Ritchielogic

First, the proportion if NHS resources going to GPs is already falling, significantly. It is now less than 9% of all resources when it was over 10%. So the service is already underfunded.

Eh? A fall of the proportion of a budget going to one activity means, by definition, that that activity is being underfunded?

What?

14 comments on “Ritchielogic

  1. Absolutely nothing must change EVER unless the LTHD personally approves of it on moral grounds.

    Oh, and “MOAR TAXES”

  2. Doesn’t he have a moral obligation to point out that the wife is a GP and so he has a financial conflict of interest?

    In that what he is really saying is that the Government is not increasing his wife’s income as fast as it is the rest of the spending on the NHS.

  3. the strange thing is that there is little need for GPs in any rational health system. NB this does not mean that there is no need for GPs.

    In a rational system, someone with an ear problem would go to an ear specialist. Someone with what be a badly-bruised or possibly broken arm would go straight to an X-ray clinic. In the UK, you go to a GP who then refers you on to the specialist support…what a waste of resources. They have become essentially a very well-paid triage system.

    These days, if you need a vaccination or a jab, it is administered by the practice nurse and not by a doctor. The nurse can even give out prescriptions for drugs. And pharmacists give just as good advice on coughs, colds, insect bites etc as the average GP.

    The question, when looked at rationally, becomes what is the value/function of the GP? In the NHS, I suspect that their major activity is to conduct unnecessary blood-pressure tests at any opportunity and then send you elsewhere for unnecessary blood analyses, as well as to referring you to specialist resources to compensate for the fact that they cannot help the majority of clinical patients with any certainty.

  4. Diogenes,

    My thoughts exactly. It strikes me as a massive waste of resources to have people going to a GP, wasting a couple of visits with him throwing cures that he hopes will fix it, to then have to go to a specialist.

    You can see there might have been historically good reasons. If you lived in Auchtermuchty in the 1920s it would have been difficult or expensive to go to a big town, so you needed a Dr Finlay to be a generalist, but it makes no sense today. We’d be better off giving everyone some general training and then getting most of them into a specialist strand after a few years.

  5. So do away with GPs and use expensive replacement.
    Have a bad headache – is it nerves , meningitisor a brain tumour. Nurse will know.
    The specialist will do all the paperwork the GP has to.
    Be old and have assorted ills – tough.

  6. Mr Malpas

    “So do away with GPs and use expensive replacement.”

    You misunderstood my point completely. The GP is the expensive part of the process and the most useless. In your example, the GP is doing paperwork. If the GP is doing paperwork then that is a waste of resources. I am not saying there is no place for a GP but that case needs to be made. Your examples just demonstrate the lack of value that the GP adds compared with the cost.

  7. “These days, if you need a vaccination or a jab, it is administered by the practice nurse and not by a doctor. The nurse can even give out prescriptions for drugs. And pharmacists give just as good advice on coughs, colds, insect bites etc as the average GP.”

    Jabs and bloods can be done by a healthcare assistant, even.

    Nurse’s need to be specifically qualified to give out prescriptions. However, nurses can have pre-signed prescriptions, from their GP employer.

    I personally don’t see anything wrong with a well run triage system. GPs are only well paid if they optimise their resources, and that usually means sending the patient to the right “specialist” (whether that’s the pharmacist or the oncologist).

    Also, didn’t GPs become more responsible for their budgets a few years ago? Maybe they’ve been quite good at it?

  8. This is limited to Richie though is it? Many people believe that public services are measured by the money poured into them, more is better.

  9. @Diogenes Yes, I agree. But, if you think you might have the clap or HIV or even if you have an unexplained pimple on your knob, you can go straight to an STD clinic and get seen by a consultant. Initial testing is done immediately and you will receive a diagnosis and treatment plan before you leave. Why the NHS can manage to do this for genitals but not for any other part of the body has always been a mystery to me.

  10. Rub-a-dub,

    Aren’t GPs the gatekeepers, to keep the masses away from the specialists?

    Yes, but does that make any sense? Why not convert the GPs into specialists? OK, not the sort of specialists we have now that have decades of experience, but more of a junior specialist.

    Consider eyes – you don’t go to a GP to get them checked. You go to an optician, an eye specialist. If there’s a problem or potential problem, he will refer you to an opthalmologist, which might eventually require an eye surgeon. And that’s a pretty good setup because you deal with the everyday crap with a fairly cheap specialist, the more complex stuff with a fairly expensive specialist, and the most complex stuff with a ridiculously expensive super specialist.

  11. ‘The question, when looked at rationally, becomes what is the value/function of the GP?’

    Their value and function is partly as gatekeepers to keep stupid people away from consultants unless it’s really necessary, and partly (if they’re any good) as generalists who pick stuff up before it gets untreatable.

    I went to the GP for something minor when I was about 28 and, after dealing with that, she looked at me and said, I think you are poorly and we should investigate further.

    Turned out I was a long way down the road to death from a problem I didn’t even know I had. Luckily it was easily treated.

    Whether her picking up on this was specifically due to her being a good GP, or whether a good nurse would have seen it, I don’t know, but she probably saved my life.

    Not saying that’s an argument for the system – I’d abolish the NHS.

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