Monday, 21 November 2016

Frail Elderly.

Ah the NHS is struggling and it is not the fault of under investment, under manpower it is the increasing demands of an aging population who are now the frail elderly. What a complete load of crap spread by the appeaseniks of the BMA, RCGP et al most of whose august members are not on the front line for more than a session a week.
When we started many decades ago in Northernshire if you went to a busy Friday once a week branch surgery you might get between 3-7 patients. Now they are always full. Most people came in then with just one acute illness problem and if they had 3 separate problems that was commented upon then.
Yet people are now healthier, live longer and yet consult more up 24% more between 1998 and 2014 an increase of 1.5% per annum offset by a decrease in NHS funding for primary care from 11% some 5 years ago to less than 8% now. Ignore the GP Forward View funding that does not even restore the status quo 5 years ago.
The increased demand in the NHS is similar to the if you build more roads to relieve congestion people drive more just think Darzhole centres and NHS Dumb, Dumb, Dumb.
Roads are free and so is the health service and so are extended hours, 7 day working all of which result in the same increased demand for want but rarely if ever true medical need.
Take a typical “emergency” appointment which have become more and more common over the last 2-3 years:
1) I think I have a chest infection for I have been coughing for 15 minutes. No you don’t you have a minor viral upper respiratory tract infection that will get better in 3 weeks just like all those other family members that you told us about who had the same symptoms and got better after they consulted their GP, had no treatment so what is different about you other than this is a freebie? (3 minutes).
2) Oh, clear disappointment here at not having blagged an antibiotic, so then comes the while I am here can I collect my blood tests I had done because I was worried I was ill 6 months ago? (Actually 2 years ago but thanks for the disinformation and wasting our time searching for them).
Until now when I didn’t get what I wanted. All normal. I thought so because no one had bothered to contact me (no patient responsibility or self care agenda here). (3 minutes).
3) Clearly disappointed so on to the next old chestnut end of consultation favourite my partner/seventh cousin twice removed/employer said I ought to get this completely unchanging skin lesions of 20 years duration checked. And why did they suggest you do this because they had noticed a change? No because they told me to.
If you want a “check” for non-illness see your bank manager but those who do others bidding without thinking won’t get that. (3 minutes).
4) I think I might be stressed, I have a busy job, I work 24/7 and never stop can I have a sick note for I hate my job?
If you have time to think you are stressed then you are not. I am a doctor the fact that you hate your job is not my problem it is your life style choice and as such yours to fix.
Hating your job is not an illness in the same way that you don’t like your spouse, mother in law, house you live in etc. But please feel free to waste your doctor’s time discussing something we can do absolutely nothing about other than give you a sick note which you are not going to get because you are actually medically fit to work. (7 minutes).
5) While I am here can I collect my repeat prescription and also my children’s, and their children’s prescriptions it will save me so much time (but waste the most expensive part of general practices’ time but your time is precious see 4) above (3 minutes but an additional 45 seconds for each prescription to print using advanced NHS IT).
6) When I got up this morning I had a twinge in my knee when I put it to the floor. It was really painful for a fraction of a second and has not bothered me since and I went for my usual 3 mile fell run without any problems this morning. Can you tell me what that was it was so painful? No. (2 minutes).
7) I am planning a trip in a few months’ time what immunizations do I need? Am I at risk of the Zika virus in the Antarctic? (Ah the emergency I am going on a holiday which I have paid for appointment but this is a freebie). (2 minutes).
Well thank you for squeezing me in as an emergency. I don’t come here very often so I thought I would save them all up to save you busy doctors’ time (usual idiot NHS freeloader’s grin here) and a typical Friday afternoon something for the weekend crap emergency appointment. You can’t be too careful at 18:10 on a Friday when demanding an emergency appointment for all of the above as there are after all no doctors whatsoever for a whole weekend in the whole of the UK until late on Monday morning.
Repeat such retarded crap across a nation and then wonder why you as a patient cannot get to see a GP and patients usually spend the first 2 minutes of their appointment whining about this fact. It is not the frail elderly it is the retarded well whose only port of call when they have acute case of non copitis and are feeling pathetic and no-one wants to listen to them is to see their GP. True illness is conspicuous by its absence.
Praise be to the Party for ensuring that via socialized medicine no one with anything wrong with them will be denied access to a GP unless they are actually ill. GPs did once used to see illness now most of their workload is social and educational inadequacy that they cannot fix.
The NHS is increasingly the convenience store for those who don’t want to pay for coping and all Party’s sponsor this message but don’t fund it.

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