Tuesday 25 October 2016

What is this man on?

One of the few things some of the team remember from grunt school psychiatry is that a delusion is a belief in the absence of reality and can be a sign of mental illness. So bearing this in mind what is a rational person to make of the great Hunto’s latest Pontification?
Clearly a man who reads learned texts like the Daily Mail for he believes that there are more than enough GPs in the UK all of whom struggle to fill their days with work and so he feels that he can help than do this by dumping yet more work onto them.
Just look at his arguments and implied facts:
1) The outpatient budget is about the same as the entire GP budget. GPs do 90% of healthcare in the UK for c. 8% of the budget c. 340 million consults a year compared with 85.6 million outpatient appointments. So the great Hunto expects a mere 25% increase in workload from a workforce struggling to cope with the day job?
2) The total cost if any to a patient for potentially a year’s worth of free access to a general practioner is £ 136 while the cheapest outpatient appointment is £ 69 for a one off follow up in dermatology. The most expensive single appointment is £ 324 for a first attendance at an infectious diseases clinic.
Will the money therefore follow the patient into general practice as a result? Clearly the day job won’t be so financially attractive and outpatient work will displace the day job so something has to give. The doctor won’t see you now for just over £ 20 for a normal GP appointment they have an urgent dermatology rash that has got better to see for £ 69. Curious number 69?
3) Hospitals are allowed to run at a £ 2 billion deficit but if GPs do so they go out of business in contrast to hospitals which are supported in their failings by the Party.
4) Hospitals get money per patient per attendance via the NHS Tariff which if GPs did would mean a very happy workforce for the harder they worked the richer they get but this system does not apply to GPs only hospitals. So Jeremy like every other Secretary of State before him thinks lets dump extra work on GPs for they are on block contracts and as such we just change their contract and don’t pay them anything else extra.
Remember comrades the concept of money following the patient within the NHS Internal Meerkat is strictly one way.
5) If work moves out of hospitals then so does money which could make deficits even worse although of course you could make the redundant hospital medical staff redundant as they would be left with nothing to do except that NHS employment is very well protected in terms of employment rights and this would not be cheap.
Once again the current Secretary of State has cracked the NHS nut with world-class efficiency savings (sorry comrades "gains) based on his limited view of the world via Oxford University’s political degree called PPE which is useless elsewhere in the real world.
Praise be to the Party for once again ensuring that the only qualification you need to run the NHS in the UK is no knowledge of the NHS at all.

Saturday 15 October 2016

Now the Muppets really have taken Manhatten.

You have to admire a Royal College that lacks both ability, leadership and academic kudos for just look at this august body’s (corpse’s) latest wizzo wheeze. A College without a clue has produced “A wellbeing pack”. 
An initiative directed at GP trainee members of the college (sorry RCGP should that be “registrars” in your Chair of Associates in Training Committee’s quote in the article?), all of whom are bright enough to see through Royal College sh*te or chaff(ing) crap called reflection, e-retardfolios and probably are bright enough to realize that chocolate coins, teabags et al are mere baubles, beads and trinkets that are once again there to convince the muppets in charge that they know best (or more accurately know nothing). 
You have to admire a bunch of appeaseniks who have screwed up medical training for years for having come up with this outstanding idea for only they could think that teabags, a chocolate coin and a reflective colouring book would bring an end to the problems in general practice at present. 
The idea of a “gratitude journal” is beyond measure for it will probably be shorter than other such masterpieces read by those on high and in charge in their formative years such as One Exciting Thing to do in Inverness on a Dull Rainy Winter Solstice Day.
We suspect the only thing most frontline GPs will put in their “gratitude journal” is the weekends, holidays, time off sick and retirement as the shortage of GPs struggles to cope with an increasingly aggressive demand for urgent appointments for trivia which cannot be met at present.
Still as someone once said every little bit helps.
Yeah, right.
Praise be to the Party for giving us the RCGP whose contribution to educating and supporting GPs is beyond measure in their own humble retarded opinion. Ideas like this would have ended the Second World War long before those slightly brighter at Bletchley Park solved the Enigma code.