Scrap NHS reforms, doctors tell Lords.

[stockhausen]

More than 260 senior doctors and public health experts are calling on the House of Lords to throw out the government's health and social care bill, saying it will do "irreparable harm to the NHS, to individual patients and to society as a whole".

The signatories include Professor Sir Michael Marmot, the author of several reports on the links between wealth and health that suggest children born into poverty are penalised for life.
...
Marmot and others in senior positions have now concluded the bill will damage all aspects of the health service.

"While we welcome the emphasis placed on establishing a closer working relationship between public health and local government, the proposed reforms as a whole will disrupt, fragment and weaken the country's public health capabilities." says the letter.

"The government claims that the reforms have the backing of the health professions. They do not. Neither do they have the general support of the public."

The letter details the harms the experts believe the health reform bill will do.

"It ushers in a significantly heightened degree of commercialisation and marketisation that will lead to the harmful fragmentation of patient care; aggravate risks to individual patient safety; erode medical ethics and trust within the healthcare system; widen health inequalities; waste much money on attempts to regulate and manage competition; and undermine the ability of the health system to respond effectively and efficiently to communicate disease outbreaks and other public health emergencies." (The Grauniad)

And still the Government will persist with their repeated lie that the medical profession support Lansley & Cameron's covert, back-door privatisation of the NHS

 

[stockhausen]

... under Labour GP's have become, or been able to become incredibly rich ...

Absolute 100% rubbish. Most of the GPs I know are on the same income as they were five years ago.

I would agree entirely that when New Labour foolishly decided that targets and QOF were the answer to absolutely everything and that out-of-hours cover could be more effectively and economically provided by health centres staffed by salaried junior doctors they screwed up in every possible way. However, they have long since clawed back the bribes they offered GPs at the time.

Incidentally, I suspect that you may be thinking about GP surgeries that include a pharmacy - now there IS a gold-mine

... As for saying doctors aren't overpaid, a lot of doctors aren't, GP's are MASSIVELY overpaid, and they are underqualified as doctors, you go into an ER and find a doctor who can diagnose just about anything, perform emergency surgery and hundreds of procedures, a GP can barely do anything these days, you can get a doc who hasn't performed a procedure on a patient in 40 years and hasn't seen a wide range of cases in decades either. ...

Again, an observation that is staggering in its blind, uncomprehending ignorance

Doctors in A&E are great at referring patients to specialists who are specialists in one area - nothing more, nothing less. If you don't believe me, ask people whether they would rather go to A&E or their GP.

... GP's are already heavy paperwork people, they essentially run businesses as is ...

Most GPs hate the paperwork that has been foisted onto them in order to meet quotas. As to the suggestion that "they essentially run businesses" - have you ever heard of Practice Managers? Most GPs tend to make lousy businessmen or women. Once again, the exceptions have often added a pharmacy as mentioned above.

... The NHS needs reform, does it need THIS reform, maybe not, and doing something rather than doing nothing isn't always the right option. ...

Dear God, an intelligent observation - at last - based on what has gone before, entirely unexpected

... But GP's at some stage will have to account for getting more money for hitting targets, while patients all complain about lack of time with doctors, serious conditions being missed and the inability to get a real appointment at short notice. The public won't accept GP's current excuses of "its the system, its not our fault", because they'll be the system.

Patients may not accept it. However, it is pretty much spot on.

I have no idea where you have got your ill-informed ideas and prejudices from but I have no doubt that you have found a solution by only ever visiting A&E where you doubtless get the care and attention that you crave and so richly deserve.


As to the people who suggest that any GP who opposes the changes being forced on them by the Tories is simply manifesting greedy, selfish self-interest, what about the occasional GP who supports the changes? I would suggest that that has far more basis in self-interest.

I know of a couple of GPs who are just dying to offer additional services entirely unrelated to medicine - they can't wait to get some of the money available from injecting Botox, using Lasers to remove unsightly body hair, etc., etc., etc.

They also know that there will be utter chaos and a complete lack of control and accountability if and when they get control of the NHS purse strings and they will have all too brief a chance to milk the system for all it is worth before the Government realises that their highly paid management consultants have one again got it wrong

 

[stockhausen]

I think you are showing you have absolutely no idea of the role of a GP there Dolph. ...

Surely not so?


According to the infamously left-wing Torygraph, back in September, Cameron claimed at PMQs that three leading medical organisations all supported the health reforms only to have them issue statements saying that he was misrepresenting their views.

• The RCN said the Bill “risks creating a new and expensive bureaucracy and fragmenting care”
• The Royal College of GPs said "it will lead to an increase in damaging competition, an increase in health inequalities, and to massively increased costs in implementing this new system”
• The Royal College of Physicians said “there are still areas that need to be changed”

With support like that, who needs opposition?

 

[stockhausen]

Are you trolling Dolph?

I seem to recall Dolph saying some time ago that he believed his Wife and Mother-in-law had suffered at the hands of the NHS

That, added to his bitter dislike of any suggestion of equality, welfare provision or state involvement is inevitably going to lead to his scraping any non-existent barrel to pursue his quest.

 

[stockhausen]

David Cameron said the letter praised the part of the bill that concerns public health. "We're saying public health - smoking cessation, diet, dealing with things like diabetes - these are incredibly important and they welcome that part of the bill" he said.

Yes, they do undoubtedly support preventive medicine - big deal

Of course though, there are doctors in the health service who don't like the idea of greater choice and competition and other organisations being able to provide free health services to patients. But I believe patients want that sort of choice and rapid quality treatment and that's why it's right to make these reforms.

Talk about conflating unsupported opinions in order to muddy the debate and give the impression that most Doctors are wholeheartedly behind Cameron & Lansley's desperate attempt to reward their private wealthcare backers

I wonder how many working GPs Lansley or Cameron have actually spoken to since they came up with their barking and generally unpopular privatisation plans

 

[stockhausen]

... it is a waste of a fully qualified Doctor to see the same old people every other day or the odd person with a cold, it would be better handled by a more junior/less well trained and paid role ...

You do realise that many larger practices do use a Nurse to triage where possible, don't you? As it happens, many patients hate it and we all know how keen both this and the previous Government are/were on giving patients the illusion of "choice", don't we?

Actually you have to be a pharmacist to dish out drugs, doctors are not considered qualified to do that and they regularly prescribe things with dangerous complications and the pharmacists advise them to correct it.

You can't expect doctors to have the same depth of knowledge of drugs and their interactions as a pharmacist unless you're going to add another 4 years to their training.

Pharmacists cannot of course prescribe drugs since they are not qualified to do that. I am sceptical that GPs "regularly prescribe things with dangerous complications". GPs will frequently reference MIMS online and the BNF when prescribing. I'm not entirely convinced that Pharmacists will always know exactly what drugs a patient is taking.

I do agree however, that Pharmacists are a very important 2nd check.

 

[stockhausen]

You do realise that a nurse has no ability to prescribe?

Don't you? ...

Yes, I do. Why don't you look up 'Triage'

... You realise not all doctors are GPs ...

I do. Many Doctors work in Hospitals with Hospital Pharmacies - so what

... There are 200 thousand + licensed doctors many in hospitals prescribing many many drugs often to patients on lots more drugs complications happen a lot especially because some drugs may have complications with others in some people but not all. ...

And you are seriously suggesting that Pharmacists have so much more insight into what drugs a Hospital patient is taking are you? Get real pal.

... I am not saying 100% of doctors regularly prescribe drugs with complications ...

Quite so.

... However the large number of doctors prescribing a large number of drugs every day across the country means complications and interactions are a regular occurrence on the whole. ...

Do you have any evidence that this is such a HUGE problem?

... even if every doctor only did it once a year that would still be tens to hundreds of thousands of complications a year. ...

"tens to hundreds of thousands of complications a year" . . . Based on your figures, a very improbable maximum of about 200,000 then


I'm not questioning the value of Pharmacists, just your somewhat strange and unsubstantiated apparent assertion that "Doctors regularly prescribe things with dangerous complications".

 

[stockhausen]

Oh dear, a GP practice in Yorkshire has decided not to carry out minor operations such as the removal of skin tags and moles, only to use the patient data to write to its patients offering the same treatment privately.

http://www.bbc.co.uk/news/health-15182186

That isn't entirely accurate. The GP practice hasn't exactly "decided" not to carry out minor operations, they have been told or "encouraged" to stop doing some minor ops because they are no longer NHS funded.

I believe that this is happening more and more these days and doubtless fits in quite nicely with Cameron and Lansley's plan to privatise the NHS.

There is more on this story HERE.

Don't for one minute doubt that the Tories want to privatise the NHS. They aren't going to admit that publicly but they know perfectly well that that is what their plans will eventually lead to.

 

[stockhausen]

... Unfortunately further training for GPs is not mandatory ...

Is this actually true I was under the impression that continuing training was a requirement of the appraisal process.

... IMO not enough is done to train GPs that are notorious for very poor referrals to hospitals. ...

How would you suggest that this could be addressed?

... There should be systems in place to address this, give feedback on referrals and give training when required. ...

Indeed there should. The medical profession, much as is the case with the Accountancy & Legal professions is far too preoccupied with the ideas "There but for the grace of God . . ." and "People who live in glass houses . . .".

It would be a damned good idea if there was a greater sense of peer review, criticism and feedback. From my discussions with GPs, they find it nigh on impossible effectively to critique or provide feedback on the behaviour of Doctors in Hospitals.


As a matter of interest, assuming that your are a Doctor working in a Hospital

• have you ever actually tried giving a GP feedback on an unwarranted referral?
• how did you do it?
• was it successful?
• If not, why not?
• what have you learned from this experience?

 

[stockhausen]

Mate all I know is ive been dependant on NHS treatment since 1984 and it was always good till Labour took over then they made changes that caused massive problems and now the NHS is rubbish by comparison ...

What did New Labour do that "caused massive problems" and in what way has the NHS become "rubbish by comparison"

 

[stockhausen]

Health service managers have called on the government to be more honest about the financial challenges facing the NHS in England.
...
One trust chief executive said ministers were not being straight with the public: "What people cannot tolerate is the lack of honesty about some of the tough choices that we're having to make. Wrapping it up in a language of modernisation and patient choice is simply unacceptable."
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Anita Charlesworth, former director of public spending at the Treasury who is now with the health research group the Nuffield Trust, says their real-terms funding increase has become a real-terms cut. "The government has increased the money available to local health authorities to buy care by 3%. But when you take into account inflation and the fact of those health authorities being asked to hold back some money to prepare for contingencies and pay for one-off investments, the money that they've got available to spend with hospitals is 3% lower in real terms on average."
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The chief executive of the Royal College of Nursing, Peter Carter - who ran a mental health trust for 12 years - says he hears this from managers all the time. "They feel that they're being duplicitous for having to sell it to their staff, the public, their stakeholders by saying all of this money is coming back in. It is not coming back in. There is no evidence of any re-investment." (BBC online)

I suspect that the Government hopes that by lying about their real plans and the consequences for the NHS, the public will continue to blame health professionals for the deteriorating service.

As to the repeated bleating about "Patient choice", that is a complete lie. The Government are forcing GPs to restrict patient choice in terms of the range of drugs they may prescribe, the treatments they can offer and the hospitals to which they can refer.

I know that the usual suspects her will pop in to say "Politicians lying, what's new, who cares?". However, the day will come eventually when you will care and will bitterly regret your selfish, short-term indifference to the demise of the NHS.