those care plans and time wasted on them which led to record admissions this winter with no snow or flu to help with this process. Outstanding.

Did you are ask consultants to write predischarge care plans to prevent readmissions as well?

7) The political football. 

Use general practice as a political football to provide bread and circuses to prop up political failures rather than use it to treat acute illnesses and chronic conditions.

A pill for every ill, an appointment the same day for any crap that is not illness. Have a problem be it housing, legal, financial, employment, debt, need big boobs see your GP they are busy doing nothing.

The only professionally qualified person in the UK with a minimum of 5 years post graduate experience after a basic 5+ year training course you can see for free is a GP and all you have to do to access this is to lie. Keep encouraging the time wasters and believe it or not even medical students during their GP training realize how much crap is seen in General Practice and say I want to see real illness each day.

8) Admit there is a problem. 

When it finally hits Westminster that there might be a problem with General Practice then do the obvious which is: 

a) deny the problem for as long as is possible (it has been there for years) 

and then

b) because you don’t live in the real world order an “independent review” = do nothing.

Clearly a man hoping that by delaying doing anything would mean the problem would be someone elses but you can always delay the publication of the inquiry (until after the next election).

9) Tell the public how good General Practice is at spotting serious illness. 

Believe it or not most doctors are mortified if they miss something serious. So repeatedly tell the public that GPs miss everything including cancer when in fact they don’t.

If medicine were this easy and so highly paid every political muppet who spouts this would have realized it was easy money just talking to hard working people day in day out and doing nothing. And don’t tell the public what really happens and that some cancers are easier to spot than others.

10) Reward long service. 

In most walks of life the more senior you become the better your pay becomes. So NHS consultants have an incremental year on year increase together with so called clinical excellence awards (formerly merit awards). So if GPs have seniority awards based on number of years of service what a brilliant idea to abolish these and put these seniority payments “into the global sum”. If you can find the Carr Hill formula used to produce the global sum then please let us know what the forumula is or how much extra of the global sum is to be made up of seniority payments.

11) Do a Maxwell/Brown and raid the pension pot which is in surplus.

It is an aweful fact that junior doctors who are 20 years our junior will now have to work longer, pay loads more to get a third of what we may expect to get in a few years time and they will do the same job as we do. There is a buzz word bullshit word called pariety of esteem which clearly does not apply to GP pensions.

Still as a politician you can get away with it and don’t forget to tax the pension pot as well. 

13) Change the funding formula to reward general practice. 

When Za Nu Labour negotiated the nGMS 2004 contract most GPs lost under Za Nu Labour’s completely secret Carr Hill formula you know the one where any extra work is “in the formula” and no one can see the formula to check it they are paid correctly.

When this formula was announced something like 80% of GPs LOST money with this revised formula and as a result Na Nu Labour introduced the Minimum Practice Income Guarentee (MPIG). The Party wishes to reduce and remove this which means that increasing workload with a decreasing work force will be rewarded with less money.

14) Stop treating patients in hospital and send them all to the local “community” centre.

Hospital care is expensive and under the NHS Soviet market tariff fixed price “free” market payment system the only way Big Government can reduce cost is by the highly nebulus concept of care closer to home which is known as care in de “community” (centre) or dumping on GPs.

So while hospital dcctor numbers have gone up while GPs have gone down what a good idea to shift work from the most resourced but expensive and fixed price sector of the healthcare economy to the least resourced where you can “negotiate” (by altering the contract unilaterally) costs down?

So there you are boys and girls why general practice is currently so attractive to those graduates leaving medical school. Less money, more work and no prospects in contrast to hospital medicine where your salary is likely to rise as a consultant and there is always private work which is rewarded at a fraction of the NHS Soviet market tariff system.

And a European Working Time Directive.

Praise be to the Party for continuing to make General Practice in the UK the job that medical students would disembowel themselves to get into – or is it to avoid? Hope that helps Dave and Jeremy.

Either of you fancy a tenner on whether at the end of 5 years there will be 5,000 new GPs based on today’s terms and conditions? Go on have a punt you know you can’t lose.

From some friends up North (of Watford).