NHS=Negligent Health Service

Tea Drinker
Don
Joined
13 Apr 2010
Posts
18,419
Location
Sunny Sussex
I bought one off eBay for £2 and for a laugh I wear the lanyard while still wearing my mask.
I was in the Chip Shop when a young bloke walked in (about 30), he was asked to wear one but then started ranting he was exempt.
I said get one of these and you don't have to wear a mask and he said "but you're wearing one" and I replied "Yes cause I'm not a dick" and he walked out.
I do have an official exemption from NHS Occupational Health but I still wear one.


Hashtag hero
 
Soldato
Joined
16 Oct 2007
Posts
7,427
Location
UK
I never said it was a bad thing..... ..

It wasn't a counter, it was just a statement. Some people are horrified to think their doctor has to look something up. If only they knew the complexity of medicine.
Seems a bit paternalistic to me, and a waste of NHS resources. I could understand it for controlled drugs as that could make a doctor unfit to practice, though from what I hear from pharmacists they do sometimes come across doctors self prescribing themselves diazepam!

Any self prescribing or prescribing to tour family will likely get a) refused by the pharmacist or b) reported to the GMC c) picked up by the GMC.

You then have a clinical responsibility to inform your/your family's GP with some clinical notes and the prescribed medication. It's a faff and not worth the trouble unless critically important
 
Soldato
Joined
16 Oct 2007
Posts
7,427
Location
UK
heeeed: Right now, whether people realize it or not, I am playing a perhaps unsubtle game of devil's advocate in order to get a discussion on this matter going, one that many seem reluctant to address, whether because they see the NHS as (ridiculously, really) sacrosanct or just because they see challenging doctors ethics as somewhat taboo. I thank you for your balanced response.

Some people naively see the medical profession as a none pecuniary advantaged profession, it's not, and I have no qualms whatsoever with that. But growing pecuniary advantage with ever expanding risk aversion are debatable bedfellows.

GP's have minimized their perceived hours and commitment in the eyes of the general public for years., No or very very few house calls, little weekend availability, automated answerphone services, in practice drug dispensaries with justifiable questions of profiteering, things are very different from how things were. A robust and dispassionate questioning is valid and may help better understanding?

The world of GP is vastly different from Doc Martin or 20 years ago. A growing comorbid population. Average healthcare issues are something like 3.2 per consultation whilst still taking into account GP availability. The medical world is so, so much more complicated than the historical perceived world of the village GP, popping out for a night time house visit or being on the end of a quick phone call.

I think the average GP works 6-7 sessions. That's a 40+ hour week despite not being the classic 'full time' schedule. They will often see 30-50 patients a day, each with a multitude of relevant (and often non relevant) considerations, each of which could lead to morbidity or mortality if not managed appropriately. The complexity is enormous. I cannot stress this enough, so much to consider and minimal room for error (although human nature suggests there will always be some). Not many other professions where you make a mistake, and could then lose your entire career. It's not like getting sacked and getting a job with another business. If you properly mess up, even just once, you risk losing everything. Many GPs burn out. Where is this risk aversion?

The money on the long run up to being qualified is not great when compared to most other developed nations and their doctor pay.

Other than pay for providing the service, which can make the practice a moderate sum (no different to any other business adding an extra service - hairdresser offering beauty treatments for example), no other profiteering is done. Drug prices are all set by a standardised NHS tariff.

At the end of the day, there just aren't enough resources for the NHS. There aren't enough GPs. There aren't enough facilities.
 
Soldato
Joined
16 Oct 2007
Posts
7,427
Location
UK
The NHS is in a mess and the sooner it privatises the better.

Opinions like this make me so sad. A privatised health service would result in millions having a lower standard of care. I'd make much more money, but like most NHS staff, I'd rather work for the whole country rather than the select classes that could afford it.
 
Soldato
Joined
16 Oct 2007
Posts
7,427
Location
UK
And just for perspective...

just over half (51)% of the 2021 GP survey said they are currently suffering from depression, anxiety, stress, burnout, emotional distress or another mental health condition.

Insufficient investment in the GP workforce does not prevent patient numbers from rising. In fact, despite there being 1,744 fewer fully-qualified FTE GPs today than there were in 2015, each practice has on average 1,918 more patients than in 2015.

There are now just 0.45 fully qualified GPs per 1,000 patients in England – down from 0.52 in 2015. For the GPs that remain, this means increasing numbers of patients to take care of. The average number of patients each GP is responsible for has increased by around 300 – or 16% - since 2015.

This brings the total appointments in October to 33.9 million, which is 10% higher than pre-COVID appointment levels in October.

More appointments, more patients, more complexity, fewer GPs, fewer allied healthcare professionals.
 
Man of Honour
Joined
21 Nov 2004
Posts
45,038
Opinions like this make me so sad. A privatised health service would result in millions having a lower standard of care. I'd make much more money, but like most NHS staff, I'd rather work for the whole country rather than the select classes that could afford it.

At least some of us would then have access to a decent level of care. Our current healthcare service is laughable and at the moment none of us have access.
 
Caporegime
Joined
12 Mar 2004
Posts
29,913
Location
England
Any self prescribing or prescribing to tour family will likely get a) refused by the pharmacist or b) reported to the GMC c) picked up by the GMC.

You then have a clinical responsibility to inform your/your family's GP with some clinical notes and the prescribed medication. It's a faff and not worth the trouble unless critically important

Right, it's absurd. A member of the public can buy prescription medication, even controlled drugs, off the internet, but a doctor prescribing themselves a medication for a rash would be reported, farcical. I can only imagine how many GP appointments are wasted by doctors having to follow these prescribing rules.

Interesting article in the BMJ about it.

https://www.bmj.com/content/344/bmj.e13

Despite these consequences, a poll conducted in 2007 by the GPs’ magazine Pulse found that 43% of GPs admitted to writing prescriptions for their own personal use, including antibiotics and strong painkillers.
 
Caporegime
Joined
8 Jan 2004
Posts
32,045
Location
Rutland
At least some of us would then have access to a decent level of care. Our current healthcare service is laughable and at the moment none of us have access.

But you can access private care now? Removing the NHS will just make private healthcare more expensive because it won't have the NHS to fall back on when things go wrong.
 
Caporegime
Joined
8 Jan 2004
Posts
32,045
Location
Rutland
Right, it's absurd. A member of the public can buy prescription medication, even controlled drugs, off the internet, but a doctor prescribing themselves a medication for a rash would be reported, farcical. I can only imagine how many GP appointments are wasted by doctors having to follow these prescribing rules.

It is what it is and I've never found a single colleague that it bothers. If doctors were able to prescribe/order tests/refer themselves amd their family it would be abused/misused/dragged up regularly in the press. It would just be a massive minefield.
 
Caporegime
Joined
12 Mar 2004
Posts
29,913
Location
England
But you can access private care now?

Not really, having the NHS monopoly on services destroys the private sector, I can't even find a private GP in my area.

It is what it is and I've never found a single colleague that it bothers. If doctors were able to prescribe/order tests/refer themselves amd their family it would be abused/misused/dragged up regularly in the press. It would just be a massive minefield.

According to that BMJ article 43% of GP's ignore the rules apparantly.

I very much doubt self prescribing privately would be an issue for any member of the public or press really. It's a non story.
 
Caporegime
Joined
8 Jan 2004
Posts
32,045
Location
Rutland
Not really, having the NHS monopoly on services destroys the private sector, I can't even find a private GP in my area.

Plenty of telemedicine companies will happily take your money. Just like NHS primary care, private GPs are mostly telemedicine currently.

According to that BMJ article 43% of GP's ignore the rules apparantly.

I very much doubt self prescribing privately would be an issue for any member of the public or press really. It's a non story.

That's almost 10 years old. There's been a big swing away from it during that time, or atleaest that is my impression. The GMC have hardened their stance considerably over that period.
 
Soldato
Joined
10 Mar 2006
Posts
2,912
Location
Fife
they are dumb as hell, anyone can just buy one no need to prove anything and now they are being abused so the people they are designed to help are instead abused.

theyre supposed to be a sign you need extra support, might feel anxious in the situation, end up overwhelmed etc..... not that you don't need a mask

I have a hidden disability but would never get a stupid lanyard, good idea but in practice just constantly abused by normal people

The goal is to include those with disabilities, not to exclude them or make them stand out. I'm against them because no one should be made to justify themselves to any other member of the public.

If you have a blue badge, someone has made that decision to award you one. It's not up to me or anyone else to challenge a blue badge holder to prove their disability. Yet some people want to.

If someone says they are exempt, you take their word on it whether you believe them or not, unless you're in a position to ask them proof. it really is none of your business.
 
Caporegime
Joined
12 Mar 2004
Posts
29,913
Location
England
Plenty of telemedicine companies will happily take your money.

Sure, I can get telemedicine from any country in the world for any speciality, but face to face? Not a chance. The NHS has destroyed the potential for great private healthcare for those that can afford it, if any healthcare company tried to imprison people for not paying for their services they would be shutdown, but with the threat of violence the NHS continues to extort money from people.

That's almost 10 years old. There's been a big swing away from it during that time, or atleaest that is my impression. The GMC have hardened their stance considerably over that period.

So I gather, but even a 90% reduction would still leave 4.3%, a very substantial number!
 
Caporegime
Joined
22 Nov 2005
Posts
45,278
Forced to pay for it or not. If it does not meet your needs then the choice is to pay for private, Bupa etc, or just put up with the nhs. Personally i have never had anything but good service from them. Can't believe how much people are whining now without seemingly a shred of support for the NHS and the bloody awful time they have had dealing with thousands of cases of Covid, deaths etc etc. I am not sure if the NHS will ever recover from the covid pandemic.
where I'm registered at you can not book appointments in advance.
They only release a few appointments on the day at 8:30am ad you have to get in the phone queue and hope you get one.

it's basically a lottery/prize phone in now.

have you tried to use your doctors since covid? why wouldn't people be whining....

it's like trying to get an emergency dental appointment now, there's nothing in advance even if you are prepared to wait days to be seen.

why wouldnt people be upset? if you can get a GP appointment is basically down to chance now unless you will pay to go private or have medical insurance through work etc.

maybe your well off and aren't so reliant on a not fit for purpose service unlike large proportions of the country..


I got prescribed steroids and penicillin this week.... wasn't from my actual registered GP surgery though no chance..... luckily still have medical insurance Europe wide that soon ends. let me have a nice choice of surgeries/GPS and they booked it for me..

how the other half life eh? no wonder a lot of people don't care when they are well of and not effected.


scrap the NHS and give everyone mandatory medical insurance like Switzerland, ibuproen might be like £10 a pack and only sold in a pharmacy but heh ,at-least you can see a GP there without a fight
 
Last edited:
Soldato
Joined
16 Oct 2007
Posts
7,427
Location
UK
At least some of us would then have access to a decent level of care. Our current healthcare service is laughable and at the moment none of us have access.
Well that's a load of absolute rubbish. It's still a world class service and most have access as normal. Yes there are delays here and there, but the entitled always seem to forget the amazing work it does on a daily basis.
 
Soldato
Joined
16 Oct 2007
Posts
7,427
Location
UK
where I'm registered at you can not book appointments in advance.
They only release a few appointments on the day at 8:30am ad you have to get in the phone queue and hope you get one.

it's basically a lottery/prize phone in now.

have you tried to use your doctors since covid? why wouldn't people be whining....

it's like trying to get an emergency dental appointment now, there's nothing in advance even if you are prepared to wait days to be seen.

why wouldnt people be upset? if you can get a GP appointment is basically down to chance now unless you will pay to go private or have medical insurance through work etc.

maybe your well off and aren't so reliant on a not fit for purpose service unlike large proportions of the country..


I got prescribed steroids and penicillin this week.... wasn't from my actual registered GP surgery though no chance..... luckily still have medical insurance Europe wide that soon ends. let me have a nice choice of surgeries/GPS and they booked it for me..

how the other half life eh? no wonder a lot of people don't care when they are well of and not effected.


scrap the NHS and give everyone mandatory medical insurance like Switzerland, ibuproen might be like £10 a pack and only sold in a pharmacy but heh ,at-least you can see a GP there without a fight

Then change practices. Simple. Your current one sounds like they're struggling.

Yes I've both been a GP during COVID as well as used them. It can be difficult to get an appointment but that's not the GPs or practice's fault.

You use dental practices as an example. They've gone down the private route. How's that going for you?

Do you use the online GP consultant service? If you've got COPD or exacerbation of asthma (or something that needs steroids and antibiotics) then it's fairly quick and easy to use the online service. The message would get picked up same day by the duty GP and could be issued remotely.

And what about the people that can't afford ibuprofen at £10 a pack?
 
Man of Honour
Joined
17 Oct 2002
Posts
29,093
Location
Ottakring, Vienna.
scrap the NHS and give everyone mandatory medical insurance like Switzerland, ibuproen might be like £10 a pack and only sold in a pharmacy but heh ,at-least you can see a GP there without a fight
Similar in Austria.
There is public healthcare paid via tax/NI contributions, but it doesn't really work like the NHS - think of it more like private medical care purchased through a state insurance provider if that makes sense.
Means you can go to pretty much any dentist, doctor, hospital you fancy rather than operating on catchment areas and waiting lists.
 
Man of Honour
Joined
21 Nov 2004
Posts
45,038
Well that's a load of absolute rubbish. It's still a world class service and most have access as normal. Yes there are delays here and there, but the entitled always seem to forget the amazing work it does on a daily basis.

Years worth of backlogs. Almost impossible to see a GP. Negligence all over the place resulting in huge compensation payouts. Not enough beds resulting in people being stuck on ambulances. Hospital buildings that are falling apart with waste bins lining the corridors. World class :cry:
 
Soldato
Joined
16 Oct 2007
Posts
7,427
Location
UK
Years worth of backlogs. Almost impossible to see a GP. Negligence all over the place resulting in huge compensation payouts. Not enough beds resulting in people being stuck on ambulances. Hospital buildings that are falling apart with waste bins lining the corridors. World class :cry:

haha you're absolutely right. I'll take back my previous comment.
The current snapshot of the NHS (COVID & winter) is not representative of the NHS though. There are always winter pressures every year but COVID has decimated waiting times, surgeries and healthcare staffing.

Just to critique your post though - certainly not impossible to see a GP - JOIN A DIFFERENT PRACTICE IF YOU ARE HAVING ISSUES. Any serious issues will get a same day review by the duty GP in any of my 8 local practices.
"Negligence all over the place" - an absolutely miniscule number of claims considering the millions upon millions of clinical encounters in a year. There will always be compensation claims as things will always go wrong - but lets not pretend it's all over the place.

Not enough beds - I give you that one, although more linked to not enough staff than not enough physical beds.

"Hospital buildings..." - I think you have a skewed viewpoint, there are many wonderful new hospitals to go alongside the ageing buildings.

I think I get defensive on these attacks of the NHS (or in particular, staff). I spend up to 75 hours a week watching the most amazing things, the dedication I see in healthcare staff is completely unrivalled. It still runs, albeit in its broken state, due to the staff staying late every day, their sacrifices to their job.
The government have deliberately screwed the organisation. It's not the staff. It's not the GPs. If you have an issue, you have an issue with the government.
 
Back
Top Bottom